Assessing Patient and Clinicians’ Attitudes about the Usability of Telehealth During the COVID-19 Pandemic

With mounting pressures on healthcare systems due to the COVID-19 pandemic, telemedicine has been used more frequently to adapt to changing needs. For patients at high risk of morbidity and mortality secondary to COVID-19, services at The George Washington Cancer Center are being provided using televisits. Researchers assessed the baseline usability of virtual cancer care delivery after initiating televisits for patients and providers across specialties.

Basic demographic information was collected, and the Telehealth Usability Questionnaire (TUQ) was completed by all participants in the study. Participants were provided with an opportunity to provide open-ended feedback, and they were surveyed on their preferences and perception of safety.

In total there were 133 patient participants. There was a high rate of completion, with 93% of surveys completed and used in the final analysis. The breakdown of ages for this group of participants was evenly split, with 26% of patients ages 60 to 69 years, 24% age 70 to 79 years, and 22% age 50 to 59 years. The most commonly reported cancer type was breast cancer, which impacted 41% of the patients in the survey. A 5-point Likert scale was used for TUQ survey questionnaires (1 = strongly disagree, 5 = strongly agree). Mean patient scores were 4.4 for interface quality, 4.3 for ease of use, 4.2 for usefulness and satisfaction, 4.1 for interaction quality, and 3.4 for reliability. These scores suggest that patients generally “agreed” or “strongly agreed” with the quality of interface and interaction, as well as ease of use and satisfaction.

For patients, mean TUQ scores were not associated with any distinct age group, sex, stage of diagnosis, treatment type, or timing of diagnosis, in relation to telemedicine visit. Compared with those patients who participated in fewer visits, patients with more telemedicine visits rated reliability and satisfaction significantly higher.

When asked to compare telemedicine visits to in-person visits, approximately three-quarters of the patients agreed or strongly agreed that telemedicine made them feel safer (77%), agreed or strongly agreed that it reduced stress (75%), and expressed interest in using it in other healthcare settings, for example, with other medical specialties (72%).

The survey completion rate was slightly lower for the 109 providers who participated, with 84% of surveys being completed and analyzed. Forty-one percent of these providers had 50 or more experiences with telemedicine. One-third of these providers were age 30 to 39 years, and 21% were age 40 to 49 years. The most common specialty reported by providers was internal medicine (27%). Using the same Likert scale, the mean provider TUQ scores were 4.3 for usefulness, 4.1 for satisfaction, 3.8 for ease of use, 3.7 for interface quality, 3.6 for interaction quality, and 2.7 for reliability. For healthcare providers with more experiences with telemedicine, satisfaction (P = .01) and usefulness (P = .02) were ranked significantly higher; however, there was no association found between mean TUQ scores and experience with telemedicine, age, or specialty.

Telemedicine improved access to care according to the 97% of providers who agreed or strongly agreed; however, 59% were concerned about missing something that may be captured during a live meeting in the clinical setting. Older providers ranked the reliability of the technology lower and expressed greater concern about the loss of personal interface with patients, when compared to younger providers (P = .006).

The authors concluded that both patients and providers had a favorable perception of telemedicine’s utility in the cancer care setting during the COVID-19 pandemic. All patient groups highly rated the ability of telemedicine to improve access, reduce stress, and improve perceived safety. The effect of telemedicine on patient-provider rapport and overall reliability were the most common concerns of older providers. As clinicians and patients in the cancer care environment adjusted to the COVID-19 pandemic, they laid the groundwork for a new standard in virtual healthcare delivery, setting the stage for advances and improvements that will extend well beyond the pandemic.

Source

Leon A, Kaltman R, Arem H, et al. Telemedicine usability for cancer care during the COVID-19 pandemic. Presented at: 2020 San Antonio Breast Cancer Symposium, December 8-11. SS2-09.