Patients and providers satisfaction with telemedicine at the beginning of the COVID 19 pandemic-a neurology department experience

Objective: To assess patients' and providers' perspective and experience with rapid implementation of telemedicine in outpatient setting at onset of COVID 19 pandemic. Background: Telemedicine in outpatient setting has been sparsely used in Neurology Department prior to COVID19 pandemic. The COVID-19 pandemic forced an unprecedent reorganization of clinical care delivery worldwide. Understanding the experience and satisfaction with telemedicine is important to finding pathways for improving the health care delivery in ambulatory setting. Design/Methods: Electronic Medical Records from a large southeastern Michigan health system were queried for adult neurology visits between March-May 2020. Surveys containing questions on experience and satisfaction with telemedicine visits were sent to patients and providers. Sociodemographic and reason for visit data were collected from patients and providers. Results: Out of over 3000 televisits, 276 patients responded of which 66% were female, 75% white, 42% had a telephone, 29% a video, 26% had both appointments. Mean age was 60.8. 85% reported a satisfactory experience, receiving expected amount of information (71%). Over 50% felt it was easy to schedule a visit and had less waiting time than clinic visit. 92% reported acceptable video/audio quality during telemedicine visit and 70% preferred combination type of visits in the future, while 8% preferred only televists. Out of 34 neurologist responders, 64% were female, 61% white, 42% had <5 years in practice, 64% did not have previous telemedicine experience. 88% reported at least moderate satisfaction, 61% preferring video and 3% telephone encounters. Providers felt that through telemedicine they satisfied patients' concerns 65%, completed history and counseling satisfactory (80%), but not physical examination (20%). 86% plan on using telemedicine in the future. Conclusions: Patients and providers had satisfactory experience with telemedicine during COVID 19 pandemic, suggesting that telemedicine is feasible for adult neurology care. However, the majority of patients prefer a combination of telemedicine and clinic visit.