Patient Experiences with Ambulatory Telehealth in Neurology: Results of a Mixed Methods Study

ABSTRACT Objective: To assess patient experiences with rapid implementation of ambulatory telehealth during the COVID-19 pandemic. Methods: A mixed methods study was performed to characterize the patients’ experience with neurology telehealth visits during the first eight weeks of the COVID-19 response. Consecutive patients who completed a telehealth visit were contacted by telephone. Assenting patients completed a survey quantifying satisfaction with the visit followed by a semi-structured telephone interview. Qualitative data were analyzed using the principles of thematic analysis. Results: 2,280 telehealth visits were performed, 753 patients (33%) were reached for post-visit feedback. Of these, 47% of visits were by video and 53% by telephone. Satisfaction was high with 77% of patients reporting that all needs were met though only 51% would consider telehealth in the future. Qualitative themes emerged suggesting that positive patient experiences were associated with elimination of commute time and associated costs as well as a positive physician interaction. Negative patient experiences were associated with the inability to complete the neurologic examination. Overall, patients tended to view telehealth as a tool that should augment, and not replace, in-person visits. Conclusion: In ambulatory telehealth, patients valued convenience, safety, and physician relationship. Barriers were observed but can be addressed.