Optimizing Patient Selection for Telehealth: Results from a Large-Scale Urology Telehealth Implementation
Kenneth A. Softness, MD, Sumedh Kaul, MS, Aaron Fleishman, MPH, Peter F. Chang, MD, Andrew Wagner, MD, Anurag K. Das, MD, Heidi Rayala, MD, PhD, Peter L. Steinberg, MD, Ruslan Korets, MD, Aria Olumi, MD, Boris Gershman, MD.
Beth Israel Deaconess Medical Center, Boston, MA, USA.
BACKGROUND: Telehealth has a number of potential benefits for patients and providers, including reductions in time and cost required to obtain healthcare, expanded access to specialty providers, and reductions in existing healthcare disparities. Despite these benefits, patients vary in their satisfaction with the telehealth experience. Herein, we characterized patient satisfaction with telehealth visits and evaluated predictors of satisfaction with telehealth visits to improve patient selection when booking telehealth visits.
METHODS: We invited patients who had a telephonic or video telehealth visit from April-May 2020 at our institution to complete an online survey, via single-wave email invitation. We abstracted baseline characteristics for respondents from the medical record, and linked zip-code level socioeconomic data from the US Census. To improve patient selection for telehealth, we used univariable logistic regression to evaluate the associations of baseline characteristics with patient preference for telehealth over an in-person visit for a future encounter.
RESULTS: 58 respondents (22% response rate) were included in the study, of whom 79% were male, 91% were white, and 45% of were privately insured. This was the first telehealth experience for 69% of patients. Reasons for consultation were: oncologic in 48%, nephrolithiasis in 10%, BPH/voiding dysfunction in 34%, and other in 7% of patients. Overall, 93% of patients would recommend telehealth to a friend/family member. When asked their preferred format for a future visit, 51% responded telehealth while 49% responded traditional, in-person visit. Additional survey responses are summarized in Figure 1. On univariable regression, having a prior telehealth visit was associated with preference for future telehealth visit format (OR 3.74; 95% CI 1.16-13.6); self-reported tech-savviness did not reach statistical significance (OR 3.47; 95% CI 0.99-14.3).
CONCLUSIONS: In this study, respondents reported high satisfaction with telehealth visits. Prior telehealth experience was the best predictor of patient preference for a future telehealth visit. These results suggest allowing patients to choose their preferred visit format may be a simple mechanism for optimizing patient satisfaction with telehealth. 
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