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Abstract Details

A Comparison of Telehealth and In-Person Visits in Ambulatory Neurology: What are the factors that patients consider when selecting future visit type?
Practice, Policy, and Ethics
P5 - Poster Session 5 (11:45 AM-12:45 PM)
1-001
To identify factors that patients consider when selecting future visit type (in-person vs video vs telephone).
Telehealth has rapidly integrated into ambulatory medicine in response to the COVID-19 pandemic. In our clinic, telemedicine comprises approximately 30% of visits.
Consecutive patients who had an ambulatory neurology visit in March 2021 were contacted by telephone. Assenting patients completed (1) a survey quantifying likelihood of scheduling a future telemedicine visit and (2) a semi-structured interview. Qualitative responses were analyzed using principles of thematic analysis.

2,493 ambulatory visits were performed; 962 patients (39%) assented to post-visit feedback; 74% were in-person visits, 13% video, and 13% telephone. Patients with video and telephone visits were more likely than in-person to consider telemedicine in the future (59% vs 62% vs 36% respectively, p<0.001). Five themes were identified that influence patient visit preferences: “Pros of Visit Type,” “Barriers to Telehealth,” “Situational Context,” “Inherent Patient Beliefs,” and “Extrinsic Variables.”  Telemedicine patients considered convenience as “Pros of Visit Type,” while in-person patients valued improved communication and quality of medical care. “Barriers to Telehealth” such as accessibility and user familiarity were prevalent among in-person and telephone patients, whereas system limitations such as poor internet connection were prevalent among video patients. “Situational Context” varied: all patients agreed that stable conditions can be monitored via telemedicine; all patients considered physical examination a driving factor for in-person visits; telephone patients cited worsening symptoms as warranting in-person visits more frequently than video patients. The “Inherent Belief” that telemedicine is equivalent to in-person care was cited more by telephone than video patients. “Extrinsic Variables” such as patient awareness of telemedicine must be addressed.

Patients view telemedicine as an adjunct to, and not replacement for, in-person visits. Future care delivery models should incorporate patient perspectives to guide improved access to care and reduction of healthcare spending.
Authors/Disclosures
Carly J. Olszewski
PRESENTER
Ms. Olszewski has nothing to disclose.
No disclosure on file
Kelly A. Pring, MD Ms. Pring has nothing to disclose.
No disclosure on file
Rebecca Merrill, MD Ms. Merrill has nothing to disclose.
No disclosure on file
Alexander P. Ambrosini Mr. Ambrosini has nothing to disclose.
Kevin A. Soltany Mr. Soltany has received personal compensation for serving as an employee of Alliance for Health Policy. Mr. Soltany has received personal compensation in the range of $0-$499 for serving as a Consultant for Health Affairs.
Gabriella M. Bognet, Other Ms. Bognet has nothing to disclose.
Lauren D. Strauss, DO (Wake Forest Univrsity Baptist Medical Center) Dr. Strauss has a non-compensated relationship as a Secretary with Southern Headache Society that is relevant to AAN interests or activities.
No disclosure on file
Amy K. Guzik, MD, FAAN (Wake Forest University Baptist Medical Center) Dr. Guzik has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Local law firms, available by request.
Roy E. Strowd III, MD, FAAN (Wake Forest School Of Medicine) Dr. Strowd has received personal compensation for serving as an employee of Kaplan. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical, Inc. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. The institution of Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SpringWorks . Dr. Strowd has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Strowd has received research support from Southeastern Brain Tumor Foundation. The institution of Dr. Strowd has received research support from Jazz Pharmaceuticals. The institution of Dr. Strowd has received research support from National Institutes of Health. The institution of Dr. Strowd has received research support from Alpha Omega Alpha. The institution of Dr. Strowd has received research support from American Board of Psychiatry and Neurology. Dr. Strowd has received publishing royalties from a publication relating to health care. Dr. Strowd has received publishing royalties from a publication relating to health care.