Are patients satisfied with online video consultations for assessing their hand disorder?

OBJECTIVES

The aim was to evaluate patient satisfaction with online video consultations in assessing hand disorder.

MATERIAL AND METHODS

This prospective study included patients who attended a video consultation, either as an initial meeting to assess the need for further evaluation or treatment or as an early postoperative follow-up consultation. After the consultation, they completed a satisfaction questionnaire. Regression models were used to reveal determinants of patient satisfaction.

RESULTS

We included 100 patients, with a mean age of 55 years (range 17-81 years). 95% were satisfied or very satisfied. The main reasons for choosing this form of consultation were shorter travel and wait times. Age, gender and educational level did not determine satisfaction. Significant factors for dissatisfaction were insufficient video and sound quality.

CONCLUSION

Online video consultation in hand surgery is a valuable alternative to in-clinic appointments for all age groups. However, it is crucial to ensure adequate video and audio quality.

Telehealth Follow-up Using a Real-Time Electrocardiogram Device Improves Electrocardiogram Monitoring Duration and Patient Satisfaction After Catheter Ablation

Background: There is a strong demand for remote monitoring systems to gather health data. This study investigated the safety, usefulness, and patient satisfaction in outpatient care using telehealth with real-time electrocardiogram (ECG) monitoring after catheter ablation. Methods and Results: In all, 38 patients who underwent catheter ablation were followed up using telehealth. At the 3- and 6-month follow-up, a self-fitted Duranta ECG monitoring device was sent to the patient's home before the online consultation. Patients attached the devices themselves, and the doctors viewed the patients by video chat and performed real-time ECG monitoring. The frequency of hospital visits and the ECG monitoring duration were compared with conventional in-person follow-up data (n=102). The completion rate for telehealth follow-up was 32 of 38 patients (84%). The number of hospital visits during the 6 months was significantly lower with telehealth follow-up than with conventional follow-up (median [interquartile range] 1 [1-1] vs. 5 [3-5]; P<0.0001). However, the ECG monitoring duration was approximately 4-fold longer for the telehealth follow-up (median [interquartile range] 89 [64-117] vs. 24 [0.1-24] h; P<0.0001). No major adverse events were observed during the telehealth follow-up. Patient surveys showed high satisfaction with telehealth follow-up due to reduced hospital visits. Conclusions: A combination of telehealth follow-up with real-time ECG monitoring increased the ECG monitoring duration and patient satisfaction without any adverse events.

Lurking or active? The influence of user participation behavior in online mental health communities on the choice and evaluation of doctors

BACKGROUND

Web-based psychological counseling sites have become an important source of health information and expert assistance. Although many studies have suggested the feasibility and effectiveness of online consultation, there is an insufficient understanding of the influence of the distinction of users' participation behaviors online on health behavior decision-making.

OBJECTIVE

This study aimed to investigate whether and how the differences in the online participation behaviors of users affect their doctor selection and evaluation characteristics.

METHODS

First, we collected information from 7,781 paid consultation clients from a professional mental health service platform in China. Effective indicators and variables were formed through data cleaning and classification. Next, we used a mixed methods research approach that included qualitative text analysis (topic and sentiment) and quantitative statistical analysis (ANOVA).

RESULTS

The ANOVA results show that differences in online participation behaviors (diving, searching and socializing) have a significant impact on doctor selection based on consultation price (F_7,780=6.05; P = 0.00), online service volume (F_7,780=4.76; P = 0.00), online reputation (F_7,780=4.30; P = 0.01) and online answers (F_7,780=5.76; P = 0.00). When evaluating doctors, the frequency of reviews (F_7,780=69.62; P = 0.00) and the average length of the text (F_7,780=15.33; P = 0.00) were significantly different among users. Two of the three topics, namely, service attitude (F_7,780=28.63; P = 0.00) and self-expression (F_7,780=40.83; P = 0.00), had significant effects. In addition, our results show that differences in participating behaviors have a significant impact on both the positive (F_7,780=7.30; P = 0.00) and negative (F_7,780=9.44; P = 0.00) emotions involved in evaluating doctors.

CONCLUSIONS

Our findings provide preliminary insights for establishing the relationship between users' online information behavior and health decision-making. Further research should be conducted to verify the validity of the results and help apply them to the design of personalized customized services for the users in an online health community.

Online consultation in an orthopedic trauma surgery outpatient clinic: is there a learning curve?

BACKGROUND

In the context of the German contact restrictions due to the COVID-19 pandemic of March 2020, an online-based consultation system was established in our university orthopedic outpatient department to maintain patient care. As a basis for contact-minimizing communication, this was continued after the contact restrictions were lifted. The aim of this prospective pilot study was to assess the effectiveness, technical feasibility, and patient flow in this system under lockdown conditions and in the period afterwards.

METHODS

The evaluation took place from the beginning of the first lockdown on March 13, 2020, until May 31, 2021. For each patient encounter, the quality of the sound and video connections was documented. The outcomes of the consultations were recorded. Four categories were distinguished: 1) no follow-up necessary, 2) follow-up via online consultation, 3) referral for surgical therapy, and 4) follow-up in the outpatient clinic for physical examination. A comparison was made between an early cohort right after implementation of the online consultation and and a late cohort after establishment of the consultation.

RESULTS

There were 408 patient encounters via online consultation. A total of 360 (88%) consultations were uninterrupted. Initial presentations accounted for 124 (30%) consultations. In 75 (18%) patients, no further follow-up was necessary. Follow-up via online consultation was scheduled in 82 (20%) patients, direct referral for surgery was made in 86 (21%) patients, and a follow-up for physical examination was arranged in 165 (40%) patients. When comparing the early and late cohort, there was no difference in the duration of the conversation (p = 0.23). A significant difference was found in the type of further treatment. In the late cohort, conservative therapy was used more often (p < 0.01), resulting in a lower number of follow-up visits for clinical examination (p < 0.01).

CONCLUSION

While a definite decision for further procedure was possible solely by online consultation in a large percentage of cases, 40% of patients still needed an additional in-person consultation for physical examination. A learning curve could be observed regarding the selection of patients suited for online consultation. Overall, online consultation is a useful measure to manage patient volume and to visibly support direct doctor-patient contact.

Examining GP online consultation in a primary care setting in east midlands, UK

Background

Increasing pressure threatens to overwhelm primary care services, affecting the quality of care and their role as gatekeepers to specialised care services. This study investigated healthcare users’ acceptability of – and the effectiveness of – an e-consultation system in primary care services.

Methods

Seven GP practices in East-Midlands, all of whom use online consultation system participated in the study, with a retrospective review being undertaken of 189 electronic patients’ records (age range of 18–76 years) over 5 months. The focus was on the electronic records of patients who accessed the service for five different conditions identified as presenting common conditions seen by the GPs practices. Statistical analysis was done using SPSS to perform an exploratory data analysis and descriptive statistics.

Results

The results showed a positive reception of the online consultation platform, with an average satisfaction score of 4.15 (most likely to recommend score = 5). Given the nature of the conditions, 47.6% of patients had experienced a previous episode of the health condition they were seeking consultation for, and a total of 72% had existing comorbidities. Follow-up activity occurred for 87.3% of patients, 66.1% of which included at least one follow-up visit for the same condition as the initial online consultation.

Conclusion

The results suggest that online consultation is convenient for patients, and it also has the potential to relieve pressure placed on primary care services. Although a number of challenges were identified, such as patient verification, this study gives insight into – and enhances our understanding of – the use of online GP consultations.

The rules for online clinical engagement in the COVID era

Coronavirus disease-2019 (COVID-19) has generated a need to rapidly increase online consulting in secondary care, an area in which it has previously been underutilised. We sought to review the guidance on conducting remote consultations and found that while there is a large amount of information about the implementation of remote consultations at an organisation level, there is a paucity of high-quality papers considering the guidelines for online consultations alongside practical advice for their implementation at the individual level. We reviewed guidelines from reputable medical sources and generated practical advice to assist practitioners to perform safe and effective video consultation. Additionally, we noted reports in the literature of a lack of transparency and resulting confusion regarding the choice of telemedicine platforms. We, therefore, sought to summarise key characteristics of a number of major telemedicine platforms. We recognised a lack of clarity regarding the legal status of performing remote consultations, and reviewed advice from medico-legal sources. Finally, we address the sources of these individual uncertainties, and give recommendations on how these might be addressed systematically, so the practitioners are well trained and competent in the use of online consultations, which will inevitably play an increasingly large role in both primary and secondary care settings in the future.

Integration of online and offline health services: The role of doctor-patient online interaction

OBJECTIVE

This study aims to investigate how doctor-patient online interaction affects the integration of online and offline health services. Drawing on justice theory and the stimulus-organism-response (S-O-R) framework, justice perceptions are conceptualized as online health communication in influencing patient experiences and subsequent responses.

METHODS

Data were collected from 241 online consultation patients. Partial least squares structural equation modeling (PLS-SEM) approach was used to test the research model and 12 hypothesized relationships.

RESULTS

Distributive justice, procedural justice, and interpersonal justice significantly affect trust, which in turn affects satisfaction and the continued intention to consult. Distributive justice and informational justice significantly affect satisfaction, which in turn affects the continued intention to consult. Finally, the continued intention to consult significantly affects the behavioral intention to visit.

CONCLUSION

Doctors can attract patients to visit them in physical hospitals by providing good online health services. Before physically visiting doctors, patients can also search for a suitable doctor that meets their needs through online consultations. To the best of our knowledge, this study is the first to integrate online and offline health services.

PRACTICE IMPLICATIONS

From the perspective of health communication, the understanding of doctor-patient online interaction offers doctors and hospitals guidance to improve doctor-patient relationships.