Introduction: There is ample data demonstrating patient satisfaction with telehealth in general, but data on patient perceptions of Telestroke is limited. Telestroke is a subset of telehealth requiring acute evaluations in high stress situations to make time-sensitive treatment decisions. We developed a survey to investigate what factors of a Telestroke evaluation are associated with overall patient satisfaction. Methods: We screened 2,053 consecutive patients who received acute Telestroke evaluations through the Yale Department of Vascular Neurology. We excluded patients who had a low suspicion of stroke, were non-English speaking, discharged to hospice or died, or who had impaired comprehension or decreased mental status during the consultation. Patients who met eligibility criteria were contacted by phone within 7-14 days if their telestroke consultation and interviewed through a structured survey. The primary outcome of patient satisfaction was measured using a 5-point Likert scale. To account for the ceiling effect, patient satisfaction was dichotomized to fully satisfied (5) versus less than fully satisfied (1 to 4). Because the survey questions were colinear, to prevent overfitting we selected the optimal covariates with a rigorous least absolute shrinkage and selection operator (lasso) model with a data-driven penalty. Results: 114 patients fulfilled eligibility criteria and provided feedback through our structured survey (62 female, mean age 63.55). We identified three factors associated with full patient satisfaction: 1) high audio quality, 2) teamwork between the Telestroke provider and emergency department team, and 3) the provider explaining the likely diagnosis. The odds ratios for the three covariates in the multivariable model were: 1) OR 5.40 (95% CI 1.50-19.5, p=0.010), 2) OR 7.64 (95% CI 2.31-25.3, p=0.001), and 3) OR 5.78 (95% CI 1.49-22.5, p=0.011). In the exploratory analysis, we found that the summary score accurately predicted full satisfaction. Conclusions: In conclusion, our single-center study demonstrates that independent factors best predicting full satisfaction were high audio quality (as opposed to video), teamwork between the Telestroke provider and emergency department team, and the provider explaining the likely diagnosis. This is in line with other data demonstrating the importance of communication with the patient. Our findings suggest that focusing on these elements could improve the overall patient experience.
Amin et al. (Thu,) studied this question.