Key result
Only 9% of surveyed heart failure patients preferred follow-up via telehealth, whereas 69% preferred in-person appointments, largely due to a perceived lack of quality and physical examination.
Why the study?
With routine outpatient HF care abruptly shifting to telehealth during COVID-19, patient-reported subjective experiences regarding telehealth needed to be solicited.
Does telehealth follow-up improve patient-reported satisfaction and perceived quality of care compared to in-person visits in patients with heart failure?
Cross-Sectional (n=35)
No
Does telehealth follow-up improve patient-reported satisfaction and perceived quality of care compared to in-person visits in patients with heart failure?
Absolute Event Rate: 9% vs 69%
Heart failure patients perceived telehealth care as inferior to in-person care, largely due to the lack of physical examination and depersonalization, with the vast majority preferring conventional in-person follow-up.
Caution is warranted before defaulting to telehealth for routine HF follow-up; leaves open whether familiarity and exam substitutes can improve acceptance.
BACKGROUND: With the onset of coronavirus disease 2019 (COVID-19), the delivery of routine outpatient heart failure (HF) care abruptly shifted to telehealth. Appropriate HF management extensively relies upon patient-reported symptoms. With the growing attention towards patient-centered care, our team recognized an invaluable opportunity to solicit patient-reported subjective experiences regarding telehealth. METHODS: In total, 127 patients with a known diagnosis of HF were contacted by phone for participation in an online questionnaire. The tool consisted of questions generated by the investigators and from prior validated patient-reported experience measures. The intention was to assess the quality of care in our HF clinic and to solicit feedback regarding telehealth. RESULTS: Thirty-five patients provided a response. Questions with the most favorable outcomes were in line with our predetermined themes of interpersonal matter, communication, and perceived quality of care. The worst performing questions exhibited a lack of satisfaction with and perceived quality of telehealth. Only 9% (n = 3) preferred follow-up via telehealth, 69% (n = 22) preferred in-person, and 22% (n = 7) were indifferent. CONCLUSIONS: Given the multitude of benefits of telehealth, especially appropriate social distancing, telehealth is quite likely here to stay. In sum, with the rapid change in care delivery, patients currently perceive the care delivered via telehealth to be of inferior quality. This lack of quality can be largely attributed to the lack of physical examination, depersonalization of healthcare, and likely, a lack of familiarity with the platform. We urge our colleagues to solicit similar feedback from their patients to improve their own telehealth efforts.
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Raman et al. (2021) conducted a cross-sectional in Heart failure (n=35). Telehealth vs. In-person care was evaluated on Preference for future appointments (virtual vs in-person). Only 9% of surveyed heart failure patients preferred follow-up via telehealth, whereas 69% preferred in-person appointments, largely due to a perceived lack of quality and physical examination.
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