Background: Telemedicine has been increasingly relied upon to deliver health care remotely. During the COVID-19 pandemic, telemedicine has been essential to conserving PPE and minimizing potential exposures. Though more frequently used in outpatient settings, telephone and video visits are now also being used to connect hospitalized patients with members of their inpatient care team. Data on the quality and nature of inpatient telemedicine visits are still quite limited. In our study, we sought to describe the patients and care team members who participate in inpatient telemedicine visits, as well as to better understand patient perceptions of these visits during hospitalization.
Methods: Our project is part of a larger study surveying patients on their understanding and perceptions of their care team and medical plan. Surveys were conducted from February, 2020 to August, 2021 at two urban hospitals and were administered in-person or by phone to randomly selected inpatients on a general medicine service who were on the third day or greater of their hospitalization. Surveys have been completed to date on a total of 144 patients, 128 of whom responded to the question, “Did any members of your care team visit you by phone or video, rather than face-to-face?”, as well as subsequent questions clarifying whether the visit was by telephone or video, which care team members were involved, and the quality of that visit. Sociodemographic information was obtained from the EMR and differences between patients who had or did not have telemedicine visits were investigated using Pearson Chi-Squared or Fisher’s Exact tests. Participants with missing demographic data were not included in those comparisons.
Results: Of the 128 patients who responded to survey questions about telemedicine, 23 (18%) self-reported having had a telephone and/or video visit during their inpatient stay; 18 (78%) of these patients had telephone visits, 3 (13%) patients had video visits, and 2 (9%) had both. No significant sociodemographic differences were found between those patients who did or did not reported a telemedicine visit (Table 1). Notably, none of the four non-English speakers surveyed received a telemedicine visit. The most frequently reported care team members utilizing inpatient telemedicine were specialists (n = 9, 23%), followed by social workers (n = 3, 13%) and physician assistants (n = 3, 13%) (Table 2). The majority of patients reported the quality of these visits as excellent, very good, or good (n = 7, 30%; n = 5, 22%; and n = 9, 39%, respectively), with only one patient (4%) reporting a visit of fair quality (Table 2).
Conclusions: Our preliminary findings suggest telemedicine visits were used by care teams on medicine services during approximately 1/5th of hospitalizations, and patient perceptions of these visits were generally favorable. Though our conclusions are limited by a small sample size, it seems medical specialists used telemedicine visits more frequently than other members of the inpatient care team. Our study did not find any differences in the sociodemographics of patients completing a telemedicine visit versus those that did not, but our study to date is likely underpowered to show small but important differences (e.g., by language). If telephone and video visits for hospitalized patients continue to expand (e.g., due to COVID-19 or future pandemics), attention should be paid to ensure that these novel visit modalities are utilized equitably by care teams and that they don’t produce decrements in care quality or patient experience.
