Virtual Visits During the COVID-19 Pandemic: The Healthcare Provider Perspective (Preprint)
Authors: Patel Avi , Phillips Jeffrey W. , Philippides George John , Gualtieri Lisa 
Published: January 2021

BACKGROUND

Telehealth adoption by healthcare institutions increased drastically when the COVID-19 pandemic necessitated a rapid transition from in-person to virtual visits. Many providers, despite minimal experience or training, were forced to adapt quickly. Learning how physicians responded to these changes has the potential to improve provider and patient experience and planning for future telehealth implementation.

OBJECTIVE

(1) To study provider experience and expectations regarding virtual visits during the COVID-19 pandemic at Newton-Wellesley Hospital. (2) To use this data to inform quality improvement efforts at the hospital to improve physician satisfaction and patient care.

METHODS

A digital survey was developed and distributed internally to Family Medicine and Cardiology providers at Newton-Wellesley Hospital. Survey responses were collected for 6 weeks and the findings were shared with Newton-Wellesley Hospital to help them better serve their providers and patients.

RESULTS

In total, 18 providers completed the study survey. Their responses revealed that during the pandemic, providers worked from home 49% of the time and virtual visits constituted 65% of their appointments. Although overall patient visits decreased relative to before the pandemic, primarily in the category of new-patient appointments, provider workload increased. Regarding telehealth training, the survey identified an inconsistent provision of training. The survey also revealed 81% of providers lacked the resources needed to perform their job most effectively during the pandemic. The resource most lacking was a high-definition microphone, followed by a stable internet connection. Several pandemic-related factors, including increased caregiver and household responsibilities and reduced connectivity and computer access, were also found to be barriers to delivering optimal patient care while working from home. These were due to more people being at home.

CONCLUSIONS

For hospitals, the finding that only half of patient encounters turned virtual during the pandemic prompts further exploration about the nature of other appointment types and modalities. Additionally, this finding can help inform hospitals’ in-person staffing needs especially if provider capacity is strained. The trend that provider workload increased during the pandemic despite fewer visits warns hospitals that a pandemic of this nature and scale, despite deterring some patients from making appointments, is not an indication to scale down non-pandemic services but rather an indication for flexible staff redeployment. Additionally, the finding that new-patient appointments decreased informs hospitals to remind the public of the importance of not delaying medical care despite pandemic concerns. Lastly, the list of resources providers felt were most lacking and the list of virtual visit barriers most worsened by the pandemic can help hospitals better equip and support their providers so they can help patients as efficiently as possible. With no end in sight for the COVID-19 pandemic and virtual visits continuing at Newton-Wellesley Hospital, physician feedback demonstrates many opportunities for hospital leadership to provide targeted support to their providers and consequently better patient care. The knowledge gained from this study should be used to adapt and improve support for providers for the remainder of the COVID-19 pandemic and beyond. Future studies will measure the impact of policy changes instigated by these recommendations and may warrant broader study at other healthcare institutions.