Self-Reported Patient and Provider Satisfaction With Neurology Telemedicine Visits After Rapid Telemedicine Implementation in an Urban Academic Center: Cross-Sectional Survey
Authors: Robertson Noah , Syed Maryam J , Song Bowen , Kaur Arshdeep , Patel Janaki G , Marawar Rohit , Basha Maysaa , Zutshi Deepti 
Published: April 2024

Background
Many clinics and health systems implemented telemedicine appointment services out of necessity due to the COVID-19 pandemic.

Objective
Our objective was to evaluate patient and general provider satisfaction with neurology telemedicine implementation at an urban academic medical center.

Methods
Patients who had completed 1 or more teleneurology visits from April 1 to December 31, 2020, were asked to complete a survey regarding their demographic information and satisfaction with teleneurology visits. Providers of all specialties within the same hospital system were given a different survey to gather their experiences of providing telemedicine care.

Results
Of the estimated 1500 patients who had completed a teleneurology visit within the given timeframe, 117 (7.8%) consented to complete the survey. Of these 117 respondents, most appointments were regarding epilepsy (n=59, 50.4%), followed by multiple sclerosis (n=33, 28.2%) and neuroimmunology (n=7, 6%). Overall, 74.4% (n=87) of patients rated their experience as 8 out of 10 or higher, with 10 being the highest satisfaction. Furthermore, 75.2% (n=88) of patients reported missing an appointment in the previous year due to transportation issues and thought telemedicine was more convenient instead. A significant relationship between racial or ethnic group and comfort sharing private information was found (P<.001), with 52% (26/50) of Black patients reporting that an office visit is better, compared to 25% (14/52) of non-Black patients. The provider survey gathered 40 responses, with 75% (n=30) of providers agreeing that virtual visits are a valuable tool for patient care and 80% (n=32) reporting few to no technical issues. The majority of provider respondents were physicians on faculty or staff (n=21, 52%), followed by residents or fellows (n=15, 38%) and nurse practitioners or physician assistants (n=4, 10%). Of the specialties represented, 15 (38%) of the providers were in neurology.

Conclusions
Our study found adequate satisfaction among patients and providers regarding telemedicine implementation and its utility for patient care in a diverse urban population. Additionally, while access to technology and technology literacy are barriers to telemedical care, a substantial majority of patients who responded to the survey had access to devices (101/117, 86.3%) and were able to connect with few to no technological difficulties (84/117, 71.8%). One area identified by patients in need of improvement was comfortability in communicating via telemedicine with their providers. Furthermore, while providers agreed that telemedicine is a useful tool for patient care, it limits their ability to perform physical exams. More research and quality studies are needed to further appreciate and support the expansion of telemedical care into underserved and rural populations, especially in the area of subspecialty neurological care.