P-745 Telemedicine during the COVID -19 pandemic: let us give the floor to the patients
Authors: Arnoldi M , Candeloro I , Lombardo G , Cappellari M , Bosisio C , Galbignani E , Cappato M , Fusi F.M 
Published: June 2022

Abstract

Study question
Could telemedicine be an efficient instrument in reproductive medicine?

Summary answer
Telemedicine could be a safe and efficacious tool to reduce waiting time to follow-up appointments, to treatments and some discomfort of in-visit person.

What is known already
During pandemic COVID- 19 in Italy the infertility centers procedures were suspendend, except of fertility preservation treatments for oncological patients. In order to stay close to our patients, to minimize exposure risks for patients and staff and to avoid an extension of waiting lists, we introduced a telemedicine service, that we called “smart ART'' for the follow-up consultations, that do not require a physical examination and for the planning of frozen embryo transfer cycles.

Study design, size, duration
All the patients, who recevied a consultation via telemedicine, had given a written consent. At our public infertility center, patients who had a telemedicine visit from May 4th, 2020 to December 21st, 2021 were surveyed to ascertain their satisfaction and perspectives using an online anonymous questionnaire, that contained 10 questions with graduated responses according to 5-point Likert scale and a free response. The questionnaire was active from 11th November 2021 until 10th January 2022.

Participants/materials, setting, methods
Three hundred twenty-nine patients received satisfaction surveys by email. Emails were sent from 11th November 2021 to 23th December 2021, with a reminder a week later to improve the completion rate. Survey responses were collected in real time via a secure, web application. We assessed the level of patients satisfaction with several aspects of the visit (technical quality, care received, convenience, comfort, and overall satisfaction). Participants were also invited to leave a comment.

Main results and the role of chance
There was an overall response rate of 66.3%. The survey was entirely completed by 89.9% of patients. By analyzing the survey responses, we noted that 90% of responders would use telemedicine services again and were satisfied with the telehealth system. Smart ART improved access to healthcare for 50% patients in terms of less discomfort for cost and time for transportation and work. 85% of responders believed that telemedicine preserves privacy, 39% of responders considered that on line consultations should probably be maintained in the future in non pandemic times and 46% absolutely maintained. 87% of patients stated that telemedicine platform was easy to access. The audio’s quality was good for 50% of patients and very good for 31% of patients. 79% of responders were satisfied with video quality and 60% of responders were very satisfied with medical approach despite non in-person visit. 32% of patients were not satisfied with transmission of documents with our platform, while 48% of patients are willing to repeat telemedicine for future visits and 34% will probably repeat it. Most patients stated that they are ‘‘very satisfied’’ with telehealth overall.Telemedicine allowed to reduce waiting time for follow-up consultations from 4 months to less than one month.

Limitations, reasons for caution
This is a monocentric study and we are aware of the small sample size. Patients were self-selected and this could introduce a bias regarding the level of satisfaction. Patients who are less technologically inclined may be more comfortable with in-person visit and coud feel uncomfortable, when discussing sensitive topics.

Wider implications of the findings
Infertility centers should continue to maintain telemedicine after the pandemic, in the interest of patients, doctors and economy. Telehealth has the potential to improve clinic flow, reduce time to treatments and drop-out, decrease costs without compromise the valuable patient–physician relationship. Further research is needed to better define these implications.

Trial registration number
not applicable