Miracle Nwachukwu
Pronouns: she/her
Research Mentor(s): Amanda Maher, Postdoctoral Fellow (starting as Clinical Assistant Professor 9/01/20)
Research Mentor School/College/Department: Department of Psychiatry, Neuropsychology Division, Michigan Medicine
Presentation Date: Thursday, April 22, 2021
Session: Session 4 (2pm-2:50pm)
Breakout Room: Room 13
Presenter: 5
Abstract
Introduction: COVID-19 has limited many patients to video-teleconference (VTC) as opposed to face-to-face (FTF) appointments. With this switch, clinicians hope to maintain the same level of patient satisfaction that was seen previously in a traditional FTF setting, including in the field of neuropsychology. Prior to the COVID-19 pandemic, studies suggested that many patients found VTC just as likable of an experience as FTF for tele-neuropsychology services. Factors such as convenience (staying in the comfort of one’s own home) and cost of travel (gas, flights) all contribute to patient satisfaction with VTC (Seritan et al 2019; Powell et al 2020). However, not all patients have the necessary equipment for telehealth appointments, such as a stable internet connection or a webcam. Additionally, some patients may be uncomfortable with technology and clinician-patient rapport may be difficult to establish (Wilkinson et al 2016). In this study, we investigate patients’ knowledge about neuropsychology prior to VTC and FTF appointments, level of comfort with the technology required for VTC visits, and level of satisfaction with the telehealth services. Methods: A retrospective analysis of patient knowledge of neuropsychology and visit satisfaction was conducted from patient surveys collected both before and during the COVID-19 pandemic. Prior to the COVID-19 pandemic, a FTF survey was collected from patients at the time of their in-person neuropsychology appointments. During the COVID-19 pandemic, online surveys were sent to patients both before and after their virtual appointments. Chi-squared tests were used to assess between-group differences in the FTF and VTC patient responses. Spearman correlations were used to assess the relationship between overall satisfaction with VTC visits and factors such as comfort with technology and ease of scheduling. Results: 176 patients completed the pre-COVID FTF survey, 74 patients completed the COVID pre-VTC survey, and 22 patients completed the COVID post-VTC survey. The chi-square test concluded that the FTF group was significantly less likely to have completed prior neuropsychological testing compared to the VTC group. While there was not an overall significant difference between the FTF and VTC groups in terms of knowledge about neuropsychological testing prior to their visit, results revealed a significant difference between patients with and without prior neuropsychology testing such that individuals who had previously undergone testing were more likely to feel they had enough information about testing than those who had not. The Spearman correlations revealed significant positive relationships between overall satisfaction with VTC and a) the VTC appointment meeting the needs of the patients, and b) how comfortable patients were voicing their concerns, however, there was no significant correlation between overall satisfaction and ease of technology use or ease of scheduling. 95% of individuals reported feeling comfortable voicing their concerns in the VTC appointment and 90% of individuals felt that the VTC appointment met their needs at least as well as traditional in-person visits. Conclusion: The present study demonstrates that patients in both FTF and VTC settings reported having similar knowledge of neuropsychological testing prior to their appointment, suggesting that VTC visits are similar to their FTF counterparts in this regard. Patients with previous neuropsychology experience were more likely to report having knowledge of NP testing and to have completed a virtual visit, suggesting that patients who had previously completed neuropsychology testing may have felt more comfortable undergoing a VTC visit. Overall patient satisfaction was related to their comfort in expressing their concerns and ability to establish rapport with clinicians in virtual visits, suggesting that patient factors may have more of an influence on patient VTC satisfaction than administrative factors such as ease of scheduling. Most patients who completed VTC felt comfortable with video visits suggesting that VTC appointments may be a satisfactory alternative to traditional FTF appointments. One limitation of this study may be that the patients who completed VTC in our study may not be a fully representative sample of the greater population undergoing neuropsychological evaluation given their ability to “opt-out” of VTC visits. Future studies may consider implementing a randomized controlled trial format to achieve a more representative sample. References Leon Guerrero, C. R., Anderson, T., & Zazulia, A. R. (2018). Education Research: Physician identification and patient satisfaction on an academic neurology inpatient service. Neurology, 90(7), e632-e636. https://doi.org/10.1212/WNL.0000000000004961 Powell, R. E., Henstenburg, J. M., Cooper, G., Hollander, J. E., & Rising, K. L. (2017). Patient Perceptions of Telehealth Primary Care Video Visits. Annals of family medicine, 15(3), 225-229. https://doi.org/10.1370/afm.2095 Ramaswamy, A., Yu, M., Drangsholt, S., Ng, E., Culligan, P. J., Schlegel, P. N., & Hu, J. C. (2020). Patient Satisfaction With Telemedicine During the COVID-19 Pandemic: Retrospective Cohort Study. Journal of medical Internet research, 22(9), e20786. https://doi.org/10.2196/20786 Seritan, A.L., Heiry, M., Iosif, AM. et al. Telepsychiatry for patients with movement disorders: a feasibility and patient satisfaction study. J Clin Mov Disord 6, 2 (2019). https://doi.org/10.1186/s40734-019-0077-y Tenforde, A. S., Borgstrom, H., Polich, G., Steere, H., Davis, I. S., Cotton, K., O’Donnolkell, M., & Silver, J. K. (2020). Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine: A Survey Study of Patient Satisfaction with Virtual Visits During the COVID-19 Pandemic. American journal of physical medicine & rehabilitation, 99(11), 977-981. https://doi.org/10.1097/PHM.0000000000001571 Wilkinson, J. R., Spindler, M., Wood, S. M., Marcus, S. C., Weintraub, D., Morley, J. F., Stineman, M. G., & Duda, J. E. (2016). High patient satisfaction with telehealth in Parkinson disease: A randomized controlled study. Neurology. Clinical practice, 6(3), 241-251. https://doi.org/10.1212/CPJ.0000000000000252
Authors: Miracle Nwachukwu, Kaitlin Oswald, Amanda Maher
Research Method: Clinical Research
