Perceptions, barriers, and costs related to telehealth among outpatient musculoskeletal patients.

BACKGROUND

Telehealth provides remote clinical care for patients using communications technology. The increased use of telehealth during the COVID-19 pandemic compels us to better understand telehealth's costs, value, and limitations.

OBJECTIVE

To describe barriers to access and costs of care for telehealth patients among an outpatient musculoskeletal cohort. This study also evaluates patients' perceptions of telehealth as a means of care delivery during the COVID-19 pandemic.

DESIGN

Cross-sectional study.

SETTING

Tertiary academic institution.

PATIENTS: Adult patients attending telehealth visits in an academic physiatry department.

INTERVENTIONS: N/A MAIN OUTCOME MEASURES: Telehealth-related barriers, costs, and perceptions were assessed using a one-time survey.

RESULTS

A total of 262 patients (mean age: 59.6 ± 15.5 years, median: 62 [interquartile range, 49-72]) completed the survey from November 23, 2020 to February 14, 2021 (completion rate: 28.3%; 262/926). Comfort levels with technology averaged 8.5 ± 2.0 out of 10 (median: 9 [interquartile range, 8-10]), and all but one patient had existing access to the electronic device used for their telehealth visit. Most patients (89.7%) had previously received in-person care for the same issue. Concern about the pandemic was the top reason for receiving telehealth care. For almost all patients, the only costs related to telehealth were direct costs of care. In contrast, patients reported they would have spent an average of $25.14 (median: $10 [interquartile range, $0-$40]) on travel if their visit had been in person. Of the 141 patients who were employed or students, 25.5% reported taking time away from work or school to attend the telehealth visit, whereas 85.1% reported they would have needed to take time away from work or school if the visit had been in-person. Satisfaction with telehealth visits averaged 9.1 out of 10 (median: 10 [interquartile range, 9-10]), and 71.6% of patients reported a better impression of telehealth compared to 1 year ago.

CONCLUSIONS

Our findings illustrate that telehealth is a low-cost form of health care delivery that has high satisfaction for the patient. This is particularly beneficial in the musculoskeletal patient population who may face additional physical barriers to accessing care in person.