Patient Experience with In-Person and Telehealth Visits Before and During the COVID-19 Pandemic at a Large Integrated Health System in the United States

Abstract

Background: Information about telehealth versus in-office visits and how patient experience before compared to during the COVID-19 pandemic is important for healthcare planning.

Objective: To compare patient experience by visit type and before and during the pandemic.

Design: Survey of patients assessing ambulatory care before and during the pandemic.

Participants: A total of 58,500 adult patients (13,928 primary care and 44,581 specialty physician visits) at a large integrated health system with 197 clinics on the west coast of the United States. The majority were female (59%), 55 or older (65%), and non-Hispanic White (55%), and had an in-office visit (87%) while 10% had a tele-video and 3% a phone visit.

Main measures: Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey 3.0 doctor communication, care coordination, access, and office staff composites; an overall rating of the doctor; and whether the patient would recommend the doctor to family and friends.

Key results: Patient experience with telehealth visits was as positive as or more positive than that with traditional office-based visits. Doctor communication on tele-video visits was viewed as slightly more positive than that of in-office or phone visits. Tele-video visits were also slightly more positive than in-office visits for care coordination, overall rating of the doctor, and willingness to recommend to family and friends. Office staff were viewed less positively on the phone than tele-video or in-office visits. Patient experience was similar before and during the COVID-19 pandemic (e.g., on a 0-100 possible range with a higher score being better, doctor communication was 94.4 before and 94.9 during).

Conclusions: The positive experiences with telehealth, especially tele-video, may be due to patient appreciation of efforts made to maintain access, the focused nature of telehealth visits, and help by staff for navigation technical issues. Lessons learned about delivering responsive telehealth care can be used to ensure high-quality care after the pandemic.

Keywords: CAHPS®; COVID-19; patient experience; telehealth.

Fig. 1

Total visits by visit type in 2020. Large drop in total visits and rapid increase in telehealth visits at the onset of the pandemic in this health system. The number of total visits returned to pre-pandemic levels with a mix of visit types and persistent use of telehealth