Investigators evaluate patient preferences on in-person vs telehealth urology visits

In this video, Daniel Carson, MD, MS, discusses the Urologic Oncology paper, “Telehealth visit type and patient-reported outcomes among patients with cancer.” Carson is a urology resident at the University of Washington in Seattle.

Your study found high satisfaction rates for both in-person and telehealth visits. Were there any specific aspects of the telehealth experience that patients particularly appreciated or found less satisfactory compared with in-person visits?

The satisfaction rates were high across the board for both in-person and telehealth visits, and while not significantly different from in-person, when reviewing the individual satisfaction-related questions, we were glad to see that patients strongly agreed that they perceived confidentiality and trust with physicians when convening new telehealth visits. And I think that finding is really important because it highlights that and supports telehealth as a platform that can create a positive patient-physician relationship even when they're meeting for the first time. We also noticed that more patients convening telehealth visits were less likely to feel that an exam was needed at every visit, and we thought that this may reflect inherent patient choice and visit modality.

The study focused on new patient visits. Do you think the findings would be similar for established patients, or might there be differences in their preferences or experiences with telehealth?

The focus of the study was new patients, but we also did assess patient satisfaction and cost for established patients convening telehealth or in-person visits, and similar to the new patients, we found high satisfaction scores in the established patient cohort for both visit modalities, but markedly lower costs for telehealth. We did note that fewer established patients using telehealth vs in person would choose that similar modality in the future, and we thought that this may be related to the nature of sampling during the COVID-19 pandemic for our cohort, in which there was a substantial increase in telehealth use because of in-person restrictions. Now, as established patients, it's possible that the visits preceding the pandemic that they had were in person, and this was their preferred visit modality.

What is the take-home message for the practicing urologist?

I would say the take-home message is that we found that from a patient-centered orientation, telehealth for new and established patients have comparably high satisfaction scores but provide substantially lower costs compared with in-person visits for patients with urologic cancer. And we don't expect or advocate for telehealth to replace in-person visits, but do see it as an important tool for urology providers to reach patients, particularly those who may struggle with access to care due to geographic constraints.

Is there anything you would like to add?

I'd say that we believe that these results can be extrapolated to patients with other cancers or health conditions, but do recognize that there may be aspects of urologic cancer that may be more feasibly managed by telehealth. Furthermore, our results may be specific to the large geographic region served by the institution in our study, and ultimately, we do need more research and more investigation to better understand the benefits and the limitations of telehealth on a broader scale and post license exemption waivers to inform clinical priorities for our health systems, as well as local and national telehealth policy.

This transcript was edited for clarity.