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Patient Perceptions of Synchronous Telemedicine Video Visits in a Fee-for-Service Model

Sirisha Mohan, MD; Wilson Lin, MS; Francis Reyes Orozco; Jehni Robinson, MD; Anjali Mahoney, MD

Corresponding Author:  Wilson Lin, MS; Marshall School of Business - University of Southern California

Contact Email: wilsonli@usc.edu

Section: Original Research

Published: www.jabfm.org/content/35/3/497

INTRODUCTION: We study perceptions of patients who receive telemedicine services in the fee-for-service setting of an academic medical center’s family medicine department. To the best of our knowledge, this study is the first to investigate patient sentiments on both experiential and financial aspects of telemedicine primary care services when co-payments have been collected as pertinent to one’s insurance.

METHODS: A cross-sectional written digital survey, hosted on Qualtrics, was delivered to the patient’s email address after a patient’s telemedicine visit. Responses were captured from April – December 2020. The survey contained 53 questions, of which an earlier version was piloted from October 2019 – March 2020, whereby the department was also piloting telemedicine services. We tabulate summary statistics and perform two-sample t-tests to compare survey responses across groups.

RESULTS: Of 3,414 potential respondents, 3,377 were successfully contacted, and 903 individuals responded to the survey, corresponding to a 26.7% effective response rate. Of the 903 respondents, 797 consented to the study, completed the survey, and had responses consistent with Family Medicine practices. 91% (727/797) of these respondents described their telemedicine video visit experience more convenient than office-based care, and 74% (592/797) reported shorter wait times than office-based care. 87% (693/797) of respondents felt confident about protection of privacy. 29% of respondents perceived copayments to be unreasonable, with lack of a physical exam and financial factors justifying this perspective. 91% (723/797) of respondents are willing to use telemedicine in future.

DISCUSSION: Our findings suggest that telemedicine is a viable alternative to in-person visits and that most patients find a copayment reasonable. The findings suggest that telemedicine offers convenience and consistency with continuity and corroborate previous studies investigating telemedicine viewpoints. Payors should consider copayment in detail when designing telehealth benefits to ensure they do not become a barrier in seeking care. Continued efforts should be placed on establishing best practices for patients and providers when using telemedicine, and to ensure that these services are accessible and available to all.

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