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Preference for Telehealth Sustained Over Three Months at an Outpatient Center for Integrative Medicine

Authors
  • Finn, Michael T. M.1, 2
  • Brown, Hannah R.1, 3
  • Friedman, Emily R.1, 3
  • Kelly, A. Grace1
  • Hansen, Kathryn1
  • 1 Osher Center for Integrative Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
  • 2 Adult Congenital Heart Disease Program, Helen DeVos Children’s Hospital, Grand Rapids, Michigan
  • 3 Vanderbilt University School of Nursing, Nashville, Tennessee
Type
Published Article
Journal
Global Advances in Health and Medicine
Publisher
SAGE Publications
Publication Date
Feb 21, 2021
Volume
10
Identifiers
DOI: 10.1177/2164956121997361
PMID: 33680574
PMCID: PMC7900841
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Background Integrative medicine is a key framework for the treatment of chronic medical conditions, particularly chronic pain conditions. The COVID-19 pandemic prompted rapid implementation of telehealth services. Objective We present outcomes of a complete and rapid transition to telehealth visits at an outpatient integrative medicine center in the Southeastern United States. Method Patients and administrative staff took surveys comparing telehealth to in-person visits within four weeks of our clinic's transition to telehealth and three months later. Beginning four weeks after the clinic’s telehealth conversion in March 2020, patients who had a telehealth visit at the center completed a survey about their telehealth experience and another survey three months later. Results Patient quality judgements significantly favored telehealth at baseline, B = .77 [0.29 – 1.25], SE = .25, t (712) = 3.15, p = .002, and increased at three months, B = .27 [–0.03 – 0.57], SE = .15, t (712) = 1.76, p = .079. Telehealth technology usability and distance from the center predicted patient ratings of telehealth favorability. Providers favored in-person visits more than patients, B = –1.00 [–1.56 – –0.44], SE = .29, t (799) = –3.48, p < .001, though did not favor either in-person or telehealth more than the other. Patient discrete choice between telehealth and in-person visits was split at baseline (in-person: n = 86 [54%]; telehealth: n = 73 [46%]), but favored telehealth at three months (in-person: n = 17 [40%]; telehealth: n = 26 [60%]). Overall, discrete choice favored telehealth at follow-up across providers and patients, OR = 2.69 [.1.18 – 6.14], z = 2.36, p = .018. Major qualitative themes highlight telehealth as acceptable and convenient, with some challenges including technological issues. Some felt a loss of interpersonal connection during telehealth visits, while others felt the opposite. Conclusion We report converging mixed-method data on the successful and sustained implementation of telehealth with associated policy and clinical implications during and beyond the COVID-19 pandemic.

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