Introduction
The COVID-19 pandemic is an unprecedented event that has led to an
abrupt and drastic shift in the practice of medicine around the world.
In an effort to balance the ongoing need for patient care with the risks
to patient and staff safety, the CDC and multiple societies, including
the American Academy of Otolaryngology – Head and Neck Surgery and the
American Head and Neck Society, have issued recommendations to delay
elective ambulatory provider visits or to consider telephone or
video-based alternatives.1–3 In response,
telemedicine has been rapidly implemented and widely adopted in many
ambulatory practices for the first time.
The World Health Organization broadly defines telemedicine as the
delivery of health care services by all health care professionals using
technology for the exchange of valid information for diagnosis,
treatment and prevention of disease and injuries.4 As
an alternative to the traditional office encounter, telemedicine refers
to a live (synchronous), two-way, interactive audio and video-based
communication between the patient and the clinician to deliver care at a
distance. While telemedicine has been successfully used in many fields
over the past two decades, including some surgical
subspecialties,5–7 its use has been less widespread
in otolaryngology8 despite studies demonstrating that
many otolaryngology diagnoses are amenable to virtual
appointments9 and that telemedicine provides a
significant cost savings and reduction in unnecessary office
visits.10–12 This is in part due to difficulty of
physical examinations in otolaryngology that often require equipment and
training to perform.13
Prior to COVID-19, patient-facing telemedicine in otolaryngology has
been largely limited to the delivery of care to remote
areas,14 primary provider-to-specialist provider
consultations10,12 or under specific circumstances,
for instance in Navy military centers and shipboard medical
departments15,16 or in the aftermath of Hurricane
Katrina.17 Telemedicine in otolaryngology has less
commonly focused on synchronous, interactive otolaryngology patient
visits in general18–23 and few studies directly
examine patient satisfaction.13,19–21,23
The sudden and sweeping transition to telemedicine in light of COVID-19
presents a unique opportunity to explore the role of telemedicine in
otolaryngology ambulatory practices and patient satisfaction with
virtual visits. Patient satisfaction is an important metric of
healthcare quality and can play a major role in the long-term acceptance
and success of a telemedicine program. As telehealth grows in prevalence
and becomes further integrated into healthcare systems, it is important
to preserve patient satisfaction across healthcare delivery modalities.
Cursory examinations of patient satisfaction in prior studies have found
high rates of patient satisfaction but these studies are limited by
their small sample sizes and choice of patient satisfaction
metrics.19–21,23 This study systematically explores
patient satisfaction with video-based telemedicine visits during
COVID-19 utilizing a validated telemedicine satisfaction survey in
patients presenting to an academic head and neck surgery practice.