JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic resulted in rapid adoption of video visits, clinician-patient communication that involved real-time video and audio patient assessment. Little is known about how the use of video visits was sustained over time during the pandemic and the perceived challenges from the perspective of clinician users.

Objective:

Monitor how video visits were used to deliver outpatient care across a large integrated healthcare delivery system. We also explored the change in video visits during the pandemic and the perceived challenges from the perspective of clinicians.

Methods:

Clinical operations leaders distributed a brief assessment to physicians, advanced practice professionals (APPs), and clinicians in May of 2020. The survey included questions regarding rates of in-person, telephone, and video for clinician-patient encounters, the rate of successful connection (i.e.: synchronous audio and video) for video visits, and perceived challenges to video visits (e.g.: software, hardware, bandwidth, technology literacy). The assessment was repeated in March of 2021. Differences between the 2020 and 2021 responses were adjusted for within-respondent correlation across surveys and tested using generalized estimating equations.

Results:

1126 surveys were completed (511 in 2020 and 615 in 2021). In 2020, only 21.7% clinicians reported no difficulty connecting with patients during video visits and 28.6% reported no difficulty in 2021. The distribution of the percentage of successfully connected video visits (“Over the past two weeks of scheduled visits, what percentage did you successfully connect with patients by video?”) was not significantly different between 2020 and 2021. (p= 0.74) Challenges in conducting in video visits persisted over time. Poor connectivity was the most common challenge reported by clinicians. This response increased over time with 30.5% selecting it as a challenge in 2020 and 37.1% in 2021 (p = 0.01). Patients not having access to their electronic health record portals was also a commonly reported challenge (21.3% in 2020 and 22.3% in 2021, p=0.73).

Conclusions:

During the pandemic, our healthcare delivery system rapidly adopted synchronous patient-provider communication using video visits. As experience with video visits increased, the reported failure rate did not significantly decline, and clinicians continued to report challenges related to general network connectivity and patient access to technology.