JMIR Publications

ABSTRACT

Background & Aims: Studies performed in urban communities with access to technology suggest high patient satisfaction with telehealth. While virtual visits can increase the reach of clinical practice in rural communities, technological barriers may reduce patient satisfaction. Our aim is to compare satisfaction with telehealth visits between patients living in rural and urban communities. Approach &

Results:

A telephone survey was developed and administered to hepatology patients seen at outpatient clinics from 3/20-3/21. Patient characteristics and survey responses were compared by urban and rural location as defined by the census tract based on ZIP code using univariable and multivariable logistic regression. Of 400 patients, 164 (41%) completed the survey. Compared to urban patients, rural patients had twice the transportation time to clinic (59 + 35 vs 39 + 37 minutes) and were more likely to cancel due to transportation issues (46% vs 13%). Rural patients reported less proficiency with technology and more technical difficulties, including an inability to log on to the portal or access the camera/microphone (75% vs 25%) and less comfort with their devices (54% vs 9%). Overall, urban patients were more likely to prefer telehealth (aOR: 5.20, 95% CI: 2.15-13.7), and were more satisfied with telehealth vs. in person visits than rural patients (62.1% vs. 20.8%). Conclusion: Rural patients reported more technical challenges to telehealth and more transportation issues than urban patients but favored in person hepatology visits. Urban patients were more satisfied with telehealth visits compared to in person visits. Research is needed to improve telehealth delivery and satisfaction for rural patients.