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TELEHEALTH SATISFACTION �AT KENNEDY KRIEGER INSTITUTE DURING SARS-COV-2 PANDEMIC

Jasmin Thames

Johns Hopkins University

Kennedy Krieger Institute, MCH-LEARN

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BACKGROUND

  • Prior SARS-CoV-2
    • Limited telehealth coverage from Medicare
  • Emergency telehealth legislation
  • Rametta et al. (2020): Child neurology visits
        • For children who had a virtual neurology visit since the COVID-19 pandemic, 93.3% of their caregivers rated it as somewhat or very satisfactory
  • Fairweather, Lincoln & Ramsden (2016): Speech- language pathology in rural AU
          • Families living in rural areas and were on a waitlist for their child's treatment appreciated the convenience of telehealth services

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AIMS/HYPOTHESES

To determine what variables affect patient satisfaction

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    • Patient age
      • Limited literature found
      • Adolescents 🡪 higher satisfaction ratings

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    • Type of service received
      • Limited literature found
      • Complex/hands-on services 🡪 Lower satisfaction ratings

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METHODS

Procedures

  • Surveys sent to patients that had a telehealth visit via Zoom between March and May.
    • First survey 🡪 June 1st
    • Reminders 🡪 June 8th and 11th
  • Measures:
    • Demographics
    • 2 questions about telehealth:
      • Satisfaction and Willingness to Use Telehealth
      • Response scale: Likert Scale (1: Not satisfied – 5: Very satisfied)

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Participants

  • Completed for most recent telehealth encounter
  • About 7,000 families received the survey
    • To date ~2,100 have responded; complete data available for 1,864
  • Subset of data analyzed
    • Caregiver responses only
    • Patient age < 21 years

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ANALYSIS

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Sample Demographics N=1,864

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Frequency

%

Age in Years

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0-5

359

19.3

6-10

642

34.4

11-15

558

29.9

16-20

305

16.4

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Service Type

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Behavioral Health

986

52.9

Medicine

555

29.8

Multidisciplinary

108

5.8

Therapeutic Services

215

11.5

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Sample Demographics N=1,864

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Frequency

%

Insurance Type

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Public

1,292

69.3

Private

572

30.7

Race

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Black/African American

545

29.2

White/European American

915

49.1

Asian

124

6.7

Native American

4

0.2

Multi-Racial

47

2.5

Unknown/Other

209

11.2

Ethnicity

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Hispanic

22

1.2

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Variable

Obs.

Mean

Std. Dev.

Median

Skew

Satisfaction

1,745

4.61

0.72

5

-2.57

Telehealth again

1,525

4.15

1.12

5

-1.24

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ANALYSES

  • Non-parametric
    • Kruskal-Wallis ANOVA test
    • Post-hoc Bonferroni pairwise comparison

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RESULTS

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DISCUSSION

  • Satisfaction did not differ between age groups or service types

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  • Willingness to use telehealth was significantly different between 0-5 age group and all other age groups (p < 0.001)

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  • Willingness to use telehealth was significantly different between the following groups:
    • Therapeutic Services and Behavioral Health (p = 0.011)
    • Therapeutic Services and Medicine (p = 0.003)
    • Multidisciplinary and Medicine (p = 0.029)

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  • Caregiver comments: Difficulty engaging and observing children via telehealth, particularly for therapy services

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CONCLUSIONS

  • Implications
    • Overall, caregivers endorsed high satisfaction with telehealth
    • Caregivers of children < 6 years were less willing to use telehealth in the future compared to caregivers of older children
    • Caregivers of children who received behavioral health and medical services were more willing to use telehealth in the future compared to multidisciplinary and therapeutic services
    • Caregivers identified a need for strategies to improve engagement
  • Future Directions
    • Does patient’s distance from clinic affect telehealth satisfaction rating?
    • What are ways to better engage younger children via telehealth?

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ACKNOWLEDGEMENTS

Dr. Andy Zabel

Dr. Rachel Peterson

Dr. Andrea Young

Dr. Harolyn Belcher

Dr. Nikeea Copeland–Linder

Dr. Kathryn Van Eck

Dr. Jenese McFadden

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QUESTIONS

Contact: jthames5@jhu.edu

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BIBLIOGRAPHY

Fairweather, G. C., Lincoln, M. A., & Ramsden, R. (2016). Speech-language pathology teletherapy in rural and remote educational settings: Decreasing service inequities. International Journal of Speech-Language Pathology, 18(6), 592. https://10.3109/17549507.2016.1143973

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Grogan-Johnson, S., Alvares, R., Rowan, L., & Creaghead, N. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of Telemedicine and Telecare, 16(3), 134. https://10.1258/jtt.2009.090608

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Holcomb, D., Faucher, M. A., Bouzid, J., Quint-Bouzid, M., Nelson, D. B., & Duryea, E. (2020). Patient Perspectives on Audio-Only Virtual Prenatal Visits Amidst the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic. Obstetrics & Gynecology, 136(2), 317. https://10.1097/AOG.0000000000004026

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Polinski, J., Barker, T., Gagliano, N., Sussman, A., Brennan, T., Shrank, W., Polinski, J. M., Brennan, T. A., & Shrank, W. H. (2016). Patients' Satisfaction with and Preference for Telehealth Visits. JGIM: Journal of General Internal Medicine, 31(3), 269. https://10.1007/s11606-015-3489-x

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Rametta, S. C., Fridinger, S. E., Gonzalez, A. K., Xian, J., Galer, P. D., Kaufman, M., Prelack, M. S., Sharif, U., Fitzgerald, M. P., Melamed, S. E., Malcolm, M. P., Kessler, S. K., Stephenson, D. J., Banwell, B. L., Abend, N. S., & Helbig, I. (2020). Analyzing 2,589 child neurology telehealth encounters necessitated by the COVID-19 pandemic. Neurology, 95(9), e1257. https://10.1212/WNL.0000000000010010

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CONCLUSION

  • Implications about Telehealth
    • May not be the most desired form of health services for children age 0-5
    • May not the ideal for receiving therapeutic services
    • Poses challenges to effectively engaging and examining patients

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  • Future Directions
    • Does patient’s distance from clinic affect telehealth satisfaction rating?
    • What are ways to better engage younger children via telehealth?

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