Multispecialty Synchronous Telehealth Utilization and Patient Satisfaction Within Regional Health Command Europe: A Readiness and Recapture System for Health

Abstract

Background: Telehealth implementation within the Military Healthcare System continues to advance toward the goal of a mature regional health platform; however, specialty-specific usage or patient satisfaction regarding synchronous or "real-time" telehealth at the regional military hospital level has not been described.

Methods: A retrospective review of synchronous telehealth encounters and patient satisfaction surveys from Landstuhl Regional Medical Center (LRMC) specialty clinics engaging in synchronous telehealth to regional Army Health Clinics (AHCs) during 2015 was conducted.

Results: 2,354 synchronous telehealth encounters were conducted for 1,886 unique patients. The majority of patients were adults (88.4%), male (71.1%), and active duty (75%). Twelve distinct distant locations were engaged in synchronous telehealth with 31 distinct specialties. 1,552 (62.5%) patients had a single telehealth visit with a median (range) of 1 (1-7) visit. Median (range) visits per specialty was 25 (1-582) with sleep medicine (24.7%), general surgery (13.1%), nutrition (9.7%), orthopedics (9.0%), and ENT (6.0%) representing 62.5% of all encounters. Median (range) number of encounters per location was 146 (13-685). Surgical specialties preferentially evaluated patients at locations with a specialty-trained presenter (p < 0.001), whereas nonsurgical specialties did not (p > 0.05). Fifteen percent (372/2,354) of patients completed an anonymous survey at the time of their telehealth visit. Mean responses on a 5-point Likert scale ranging from "strongly disagree" (1) to "strongly agree" (5) was 4.8 ± 0.5 for both recommending and being satisfied with their telehealth visit. The 2,354 telehealth visits represented 2.4% (2,354/100,094) of all visits to LRMC during 2015 for 25 of 31 specialties whose total outpatient visits could be determined.

Conclusion: Clinic utilization varied between specialties as well as whether a specialty-trained patient presenter was preferred. This robust multispecialty synchronous telehealth experience provides insight into both specialty-specific utilization and patient satisfaction which may aid regional medical centers recognizing avenues for specialty-specific telehealth initiatives.