Patient Satisfaction of Telehealth with an Emphasis on Women’s Health

Patient Satisfaction of Telehealth with an emphasis on Women's Health: A Meta-Analysis

Introduction

Scope of Study

Telehealth is perceived as the new frontier for healthcare treatment delivery in the United States. With its increased implimentation across an array of medical specialties, the benefits of telehealth influence a wide scope. Telehealth has been shown to yeild an increase in convinience and accessibility to the patient, providing an overall positive satisfaction. Telehealth treatment is not confined to one specialty or clinical standard. Relating closely to clinical psychology, Neuroscience and Behavior consists of two major components to its study; quantitative medicinal sciences, and the analysis of human behavior. Human behavior and psychology play a major part in assessing patient satisfaction, concinciding greatly with human factors and preference statistics. This observational study aims to investigate the effect of patient satisfaction from virtual medicine as a means of clinical treatment delivery. A meta-analysis was synthesized using methods of literature review. Taking into account the author's background in Women's Health clinical care and Neuroscience, not only is the quality of care a main focus for this investigation, the step further into patient satisfaction holds the same level of importance. The buissiness of Telehealth, its code of ethics, stakeholders, population and community all influence the fundamental of the Telehealth practice entirely. Each factor is a variable into the study of its patient satisfaction. This observational study of Telehealth patient satisfaction will be analyzed through meta-analysis of multiple resources, with an enphasis on Women's clinical and mental health. When evaluating options for delivery of care, does Telehealth exhibit a comparable satisfaction in Women’s Health to conventional in-office visits? The testing hypothesis of this analysis is whether Telehealth exubarates an overall and comparable level of treatment satisfaction for female patients. 

Previous Research

A literature review was conducted to compile articles pertaining to patient satisfaction of telehealth across an array of variables. Article legitimacy was priotitized through proper investigative technique and source confirmation. Scientific articles used were compiled from wellknown journal publications such as PubMed, KFF, Liebertpub, the American Journal of Preventative Medicine, and more. To account for a variety of source types, news articles were also compiled from the reputible newsource HealthIT News. With objective intent behind proper source preparation and selection, highly reputable and varying sources were used to analyze overall patient satisfaction of Telehealth as a whole. 

Previous research reflects a wealth of statistical data pertaining to overall patient satisfaction of Telehealth, most especially in the wake of the Covid-19 pandemic. In correspondence to patient satisfaction of telehealth among differing socioeconomic groups, 60% of patients within a sample of underserved individuals residing in a rural area on the US-Mexican boarder consider telehealth as a comparable option to in-person visits (Phenicie et. al., (2021). Patient satisfaction trends among metropolitan and affluent populations’ also provide evidence for patient contentment. Research shows telehealth insurance claims increased twentyfold during the pandemic. Following a 50% decline in office-centered patient visits, telehealth was concieved as the primary-most means of providing care to the insured in the year 2020 (Cantor, et. al., 2021). Telehealth is also shown to provide patient satisfaction across multiple specialties. 83.7% of patients at a Spine Physical Medicine and Rehabilitation Institude presented satisfaction in their care, and 67.4% would prefer telehealth visits in place of conventional patient visits (Bhuva et. al., 2020). Whereas among the pediatric care specialty, patient satisfaction statistics also yield an overwhelming response of telehealth preferedness in comparison to in-office visits. Most preferred for by parents in diagnosis and treatment of acute childhood illnesses and preventitive medicine (Conners, 2021). Based on the compiled research, is it evident that treatment delivery through telehealth is comparable, if not even more convenient for patients than in-office visits. This data reflects patient satisfaction of Telehealth across a wide array of specialties, but what about Women's Health specifically?

This study illuminates the subset of female specific virtual care and Telehealth treatment means. In terms of Women’s Health clinical care, Telehealth is utilized commonly by providers for the relay of preventitive medical information. Pertaining to test result elaboration and follow-up appointments, Telehealth has gained a large presence in the realm of the obestrics and gynecology subdivision of female healthcare. Birth control management can be contucted online with ease, saving many women a trip to the office for various collaborative based appointments. Virtual options for prenatal care have also been shown to demonstrate success most commonly among second or third time mother's, emphasising that "the virtual-care model was selected by significantly more women who already have children than those experiencing pregnancy for the first time" (Plugeisen, Mou 2020). While there are still some barriers influencing ellicit patient satisfaction for obestric management via Telehealth, the option for more consistant collaboration between the physician and mother is noteworthy for patients. Online health technology greatly influences the accesibility of quality of Women's health preventitive care, allowing healthcare professionals to more easily assist and collaborate with patients pertaining to cervical and breast cancer screening. Similar to prenatal care, there are still many aspects of Women's Health that are required to be conducted in-office such as pap smears, mammograms, and testing of sexually transmitted diseases. Follow-up visits and results conversations have shown to be popular topics among Telehealth treatment in women. What shows the most promise among research regarding women's satisfaction with Telehealth is the availability and accesibility to conduct collaborative care and create a stronger line of communication between patient and provier (Weigel et.,al 2019). However with the rise in Telehealth utilization in recent years, the statistics are widely variable per specialty. Telehealth delivery for treatment in women's care is utilized at a much lower rate than other specialty types. With the positive feedback recieved by women using Telehealth platforms for preventitive and diagnostic care, it may seem that more virtual options need to be available. 

Problem of Interest

Through its provision of increased patient accessibility and convinience in conducting both diagnostic and preventative Women's care virtually, Telehealth has gained popularity among providers and patients alike. Following the Covid-19 pandemic, Telehealth has become a recognizable and satisfactory means of treatment to many. As crucial the treatment option of Telehealth is in itself, is the study of its satisfaction on patients. In order to gain an understanding of its efficacy for treatment and awareness for what works, and what does not, investigative study on patient satisfaction is the heart of its future development and continued treatment  success. 

Contributing Parties

Population

The study population for this meta-analysis testing for patient satisfaction of Telehealth among women's healthcare would be most notibly the patients themselves. In order to obtain a proper understanding of a well-rounded, unbiased standpoint, the entire population of female patients must be taken into account across an array of multiple variables. This variety is aimed to provide evidence of Telehealth satisfaction from the most sources possible to enstill a true judgement on Women's satisfaction to their virtual healthcare. This is done in hopes to evaluate true opinions, independent of  variables like socioeconomic status differences or location. Thus laying the foundation to investigate transparent and non-populativly dependent patient opionions on their satisfaction with telehealth. For example, prior to the federal temporary extension increasing covered and reimbursed Telehealth services, some state insurance required patients to reside in a rural region to utilize the service. Telehealth in Women's care is increasing in popularity and can be percieved as fairly new as opposed to other specialties. Yet this extension may have served as a catalyst for the Women's Health specialty to optimize virtual methods. With more coverage and reimbursment enstilled from the temporary extension, it allowed for a wider band of the female population to utilize Telehealth for their preventitive and diagnostic care. 

Community

A patient centered approach is a proper explination behind the community of interest in this study. With a collaboration between members of a care team and the patient themselves, a cohesive network exists with the patient's needs as the focal point. This community of healthcare professionals with a patient centered focus is consistant with both face-to-face and virtual treatments. In terms of this study, this community is focused strictly on Women's care. Providers included in this community can be OB-GYN Medical Doctors, WHNP providers, and even PCP's. The virtual community of Women's Health treatment professionals ultimatelty extends to the scope of practice reimbursment and patient insurance coverage. The buissiness of Telehealth significantly effects the implimentation of its practice. “Service parity and payment parity for telehealth across all insurers would help increase access for patients and incentivize providers to offer these services,” (Weigel, 2021) according to a study conducted on telemedicine opportunities and barriers. Based on the nature of positive patient satisfaction of telehealth, more and more patients desire the option to conduct treatment from home if medically appropriate. It seems that once this parity is in place, insurance companies do not have the option to return back to the latter. 

Stakeholders

Stakeholder's influenced by Telehealth patient satisfaction is consistant with the community and population of individuals involved. Patients for example hold the most stake, as the influence of accessible treatment and delivery is crucial to the sake of their health. It is necessary for patient's to recieve and have access to quality and effective care. Based on the satisfaction data above, for most that would be accessibility for the option of Telehealth. Provider's too, are stakeholders when it comes to the ideal of patient satisfaction with Telehealth. With increase in Telehealth treatment popularity among their patients, the more provider's will be reimbursed for their services. The concept of satisfied and cared-for clients is another major contributor for stakeholder position pertaining to providers. For the stakeholder groups listed above, there are cultural and social issues that affect the level at which telehealth is conducted by insurance companies. Privatized insurance companies typically offer different coverage and abide by their own regulations and policies opposed to state Medicaid or federal Medicare. In terms of virtual Women's Health, this may pose an issue of accessibility for lower socioeconomic groups, creating a barrier in terms of healthcare continuity. With the ability for privatized companies to operate at their own policies, the options for virtual Women's Care may be more extensive than state and federal insurance. Culturally and socially speaking, those with lower income often cannot afford private insurance with high premiums and out-of-pocket costs. While, those who do subscribe to private insurance companies are alloted more leeway in terms of Telehealth coverage and provider reimbursement. This difference in continuity between state Medicaid and privatized insurance companies’ policies may constitute a socioeconomic gap in access to telemedicine accessibility and is a potential implication to females who require virtual women's care. (Center for Connected Health Policy, 2021)

Current Human and Health Services Practices

Today, there are a few notable Human and Health Service practices in place in attempt to mitigate this disparity. Many professionals in the field of healthcare and public health are initiating a stride to continue the temporary extension of covered and reimbursed Telehealth benefits. In order to reinstate Telehealth as a viable option for patients who require its means, many allocations from the public are being put in place to ensure the parity remains. According to a letter from the chair of the Statewide Oversight Commission on Mental Health Workforce Development to Governor Chris Sununu, there was a “70 percent increase in psychotherapy” (Wildofo, 2020) following the Executive Order 2019-03 grant to extend legal policy coverage for Telehealth provision. Many believe that reimbursement should not be determined by the means of delivery if the level of care is consistent and adequate to in-person visits. With continuation of the parity, the extension of covered Telehealth services will also continue. As Women's Health is not a conventional Telehealth treatment specialty, its provision has the potential to forsee extreme effects if the parity does not continue. 

Ethical Concerns

Ethical practice plays a significant role in healthcare as a whole, but has notable importance in regards to Telehealth provision. As for Women's Health clinical assistants, every single aspect of the job description pertains to an immense responsibility of ethics. For the sake of patient's care most importantly, but also office and lab regulations, licensing and legality. Following HIPAA guidelines and proper use of HPI is one of the most important considerations. Bringing treatment online can of course bring about a variety of challenges in terms of telehealth security. As well as the location in which the patient and/or the provider are conducting the call. These challenges can be avoided by utilizing a secure platform for telehealth calls and communications, especially when accessing or referencing any PHI. According to Techradar (2021) the best-rated platforms for Telehealth in 2021 are Mend, Doxyme, AMC health and more. When electronically collaborating for the purpose of patient treatment with other staff, the patients member ID must be used in transactions, never giving away any identifyable information.For healthcare professionals, following the code of ethics is crucial when taking on responsibility to treat patients with their sensitive health information. The Code of Ethics for the American Association of Medical Assistants is as follows: 

“Render service with full respect for the dignity of humanity. Respect confidential information obtained through employment unless legally authorized or required by responsible performance of duty to divulge such information. Uphold the honor and high principles of the profession and accept its disciplines. Seek to continually improve the knowledge and skills of medical assistants for the benefit of patients and professional colleagues. Participate in additional service activities aimed toward improving the health and well-being of the community” (AAMA, 2021). 

Discussion

While it is not possible to articulate patient satisfaction with Telehealth across every different factor or context, it is important to consider the data pertaining to the benefits and quantifyable satisfaction with its practice among women. Research suggests that women overall view Telehealth treatment for their healthcare as a suitable and satisfying method comparitive to in-person treatment visits. While there is not enough research yet tying each subdivision of Women's health to Telehealth utilization satisfaction, the assumption that is is a suitable method if advised can be assumed. There are still many instances in which Women's healthcare is required to be conducted in-office, however allowing the option for collaborative preventitive and dignostic care has been shown to be very promising. The compilation of Women's Health and Telehealth is still in its infancy but following the temporary extended coverage for Telehealth treatment, it will continue to portray growth. In conclusion, Telehealth is a very great resource for collaboration between patients and their providers regarding their Women's Health treatment. Gynecological treatments, Obstetrics treatments, and regular well-women care are all major elements benefited by virtual practice. The next step for research on this new topic would be continuous analyzation of the policies, ethics, and patient satisfaction regarding virtual Women's Care specialty treatment. As the world shifts to technology, one can assume the trend in virtual healthcare will everso increase. It is important to analyze patient satisfaction for treatment services like Telehealth in order to fine-tune its practice and ensure upmost quality of patient care.