Sample Comments from MHQP’s Pandemic Telehealth Experience Surveys

The following is a sampling of verbatim quotes collected in MHQP’s pandemic telehealth experience surveys conducted during the summer of 2021. The purpose of these surveys was to evaluate and contrast telehealth experiences for both clinicians and patients. These quotes illustrate MHQP’s key findings from the surveys.

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Patients Loved Telehealth for Its Convenience
Patients Understood Telehealth Is Not Always Practical
Patients Appreciated Telehealth for Quality and Safety Reasons
Technology Issues Hindered Some Patient Encounters
Clinicians Bemoaned Telehealth Technology More Than Patients Do
Some Clinicians Simply Preferred In-Person Visits
Many Clinicians Recognized that Telehealth Is Better in Some Circumstances
Many Clinicians Found Unexpected Positive Aspects of Telehealth

Most Patients Loved Telehealth for One Reason: Convenience

Here are a few comments from patients that illustrate this point:

“I was able to be seen quickly and efficiently without needing to leave my house which would have required me to get someone to care for my kids, take time off work, etc.”
“The lack of transportation enables me to keep my personal appointments more often as I live very rurally.”
“Instead of spending half a day driving in, leaving extra time for traffic, circling for a parking spot, and walking through the building for five minutes of conversation, I signed on 10 minutes early, turning this into 15 minutes out of my day for the physician to look at my labs and say, ‘Looks the same as the past 10 years. Let’s keep the same medications.’”
“Didn’t have to leave the house. No need to fight traffic or find parking. Same visit as usual otherwise.”
“I could take the call anywhere. I could schedule the call during off hours. This is how healthcare should be, for at least half my ‘visits’!”
“Not having to worry about missing work or being late or having to cancel due to issues with traffic or public transportation.”
“I was able to ask my questions and answer the doctor’s questions concerning my health. The doctor was able to see me and assess my general health.”
“It took me a day or so of psychotherapy to get used to it, and then it felt the same as in person.”
“I probably should have gotten back into therapy years ago but couldn’t picture fitting it into my schedule. The availability of telehealth was a big factor in going back. I also like that my PCP’s office has introduced online scheduling to go along with it.”

Patients Understood that Telehealth Is Not Practical in All Clinical Circumstances

Here are a few comments from patients that illustrate this point:

“Very helpful for follow up visits, and visits which are primarily conversation, not examination.”
“Telehealth has been excellent for our family. It’s obviously imperfect, as you can’t do a proper physical examination over a webcam, but it’s been perfect for mental health and other non-tactile consultations.”
“This was an annual follow-up visit. The only obvious thing missing, was a hands-on examination (e.g., blood pressure, temperature, weight, height, listen to heart & lungs).”
“Dermatologist couldn’t make definitive diagnosis without seeing me up close. My PCP visit was likewise limited to complaints that I could verbalize and did not enable physical examination.”
“Only could do part of the exam as I was not physically with my Dr.”
“A nice balance of telehealth and in person appointments is a great balance to any person with busy schedule.”
“It’s an option for being able to meet patients where they are, though its only good for some types of visits and I would not want it to replace all face to face care.”

Some Patients Appreciated Telehealth for Quality and Safety Reasons

Here are a few comments from patients that illustrate this point:

“Safety of not having to go out in pandemic.”
“Personal safety in terms of balance and walking.”
“Increases flexibility and will probably improve quality of care overall as it increases access as well.”
“The convenience was second to none, and the quality of care as high as in-person.”
“Allows for better management of my BP with my physician.”
“Ease of service. Especially with small children, it’s easier to talk to their pediatrician via a telehealth visit for some sick appts rather than bringing them in person.”
“Less stress: don’t have to worry about timing or parking or getting dressed up. Liked the intimacy & privacy of telehealth from home. Also liked avoiding possible COVID.”

Technology Issues Hindered Some Patient Encounters

Here are a few comments from patients that illustrate this point:

“Both times spent 45 min trying to work out the technology. They were simply not prepared, organized or structured to help ensure success.”
“The provider couldn’t figure out video and had to switch to phone. This was several months into the pandemic. I wonder if they ever figured it out!”
“The software was a little bit clunky.”
“I was fine with Zoom for other things but the technology used by my Dr. was hard to get to work. We actually had to stop and just do a phone call on one of my appointments.”
“The choppy reception and worrying about not having enough data on my phone to do it.”
“Technology at my PCP’s office – you can only do telehealth via their mobile app and you have to use your phone, you can’t use a laptop or computer.”
“When the doctor and their office are ill-prepared technology-wise and then it results in a phone call (when it’s supposed to be video) after all that time and effort; and then I don’t get to have the visual contact (visual/virtual face to face improves the communication and the human connection, especially if it is a doctor you have never met before).”
“Hospitals and Clinics should invest in telehealth devices and improve their internet speed, and support providers on achieving this also in case they work from home.”

Clinicians Bemoaned Telehealth Technology More Than Patients Do

Here are a few comments from clinicians that illustrate this point:

“Frequent crashes/freezes caused me chest pain and caused me to retire sooner than expected. The actual CARE went well, but the technical difficulties wore me OUT.”
“Very little preparation from the people who were supposed to train us. The educational video was very poorly done very long.”
“Total disaster. Waste of my time and my patient’s time.”
“Generally successful video visits occurring about 33% of time.”
“I love to see patient faces and this is lovely, but the time spent trying to help people connect to video adds to my stress.”
“Makes our jobs harder, buggy, slow and rarely enhances care.”
“Seemed to not work well for me most of the time. I don’t have audio with my remote access so I would have to use my personal phone for this which was not ideal.”
“I have struggled with video visits as many of my patients experience poor connections and lag times with their devices during those visits.”
“Bad virtual connections. Having patient show me part of body that needs to be seen… usually they are unable to do so in a manner that helps me.”
“Video visits worked best when we have adequate staff to perform “pre visit” ensuring that patient has video up and running at the time of the visit. When that staffing level is not available, things run much less smoothly.”
“My site did not have a video platform available which limited my ability to obtain objective data about my patients during visits. Challenges also included inaccurate phone numbers, emails or difficulty with a clear connection. Furthermore, there were sometimes issues with patients being pre-occupied with other things, such as driving or errands, during our visits, which I found to be distracting, sometimes dangerous and perhaps slightly rude. Finally, working with (patients with limited English proficiency) virtually was also difficult due to the need to incorporate an interpreter into what could be a technically and feasibly difficult encounter.”

Some Clinicians Simply Preferred In-Person Visits

Here are a few comments from clinicians that illustrate this point:

“Nothing replaces the human physical interaction between physician and patient. A healer needs the incredible unseen power of touch to truly connect with patients.”
“It’s a very poor substitute for person-to-person interactions.”
“It is harder to assess issues requiring a physical exam (cardiovascular, musculoskeletal, dermatologic) and getting people in for in-person care is sometimes logistically hard.”
“Inability to do complete exams and therefore worries about missed diagnosis.”
“Patients also frequently tried to attend visits in inappropriate locations, such as grocery and retail stores, while driving, or in loud locations with distractions inappropriate to a clinical encounter.”
“Reduced closeness/quality of relationship due to not being able to meet patients in person.”
“Not a great replacement for a real exam. Not as emotionally satisfying as an in person visit.”
“I found patient reports of concerns were flatter and less nuanced. I also got much less interpersonal energy and commitment to a shared plan of care. It exhausted me much more than in person care.”

Yet, Many Clinicians Recognized that Telehealth Is Better in Some Circumstances

Here are a few comments from clinicians that illustrate this point:

“The ability to keep closer tabs on the patient’s progress, worries and fears. In the end, this represents greater peace of mind for the patient, and greater job satisfaction for me. While I have always conversed with many patients between visits, it’s great that this type of access is legitimized as actual patient encounters.”
“Making sure the RIGHT thing gets booked for a video visit. I cannot evaluate ear pain by video but on the other hand management of depression medications is almost improved by video because they can speak in the comfort of their own home.”
“Urgent or sick visits are very challenging to conduct, as physical exam is limited.”
“It’s easier to connect/engage clients who had challenges engaging in person.”
“They fill a need and continue to be of benefit for patients who have transportation or childcare barriers to in-person visits. They are particularly useful for behavioral/mental health visits.”
“Great for follow up of stable problems, such as ADHD or mental health issues.”
“Ability to check on patients that don’t need vital signs in office. Able to increase compliance with meds and especially helpful with mental health appointments.”
“I conducted monthly video visits with my complex care patients at a skilled nursing facility. Given that most of a monthly visit involves reviewing records from the past month, this is a great solution for these patients. The telehealth subspecialty visits that occurred were invaluable in that we did not have to load up a trached/vented/wheelchair-bound patient into an ambulance and utilize an extraordinary amount of resources (ambulance, staff, time) taking patients in for these appointments when they can easily occur by video in most cases.”
“I often did these virtual visits while the visiting nurse was at the patient’s bedside. This helped to forge good working relationships with the VNA, and good collaboration with the patient. The only problem with video is that sometimes the technology was not smooth. Assuming this will continue to improve, I think it provides a great ongoing adjunct for flexible connection to our patients.”
“Group therapy over video was extremely beneficial.”
“I have been able to guide patients and caregivers with complex problems. A major advantage has been that patients whose mobility is very poor and would not be able to come to the office have been able to get the care they really needed.”
“Video visits are excellent when the patient has access to internet/internet-accessible device. However, my program works with primarily homeless and low/no income clients who often lack internet-accessible devices, internet access or private spaces that make video telehealth less viable and who benefit more from telephonic telehealth. I think its important to remember that when allowances end for telephonic-only telehealth, this will essentially and unintentionally omit low income individuals, especially those that are homeless from receiving telehealth services which is an equity and parity health issue.”
“Prior to the pandemic, I was often in touch with my wound care patients on the phone. Things come up, and they need guidance or reassurance, or the visiting nurse has a bit of news that should not wait. Prior to the pandemic, none of this time was billable for the hospital, and the documentation burden as an addendum to the prior note was extremely time consumptive. Video visits are best, but when they’re not possible or when there is a bad video connection, telephone visits have been extremely useful. They let me hear the patient’s vocal energy presence to help determine if I think I’m dealing with someone septic. I can tell if they sound newly depressed, etc. With legitimized access to telephone encounters, I feel that I can keep closer contact with my patients, and they feel that it is easy to get hold of me.”
“Home-bound geriatric visits with a family member present have been very satisfying over video. It removes the anxiety about the transfer from house to clinic, and are typically very productive to reconcile medications and answer questions. It also allows frequent check-ins, when needed, without undue burden on the family.”
“These modalities allow patients to safely access providers, and were particularly beneficial to my older patients in inclement weather. There was no fear of falling on the ice or need to go out and shovel the snow to make their appointment. Patients with unreliable transportation were much more likely to make their telehealth appointments.”
“Countless medical issues cannot be sorted out on the phone or in video and we seem to be unable to triage patients correctly to in person vs. televisits/video.”

And Many Clinicians Found Unexpected Positive Aspects of Telehealth

Here are a few comments from clinicians that illustrate this point:

“It is helpful and lovely to see patients in their own homes to see family members and pets wandering in feels more personal I hope patients are more relaxed. easier for family caregivers.”
“Ability to get people seen and work in the comfort of my home with time to reflect and think about patients without the stress and risk of going to the hospital.”
“Ability for patient to be at home, comfortable, and can check their meds, consult with family if necessary.”
“It helped us address lack of revenue during the pandemic by allowing us to adjust our scheduling in the office to be more efficient with employee time. The ability to conduct a virtual visit when on call was helpful as well.”
“Significantly reduced no show rates, improving access.”
“This provides access to care for patients who may not otherwise find a touchpoint with the healthcare system.”
“The biggest joy was being able to stay in touch with patients–most of the time actually seeing them. We had many heartfelt conversations about their fears, uncertainties, and ongoing clinical issues. Many opted for much more frequent visits than they would have in person.”
“As a physical therapist, I have found that using video visits helps me see the mobility challenges that patient’s face in their homes. For example, I can see the chair they sit in which may contribute to their back pain, I can watch them try to perform a sit to stand from their couch, and I can guide them as they navigate the bathroom with a cane.”
“Allows for convenient and safe delivery of healthcare. Reduces waste. Allows for innovation and creation of value.”