Annual Scientific Meeting
Introduction: Telehealth is an emerging technology that enables remote video visits between providers and their patients. The role of a telehealth visit prior to high-risk endoscopy has not been evaluated. The purpose of this study was to pilot a patient survey to assess experiences and preferences for different visit types including telehealth (TH), face-to-face (F2F), and direct access (DA) (i.e., without meeting with a GI physician) prior to undergoing advanced endoscopic procedures.
Methods: We developed a survey instrument to assess patient knowledge and preference regarding visit types prior to advanced endoscopic procedures. The survey was refined through input from an expert survey working group. The questionnaire was then administered immediately prior to informed consent to patients undergoing advanced endoscopy procedures at a tertiary referral academic VA medical center. Exclusion criteria included inability to consent and prior exposure to advanced endoscopic procedures. Data were collected on demographics, computer and health literacy, knowledge of procedural risks, benefits, and alternatives, comfort with the proceduralist, visit satisfaction, and overall preference of pre-procedural visit modality. Differences between groups were analyzed using a Chi-Square test.
Results: A total of 40 patients completed the pilot questionnaire (Table 1). 20 patients were in the DA group, 11 in the F2F group, and 9 in the TH group. Most respondents in the TH and F2F visit groups (78% and 82%, respectively) were satisfied with their visit types and would choose the same visit modality in the future (Table 2, Figure 1). In contrast, significantly fewer (30%, p=0.003) in the DA group were satisfied with their visit type. Patients with transportation difficulties were more likely to choose a TH visit (p=0.018).
Discussion: In this pilot survey, a telehealth visit prior to advanced endoscopic procedures appears to be an acceptable alternative to a F2F visit in terms of patient satisfaction. Most respondents preferred a pre-procedural clinic visit with GI (via either telehealth or F2F) over DA, underscoring the importance of a measured discussion about risks and alternatives for high-risk endoscopic procedures. In the future, telehealth could be considered the visit modality of choice for patients referred for advanced endoscopic procedures who live a significant distance from the procedure site. These results will be confirmed with a larger sample in a future study.