الفهرس 
TELEMEDICINEOnly 14 pages are availabe for public view
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Abstract
Video-consultation (VC) is a specialized type of telemedicine that uses technology to provide real-time visual and audio patient assessment at a distance. It`s considered as part of telemedicine which is a broad term comprising several technologies, from digital X-rays to over-the-phone consultations, and utilization of video conferencing. With the onset of covid-19 crisis, massive conversion to telemedicine found and it demonstrates its utility as an effective tool for social distancing in clinical settings.
Video consultations users` satisfaction either patients or providers is a key indicator of how well the telemedicine modality met their expectations. Thus, there is a need to measure the satisfaction with telemedicine.
Objective: To measure satisfaction of patients and providers using video consultations services provided at Ain Shams University Virtual Hospital and identify the factors affecting their satisfaction.
The current study was a descriptive cross-sectional study, conducted to measure the satisfaction of the patients, and healthcare providers towards video consultations during a six months period from December 2020 to May 2021. The target population of the study was all outpatients of different clinic specialties and healthcare providers of different specialties who were involved in video consultations at Ain Shams University Virtual Hospitals during the study period. The sample size was 196 patients and 37 providers who fulfilled the inclusion criteria. The study tools used were two data collection questionnaires, one for providers and the other for patients.
As regards to the questionnaire for patients, it was composed of 2 domains, general satisfaction domain and patient experience domains with a 4-point Likert scale.
Regarding the provider`s “physicians`” questionnaire, it was sent via email. It was composed of two domains, experience domain and satisfaction domain.
As regards to the patients, a total of 187 patients were included, about 83.5% were males, the mean age was (36.8 ± 18.6). The main/highest level of education was university. 61% sought clinic specialty was psychiatry clinic. Smart phones were the most used device in the video consultation. We found that 89.3% of the patients agreed that it was easy to use ”Eksheff.asuvh.com” currently (exeera) application. About 60% of the patients suffered from both poor image and sound quality in video consultations and 90% of them were satisfied with all of the following, degree to which staff respected their privacy, and explanation of their diagnoses and treatment by the specialist in video consultations. About 60% of the patients agreed that lack of physical examination negatively affected the diagnosis/management of their condition. The current study found that 87% of the patients agreed to recommend video consultations to family/friends). 90% of our patients agreed that Video consultations saved their effort, time and money. While 80% would prefer to be seen in person for evaluation or treatment. In the current study, 100% obtained the service they needed, and would repeat video consultations in the future.
The association between patient`s gender, age, educational level and residence with general satisfaction domain wasn`t statistically significant, while the association with specialty, device used and disability status of the patient was statistically significant. As regards to patient experience domain, the association between age, educational level, device used, disability status and residence wasn`t statistically significant, while there was a statistically significant association between male gender, pediatric clinic consultations and good patient experience.
As regards to providers, 29 providers were included, about 48.3% of the sample studied were males, the mean age was 37.97 ±6.3 years. Most of the physicians were lecturers, and psychiatrists were the most involved in the study. Smart phones were the most used device in the video consultation. In the present study, 80% were always confident with their diagnoses in video consultations. It is found that about 14% were never concerned with medical errors in video consultations and it is also found that 13%, 14% always suffered from poor quality of sound and image respectively in the sessions. About 72% of the providers don`t think that video consultation service suitable for following up patients after ICU discharge. Almost all the healthcare providers were satisfied with the privacy of patient information in the sessions. In the current study, 72.4% disagreed that Video consultations cost me more than the in-person consultation. The association between provider`s age, gender, professional title, specialty and device used in video consultation with experience domain satisfaction score was statistically insignificant, the same with satisfaction domain except for the age, ≥ 40 years age group was positively associated with higher satisfaction domain score.
Its recommended to, provide more technical support to improve quality of image and sound during video consultations for patients and providers, encourage physicians to use WIFI instead of 3G/4G for better audio/video quality, to monitor patients` and providers` satisfaction over time and to improve integration of tele-consultations in healthcare systems for continuity of care.
CONCLUSION
from the findings of the present study regarding the patients, we can conclude that:
• Most of patients were generally satisfied with video consultations, while half of them had a positive experience with video consultations.
• More than two thirds of patients agreed that ”Eksheff.asuvh.com” currently (exeera) application was easy to use.
• Most of patients were satisfied with length of time to get an appointment and length of time spent with their physicians.
• Most of patients and application users were satisfied with the degree to which staff respected their privacy and were satisfied with the explanation of the physicians about their diagnoses and treatment.
• Most of patients agreed that video consultations saved them time, effort and money.
• All the patients reported that they obtained the service they needed and they would repeat video consultation experience in the future, and most of them would recommend video consultations to their families/friends.
• Almost half of patients suffered from poor quality of image and sound
from the findings of the present study regarding the providers, we can conclude that:
• Two thirds of the physicians had a positive experience and satisfied with using video consultations in their clinical practices.
• Most of the physicians would recommend video consultations to others and would repeat video consultations in the future.
• Most of the physicians were always confident with their diagnosis, however half of them thought that lack of physical examination affected diagnoses.
• Almost half of physicians agreed that video consultations were suitable for post operative follow up of patients, while two thirds of them thought that video consultations weren`t suitable for follow up of patients discharged from ICU.
• Almost one third of the physicians were always concerned about medical errors.
• Almost one sixth of the physicians suffered from bad quality of image and sound and more than half of them sometimes needed to refer patients to be seen in person.
• The two most frequent causes chosen by physicians for referral of patients were: “patients needed physical examination” and “patients needed investigations”.
• Technical support was the most common suggestion chosen by the physicians to improve the service, followed by sending an alert before video consultation.
RECOMMENDATIONS
• It is recommended to encourage use of video consultations during times of crises and when face to face consultations is not possible and Increase awareness of patients about availability of video consultations.
• It is recommended to provide more technical support to improve quality of image and sound during video consultations for patients and providers and Encourage physicians to use WIFI instead of 3G/4G for better quality.
• Although flexibility in choosing the suitable times of video consultation session by the providers is applied nowadays on ”Eksheff.asuvh.com” currently (exeera) yet it is recommended to offer more time flexibility in working schedules to improve customer satisfaction.
• It is recommended to monitor patients` and providers` satisfaction over time.
• Future studies are needed to measure quality of care provided by video consultations and its relation to clinical outcomes of the patients at different health care system levels.