Telepsychiatry and In-Person Care for Pediatric Patients During COVID-19: Patients Perspectives

Abstract

Background

The COVID-19 pandemic has greatly affected how physicians, including child and adolescent psychiatrists, practice. A major shift came in the form of telehealth, in which patients attend clinic appointments online.

Objectives

The objective of this study was to identify the advantages and disadvantages of the telepsychiatry care delivery system and to devise future strategies to resolve drawbacks to improve patient and caregiver satisfaction.

Methods

A proposal was approved by the University of Missouri-Columbia Internal Review Board to conduct this study. One hundred patients were randomly selected for the study questionnaires. To understand patient satisfaction with telehealth and work toward improvements, this study conducted comparative survey research with 50 patients seen virtually and 50 patients seen in-person. Identical survey questions were filled out by patients and their respective guardians. The survey’s first question asked which setting was preferred during the COVID-19 crisis and was followed by free-response questions prompting responses about what they liked and disliked about telehealth and in-person visits.

Results

Of the 50 patients seen virtually, 72% indicated a preference for telehealth, 14% preferred in-person, and 14% had no preference. These patients stated they preferred telehealth because it was convenient, required no travel and required fewer absences from school or work. A total of 28% of patients listed safety from exposure to COVID-19 as a reason they liked telehealth. Over half of these patients reported no complaints with telehealth, the most common issue according to patients seen virtually was internet connectivity and technology problems. A total of 64% of in-person patients reported a preference for in-person visits during the COVID-19 crisis. Similar to virtual patients, convenience was the most popular advantage of telehealth and personal connection was the most common disadvantage. The second most common complaint regarding telehealth and the highest reported advantage of in-person visits is the element of personal connection. A total of 16% of patients seen virtually and 24% of patients seen in-person reported more accurate assessment advantage of in-person care. These patients listed concerns about body language, vital signs, and other physical symptoms.

Conclusion

With telehealth as a seemingly permanent aspect of medicine, the field of psychiatry must adapt. Expansion of broadband and increasing affordability of high-speed internet connection are practical solutions to technological issues with telehealth. For patients preferring to be seen virtually, a recommendation can be made to have at least the first visit in-person to establish a personal relationship. Vital signs can be checked at home with proper training. Telepsychiatry is likely to continue to be a part of our care delivery system. To that end, we must be vigilant and develop better strategies to improve the quality of patient care and patient satisfaction.

Funding

No funding