Patient Acceptance of Teleurology via Telephone vs Face-to-Face Clinic Visits for Hematuria Consultation at a Veterans Affairs Medical Center

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Abstract

Introduction

We evaluated the experience and preferences of patients undergoing hematuria consultation via teleurology compared to a conventional face-to-face clinic visit.

Methods

Patients evaluated for hematuria with teleurology or face-to-face clinic visit were surveyed regarding their experience and preferences. The survey consisted of 27 questions evaluating overall acceptance and satisfaction (8 questions), impact factors (17) and preference (2).

Results

A total of 450 patients participated in the survey at a 2-to-1 ratio (300 via teleurology, 150 via face-to-face visits). Overall, patient satisfaction level was higher with teleurology compared to face-to-face clinic visits (mean score 9.2 vs 8.4, p <0.0001). This finding was observed in all 8 domains (acceptance, efficiency, convenience, friendliness, quality of interview, communication and care, provider professionalism and privacy protection, all p <0.001). Transportation related issues were the most common underlying reason that influenced patient opinion, with at least 1 transportation factor being reported by 280 of 300 teleurology patients (93.3%) and 133 of 150 patients seen face-to-face (88.7%). Clinic operation and provider interaction factors similarly impacted patient satisfaction and preference. Time to access was significantly better for teleurology (12 days) compared to face-to-face clinics (72 days, p <0.001). Overall incidence of bladder cancer was 5.6% (25 of 450 patients), which was observed in 6.3% of the teleurology group (19 of 300) and 4.0% of the face-to-face group (6 of 150, p = 0.386).

Conclusions

Patients prefer teleurology to face-to-face clinic visits for the initial evaluation of hematuria. Teleurology positively impacts compliance and access by potentially eliminating common challenges facing patients, and by improving efficiency, convenience and flexibility.

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