Prospective Analysis Of Patient Satisfaction With Inherited Retinal Disease Clinic Visits Conducted Via A Hybrid Telemedicine-Based Approach

Purpose : The COVID-19 pandemic adversely impacted patient access to in-person healthcare, bringing telemedicine to the forefront. The Emory Ophthalmic Genetics Service (EOGS) adopted a hybrid model of care, allowing patients to meet the physician via a video telehealth encounter and separately obtain ancillary in-person diagnostic testing. The goal of this study is to evaluate patient satisfaction and completion rate of diagnostic genetic testing with this novel care model for patients with inherited retinal diseases (IRDs). Methods : Patients age 18 and older who were new to the EOGS and participated in a telemedicine-based IRD clinic appointment after October 1 , 2020, were eligible for this study. After obtaining informed consent, a trained interviewer administered a 14-question survey over the telephone. Each survey item contained 5 Likert-scale response options, assigned a value from 1 to 5. The survey was designed to address two main factors information exchange and patient comfort. A mean favorability index for patient satisfaction was calculated for each item with a score of 5 being most favorable. Completion rate of diagnostic genetic testing was also evaluated. Diagnostic accuracy was determined by comparing the clinical diagnosis to the genetic diagnosis, where available, and results compared to a control group of in-person encounters from July 2019 to December 2019. Results : Sixteen of 21 eligible patients completed the survey (Figure 1). Of these, 7 (44%) were female, with median age 56.5 (range, 25 to 73 years). Patients lived a median of 29.5 miles (range, 5 to 147 miles) from the Emory Eye Center. Six (37.5%), 6 (37.5%), and 14 (87.5%) patients underwent ancillary in-person testing with electroretinography, perimetry, and fundus imaging, respectively. The median (range) favorability index was 5 (4-5) and 4 (3-5) for information exchange and patient comfort, respectively. Responses were favorable (>3) for telemedicine for all survey items except one. Diagnostic genetic testing was recommended for 12 (75%) patients, and completed in 10 (83%) of those. Conclusions : Our results suggest high patient satisfaction with a hybrid telemedicinebased approach for care delivery to patients with IRDs. Further study in a larger sample is warranted.