Evaluación de la usabilidad de los pacientes atendidos por teleconsultas de gastroenterología post pandemia en una clínica universitaria

Lorena Castro; Rodrigo Quera; Paulina Núñez; Christian von Mühlenbrock; Pamela San Martín; Felipe Donoso; Karin Herrera

doi:10.47892/rgp.2024.443.1735

Authors

Lorena Castro Universidad de los Andes, Centro Enfermedades Digestivas, Clínica Universidad de los Andes, Santiago, Chile. https://orcid.org/0000-0002-6829-6456
Rodrigo Quera Universidad de los Andes, Centro Enfermedades Digestivas, Clínica Universidad de los Andes, Santiago, Chile. https://orcid.org/0000-0001-5854-0526
Paulina Núñez Universidad de los Andes, Centro Enfermedades Digestivas, Clínica Universidad de los Andes, Santiago, Chile; Programa de Enfermedad Inflamatoria Intestinal, Hospital San Juan de Dios, Santiago, Chile; Facultad Medicina Occidente, Universidad de Chile, Santiago, Chile. https://orcid.org/0000-0003-3727-1851
Christian von Mühlenbrock Universidad de los Andes, Centro Enfermedades Digestivas, Clínica Universidad de los Andes, Santiago, Chile. https://orcid.org/0000-0001-5285-1147
Pamela San Martín DIDeP, Área de Investigación, Clínica Universidad de los Andes, Santiago, Chile; IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Universidad de los Andes, Santiago, Chile; Centro de Investigación e Innovación Biomédica, Facultad de Medicina, Universidad de Los Andes, Santiago, Chile. https://orcid.org/0000-0003-1974-3050
Felipe Donoso Universidad de los Andes, Centro Enfermedades Digestivas, Clínica Universidad de los Andes, Santiago, Chile. https://orcid.org/0009-0000-1467-6026
Karin Herrera DIDeP, Área de Investigación, Clínica Universidad de los Andes, Santiago, Chile; Programa de Nutrición y Ciencia de los Alimentos, Universidad de Granada, Granada, España. https://orcid.org/0000-0003-1841-5266

DOI:

https://doi.org/10.47892/rgp.2024.443.1735

Keywords:

Telemedicine, Testing, usability, Gastroenterology

Abstract

Telemedicine has grown during the COVID-19 pandemic. Gastroenterology at Clínica Universidad de los Andes has continued it post-pandemic. Usability is the measure by which users evaluate the effectiveness, efficiency, and satisfaction in telemedicine. The usability of this type of consultation in Chile is unknown. Objective: To evaluate the level of usability among patients attended through teleconsultations in Gastroenterology at Clínica Universidad de los Andes (March-August 2023). Materials and methods: A cross-sectional descriptive study on the level of usability using the adapted and modified Telehealth Usability Questionnaire. It consists of 12 items (score range 12-84) and comprises 2 factors: effectiveness and ease of use. Sociodemographic characteristics were also evaluated. Results: A total of 150 questionnaires were analyzed. A high level of usability was observed (median: 81; range 54-84), with high scores in effectiveness (median: 28; range 20-28) and ease of use (median: 53; range 30-56), without significant differences according to sex, age, educational level, geographic location, and health insurance. Of the respondents, 76.7% were aged 30 to 64 years. 36% resided in the metropolitan region, 61% were women, and 80% were from the private health system. 29% consulted for abdominal pain, 20% for inflammatory bowel disease, and 17% for abnormal liver function tests. For 53.3%, it was their first consultation, and 46.7% were in follow-up via this method. Conclusion: In this cohort, telemedicine is perceived as an effective and easy-to-use tool, with a high level of usability regardless of the patients' sociodemographic characteristics. Therefore, in gastroenterology, telemedicine appears to be a form of healthcare accepted by patients.

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References

Organización Panamericana de la Salud. Marco de Implementación de un Servicio de Telemedicina [Internet]. Washington, D.C.: OPS/OMS; 2016 [citado el 15 de enero de 2024]. Disponible en: http://iris.paho.org/xmlui/bitstream/handle/123456789/28413/9789275319031_spa.pdf?sequence=6&isAllowed=y

Drerup B, Espenschied J, Wiedemer J, Hamilton L. Reduced No-Show Rates and Sustained Patient Satisfaction of Telehealth During the COVID-19 Pandemic. Telemed J E Health. 2021;27(12):1409-1415 doi: 10.1089/tmj.2021.0002.

Lahat A, Shatz Z. Telemedicine in clinical gastroenterology practice: what do patients prefer? Therap Adv Gastroenterol. 2021;14:1756284821989178. doi: 10.1177/1756284821989178.

Lee T, Kim L. Telemedicine in Gastroenterology: A Value-Added Service for Patients. Clin Gastroenterol Hepatol. 2020,18(3):530-3. doi: 10.1016/j.cgh.2019.12.005.

Wegermann K, Patel Y, Wilder J. Health Equity and Telemedicine in Gastroenterology and Hepatology. Clin Gastroenterol Hepatol. 2021;19(8):1516-1519. doi: 10.1016/j.cgh.2021.04.024.

Greenberg-Worisek AJ, Kurani S, Finney Rutten LJ, Blake KD, Moser RP, Hesse BW. Tracking Healthy People 2020 Internet, Broadband, and Mobile Device Access Goals: An Update Using Data From the Health Information National Trends Survey. J Med Internet Res. 2019;21(6):e13300. doi: 10.2196/13300.

Cortes F, Tezanos-Pinto P De, Helsper E, Lay S, Manzi J, Novoa C. ¿Se ha reducido la brecha digital en Chile? Diferencias entre acceso, uso y factores asociados al empleo de Internet. MIDevidencias [Internet]. 2021 [citado el 15 de enero de 2024];22:1-6. Disponible en: https://www.mideuc.cl/wp-content/uploads/2020/08/MIDevidencias-N22.pdf

Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, et al. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011;364(23):2199-207.doi: 10.1056/NEJMoa1009370.

Piao C, Terrault NA, Sarkar S. Telemedicine: An Evolving Field in Hepatology. Hepatol Commun. 2019;3(5):716-721. doi: 10.1002/hep4.1340.

Lewin S, Lees C, Regueiro M, Hart A, Mahadevan U. International organization for the study of infammatory bowel disease: global strategies for telemedicine and infammatory bowel diseases. J Crohns Colitis. 2020;14(14 Suppl 3):S780-S784. doi: 10.1093/ecco-jcc/jjaa140.

Lees CW, Regueiro M, Mahadevan U. Innovation in infammatory bowel disease care during the COVID-19 pandemic: results of a global telemedicine survey by the international organization for the study of infammatory bowel disease. Gastroenterology. 2020;159(3):805-808.e1. doi: 10.1053/j.gastro.2020.05.063.

Perisetti A, Goyal H. Successful Distancing: Telemedicine in Gastroenterology and Hepatology During the COVID-19 Pandemic. Dig Dis Sci. 2021;66(4):945-53. doi: 10.1007/s10620-021-06874-x.

Middleton B, Bloomrosen M, Dente MA, Hashmat B, Koppel R, Overhage JM, et al. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. J Am Med Inform Assoc. 2013;20(e1):e2-8. doi: 10.1136/amiajnl-2012-001458.

Klaassen B, van Beijnum BJ, Hermens HJ. Usability in telemedicine systems-A literature survey. Int J Med Inform. 2016;93:57-69. doi: 10.1016/j.ijmedinf.2016.06.004.

Hajesmaeel-Gohari S, Bahaadinbeigy K. The most used questionnaires for evaluating telemedicine services. BMC Med Inform Decis Mak. 2021;21(1):36. doi: 10.1186/s12911-021-01407-y.

Parmanto B, Lewis, Jr. AN, Graham KM, Bertolet MH. Development of the Telehealth Usability Questionnaire (TUQ). Int J Telerehabilitation. 2016;8(1):3-10. doi: 10.5195/ijt.2016.6196.

Telemedicine in Chile: use, development and controversies in a southern public health network of country. Rev Chil Salud Pública. 2022;26(1):48-57. doi: 10.5354/0719-5281.2022.69151.

Flores R, Donoso R, Anguita R. Modelo de manejo en red y por telemedicina de la retinopatía diabética en dos comunas del Servicio de Salud Metropolitano Oriente [Management of diabetic retinopathy using telemedicine and network integration]. Rev Med Chil. 2019;147(4):444-450. doi: 10.4067/S0034-98872019000400444.

Ramírez-Cornejo C, Muñoz-López C, Del Barrio-Díaz P, Jaque A, Majerson D, Navarrete-Dechent C, et al. Rápida implementación de teledermatología durante la pandemia por COVID-19: lecciones aprendidas de un departamento académico de Dermatología. Rev Med Chil. 2021;149(10):1467-1472. doi: 10.4067/s0034-98872021001001467.

Morales P ÁJ, Torrealba F JI, Bergoeing R M, Mariné M L, Mertens M R, valdÉs E F, et al. Telemedicina en cirugía vascular y endovascular: experiencia en un centro universitario. Rev Med Chil. 2022;150(5):611-617. doi: 10.4067/s0034-98872022000500611.

Fuenzalida C J, Solari G C, Farías J M, Naveas P R, Poblete L JA. Evaluación de un modelo remoto de seguimiento de pacientes embarazadas y puérperas con infección por SARS-CoV-2. Rev Chil Obstet Ginecol. 2020;85(Suppl 1):S35-S49. doi: 10.4067/S0717-75262020000700007.

Torre AC, Bibiloni N, Sommer J, Plazzotta F, Angles MV, Terrasa SA, et al. Traducción al español y adaptación transcultural de un cuestionario sobre la usabilidad de la telemedicina. Medicina (B. Aires). 2020;80(2):134-137.

Bibiloni N, Torre AC, Angles MV, Terrasa SA, Vazquez Peña FR, Sommer J, et al. Validación de un cuestionario en español sobre la usabilidad de la telemedicina. Medicina (B. Aires). 2020;80(6):649-653.

Economic Cooperation and Development (OECD). OECD Health Policy Studies: The COVID-19 Pandemic and the Future of Telemedicine [Internet]. Paris: OECD Publishing, 2023 [15 de enero de 2024]. Disponible en: https://doi.org/10.1787/ac8b0a27-en

Chomalí M, García A, Härtel S, Liberona F, Pino R, Prado G, et el. Guía de buenas prácticas y recomendaciones para innovar en salud [Internet]. Santiago: Centro Nacional en Sistemas de Información en Salud; 2024 [citado el 15 de marzo de 2024]. Disponible en: https://cens.cl/wp-content/uploads/2024/04/CENS-Guia-de-buenas-practicas-y-recomendaciones-parainnovar-en-salud_compressed.pdf

Hatef E, Lans D, Bandeian S, Lasser EC, Goldsack J, Weiner JP. Outcomes of In-Person and Telehealth Ambulatory Encounters During COVID-19 Within a Large Commercially Insured Cohort. JAMA Netw Open. 2022;5(4):e228954. doi: 10.1001/jamanetworkopen.2022.8954.

Predmore ZS, Roth E, Breslau J, Fischer SH, Uscher-Pines L. Assessment of Patient Preferences for Telehealth in Post-COVID-19 Pandemic Health Care. JAMA Netw Open. 2021;4(12):e2136405. doi: 10.1001/jamanetworkopen.2021.36405.

Wegermann K, Wilder JM, Parish A, Niedzwiecki D, Gellad ZF, Muir AJ, et al. Racial and Socioeconomic Disparities in Utilization of Telehealth in Patients with Liver Disease During COVID-19. Dig Dis Sci. 2022 Jan;67(1):93-99. doi: 10.1007/s10620-021-06842-5.

Kim RG, Medina SP, Magee C, Khalili M. Fatty liver and the coronavirus disease 2019 pandemic: health behaviors, social factors, and telemedicine satisfaction in vulnerable populations. Hepatol Commun. 2022,6(5):1045-55. doi: 10.1002/hep4.1873.

Torres-Quevedo R. Déficit de médicos especialistas en las regiones y en el sistema público. Rev Chil Cir. 2016;68(4):279-280. doi: 10.1016/j.rchic.2016.05.001.

Dobrusin A, Hawa F, Gladshteyn M, Corsello P, Harlen K, Walsh CX, et al. Gastroenterologists and patients report high satisfaction rates with telehealth services during the novel coronavirus 2019 pandemic. C Clin Gastroenterol Hepatol. 2020;18(11):2393-2397.e2. doi: 10.1016/j.cgh.2020.07.014.

Shah R, Wright E, Tambakis G, Holmes J, Thompson A, Connell W, Lust M, Niewiadomski O, Kamm M, Basnayake C, Ding J. Telehealth model of care for outpatient inflammatory bowel disease care in the setting of the COVID-19 pandemic. Intern Med J. 2021;51(7):1038-1042. doi: 10.1111/imj.15168.

Nguyen NH, Martinez I, Atreja A, Sitapati AM, Sandborn WJ, Ohno-Machado L, et al. Digital health technologies for remote monitoring and management of inflammatory bowel disease: a systematic review. Am J Gastroenterol. 2022;117(1):78-97. doi: 10.14309/ajg.0000000000001545.

Pang L, Liu H, Liu Z, Tan J, Zhou LY, Qiu Y, et al. Role of telemedicine in inflammatory bowel disease: systematic review and meta-analysis of randomized controlled trials. J Med Internet Res. 2022;24(3):e28978. doi:10.2196/28978.

Gellad ZF, Diamond S, Crockett SD, Cross RK. AGA Clinical Practice Update on Telemedicine in Gastroenterology: Commentary. Gastroenterology. 2023;164(4):690-695. doi: 10.1053/j.gastro.2022.12.043.