Telehealth Satisfaction: Up for Clinicians, Down for Patients

(October 2022)

Two-and-a-half years since the beginning of the pandemic, what have we learned about telehealth and how can we make it better for everyone? MHQP has endeavored to answer this question throughout the pandemic in multiple ways.

First, we launched “Together for Better Telehealth” in the summer of 2020, a series of surveys to help clinicians share what they were learning from their telehealth experiences.

Then, in the summer of 2021, we fielded our “Telehealth One Year Later” surveys to better understand how both patients and clinicians were experiencing telehealth. These surveys exposed a concerning gap between patient satisfaction and clinician satisfaction with regard to telehealth. At that point, 89% of the patients we surveyed reported that their telehealth experience was either “Excellent” or “Very Good.” This stood in stark contrast to the 43% of clinicians who gave their telehealth experiences such high ratings. Patients loved it but clinicians were much less enthusiastic. This enormous satisfaction gap between those serving and those being served was troubling.

This past summer, we fielded another set of surveys for both clinicians (n = 217) and patients (n = 111) to assess how things have changed in the past year. While these surveys involved convenience samples, the data and rich comments we collected offer important reflections on what we still need to do to ensure telehealth lives up to its full potential.

These surveys reveal that clinician satisfaction increased in 2022 versus 2021, while patient satisfaction decreased. Although patients continue to like the telehealth experience in 2022 much more than clinicians do, that gap has narrowed since 2021.

What’s Behind the Increase in Clinician Satisfaction?

58% of clinicians who responded said their overall satisfaction with telehealth visits in the past year was either “Excellent” or “Very Good,” as compared to 43% in 2021. Only 1% of clinicians rated their satisfaction as “Poor” in 2022, as compared to 12% in 2021.

79% of clinicians reported that their personal experiences with telehealth were “Significantly Better” or “Somewhat Better” than at the beginning of the pandemic.

Based on comments from respondents, this improvement seems to be largely driven by two factors:

(Click on the “+” to see comments illustrating each theme)

  • “Embedding the telehealth in the EMR has helped make it seem more seamless.”
  • “Our technology improved with ability to do video embedded in our desktop computers.”
  • “Less tech headaches that interfere with clinical process.”
  • “More streamlined, more reliable, patients understand what to expect.”
  • “I became more organized, and we developed ways of helping the patients be more organized for the visit as well, such as weighing their child on a scale at home.”
  • “I got faster at the documentation.”
  • “Both patients and providers are more used to the technology, systems have improved and overall both patients and providers are more accepting of the concept.”
  • “The portal is more user friendly and within internal system, patients are more tech savvy and familiar with telehealth”
  • “Patients and I feel more comfortable dealing with video appts.”
  • “I learned to better utilize video conferencing platforms to streamline telehealth visits.”
  • “It took me a while to adjust to this new way of providing care – what kind of questions, how best to conduct an interview, etc.”

What’s Behind the Decrease in Patient Satisfaction?

The positive news about clinician satisfaction increasing is tempered by the fact that the percent of patients reporting that their telehealth experience was either “Excellent” or “Very Good” decreased from 89% in 2021 to 81% 2022. 7% of patients rated their satisfaction as “Fair” or “Poor” in 2022, as compared to 3% in 2021. Although patients continue to have high levels of satisfaction with telehealth, the eight point drop in satisfaction in one year is notable.

Based on comments from patients, this decline seems to be driven primary by:

  • “When I move out-of-state, I will lose my therapist because she will not be licensed in my new home state.”
  • “Needs to become more standardized and have the ability to treat patients across state lines. Many of us are quite mobile and work remotely from different locations/states. Telehealth should be able to travel with us.”
  • “The legislation that regulates telehealth needs to be changed and visits across state lines need to be allowed as they were during the height of COVID.”
  • “Insurers should pay if you are not in your home zip code and are away.”
  • “I think state barriers need to be modified. You should be able to see your provider from anywhere.”
  • “I would like to see license reciprocity for clinicians (including Behavioral Health providers) to treat patients that live in neighboring states via telehealth.”
  • “To be allowed access to telehealth visits with my doctors regardless of where I’m physically located. I should NOT be penalized for being a “snowbird”; especially since my cough variant asthma can no longer tolerate the cold MA winters!”
  • “I live in NH and see an MD in MA. For him to do a televisit, I had to drive across the border into MA and sit in a parking lot. It was silly.”

25% of patients reported that there was at least one time in the past 12 months that they wanted to visit their provider via telehealth but were not given that option.

  •  “I had to wait a long time to get in, take time off of work and therefore lost money, had to travel and be in an uncomfortable environment while having a migraine, just to see a doctor for 5 minutes who didn’t even physically assess me.”
  • “It annoyed me because it was an in-depth conversation appointment with a specialist. The only physical check was my BP and heart and I know those were just gratuitous. I spent (truly) 2 hours getting there and an hour and a half getting home because the only option was for me to go to the network’s office on the other side of the city from where I live (close to 40 miles each way). I ended up needing to take a half day off of work.”
  • “Sometimes I was not allowed to have a virtual appointment.”
  • “Had to travel, sit in waiting rooms, and move an ill mother to and from many doctors’ offices while she was experiencing pain. Sometimes to wait 2+ hours to see the doctor or have appointment cancelled when doctor was stuck in surgery.”
  • “Missed appointment because I thought it was virtual. There was no need to be seen in person. I don’t like sitting in waiting rooms. Also, at one visit the patient room was not clean, increasing my concern about getting sick.”
  • “They no longer offered telehealth.”
  • “Medical health provider has very limited slots for telehealth.”
  • “The quality of the connection isn’t always great & some providers seem to not yet be up to speed on how the technology works. They definitely are not proficient at troubleshooting on their end.”
  • “Lack of smooth connectivity of zoom/virtual method. Not sure if logged into correct place while waiting for doctor to arrive to meeting.”
  • “Practice work flow has not fully caught up with the telehealth technology. And, it’s not always timely or clear how the call gets initiated and what the patient needs to do.”
  • “Technical issues…gaps in audio, blur.”
  • “Uncertainty as to whether the technology would work correctly. We never know this until the moment of starting the visit.”
  • “My computer is old and one of the telehealth visits needed to be by phone only until I upgraded my computer.”
  • “Spotty internet that required us to do a telephone call instead of a zoom call.”
  • “Bandwidth can be variable sometimes, disrupting visit.”

Work To Be Done

Telehealth has tremendous potential to improve access to care for many patients and in many circumstances. Patients continue to have very high levels of satisfaction with telehealth, as we have previously reported, primarily because of the convenience it offers and especially when the clinical situation does not require an in-person visit. Continued focus on technological advancements, policy improvements, and a relentless focus on the patient as the customer will go a long way to restoring and retaining high levels of patient satisfaction with telehealth.

Clinician satisfaction, while improving, still remains relatively low. Great progress appears to have been made over the past few years, and patients and clinicians have become more comfortable with using telehealth, but we still have much work to do to make telehealth a technology that clinicians will consistently turn to and patients can reliably count on for accessing care.

81% of patients and 75% of clinicians responding in 2022 believed that telehealth will be “Extremely Important” or “Very Important” to the future of care.

As we look to that future, we see many opportunities to improve this technology to ensure telehealth lives up to its full potential for both patients and providers.