Patient-centered care in telemedicine - An experimental-design study

Abstract

Background: Patients using telemedicine expect health providers to meet their expectations and are concerned about losing interpersonal contact. Studies on tailoring telemedicine to patient expectations are scant. This experimental design starts to close the gap in the state-of-the-art testing of patient expectations of communication with healthcare providers in telemedicine based on the patient-centered approach. The study was conducted from June 2021 through September 2021.

Methods: The convenience sample comprised 677 students, 298 females and 379 males, ages 18 to 64 who are all patients of one of four national health funds in Israel, using telemedicine. We used a conjoint-based experimental design. Each respondent evaluated a unique set of 24 vignettes of messages. The dependent variable was patient expectations of communication with healthcare providers in Telemedicine. The independent variables were four acknowledged categories of patient expectations of provider-patient communication.

Results: Coefficients for the total panel suggest no significant differences. Applying mathematical clustering, three mindsets emerged. A Post-hoc ANOVA test indicated that the mindsets are significantly different. Members of Mindset 1 expect the provider to walk them through the change process. Members of Mindset 2 expect healthcare providers to refer them to a reliable source of information to enhance their healthcare literacy. Members of Mindset 3 expect respect, both in non-verbal conduct and for their time. We developed a prediction tool enabling to identify the mindset-belonging of each patient in the population to a mindset in the sample.

Conclusions: Findings call healthcare providers to communicate with patients via telemedicine based on mindset-tailored messages rather than based on socio-demographics for optimum patient-centered communication. Using the prediction tool, providers may identify the mindset-belonging of each patient. To enhance patient-centered care via telemedicine, providers are called upon to meet expectations by using mindset-tailored communication that structures the communication with greater specificity enhancing patient-centered care.

Keywords: Mindsets; Patient-centered care; Patient-expectations; Telehealth; Telemedicine.