0749: Virtual Care in Rheumatology Ambulatory Clinics During the COVID-19 Pandemic: Patient/Family and Healthcare Provider Perspectives and Experiences

Whitney Hung, Carina Majaesic, Katharina Kovacs Burns, Aisha Bruce and Elaine Yacyshyn, University of Alberta, Edmonton, AB, Canada

Background/Purpose: With the expansion of virtual care during COVID-19, a cross-sectional study was designed to explore the experiences of adult patients and their families (PFs), as well as healthcare providers (HCPs), with virtual care in ambulatory medicine within Alberta Health Services, Canada.

Methods: A randomly selected 10-15% of PFs and 200 HCPs in seven ambulatory care clinics, including adult Rheumatology, were invited to complete a telephone or online survey, respectively. Quantitative and qualitative questions for both surveys included virtual care appointment set-ups as compared with in-person visits, associated benefits, impacts of virtual care, preferences for future appointments, and improvement suggestions. Data for both surveys were descriptively analyzed. The subset of PFs and HCPs from the Rheumatology Clinic was then extracted and analyzed separately as well.

Results: Of 27 Rheumatology Clinic PFs who completed the telephone survey, 63% rated their overall experience with the virtual clinic appointment setup as 'excellent' (i.e. 8,9, or 10 out of 10) versus 36% of 14 HCPs who responded. Half of HCPs felt that all necessary information for clinical decision-making was captured during video and telephone appointments. However, very few felt that the use of video (14%) or telephone appointments (7%) negatively affected patient care when compared to in-person appointments despite concerns from other colleagues, which included lack of physical exams, patients having difficulty navigating the technology, and virtual appointments taking longer to set up and conduct. PFs had mixed views, with 63% feeling that their discussions with HCPs did not go as well during their virtual appointment as in previous in-person visits. Similarly, 52% felt confident that these appointments were just as good as in-person appointments despite the majority rating the actual virtual appointment experiences as 'excellent.' Advantages of virtual appointments noted by HCPs and PFs included convenience, reduced costs, and decreased risk of COVID-19 exposure. Thirty-six percent and 43% of HCPs having video and telephone appointments, respectively, preferred to continue with these corresponding appointments. Comparatively, 53% of PFs preferred to continue with virtual appointments, while 44% desired in-person appointments.

Conclusion: PFs and HCPs would like to see virtual care become a regular option for healthcare delivery beyond the pandemic. Such implementation will require expansion of health system supports and technologies, guidelines for virtual care practices and policies. This study provides a cross-sectional snapshot of key aspects of virtual care experiences of both PFs and HCPs within the same ambulatory clinics, with focus on Rheumatology, during the first year of COVID-19. Additional cross-sectional repeat studies and others correlating virtual care experiences with outcome measures are needed.

Disclosures: W. Hung, None; C. Majaesic, None; K. Kovacs Burns, None; A. Bruce, None; E. Yacyshyn, None.