Patient preference for paper vs electronic provider evaluations in a urogynecologic setting

Objectives: While prior studies have examined electronic versus paper feedback of learners within the medical education system, there are few data comparing patient satisfaction or comfort with these methods. Our primary objective was to compare patient satisfaction with completing provider evaluations electronically versus on paper. Secondary objectives were assessing the effect of age, education, and socio-economic status on comfort with use of technology, preference for evaluation type, and feasibility of completing provider evaluations in real-time in a clinical setting.

Methods: This was a single-center, IRB-approved randomized trial comparing two methods of completing provider evaluations—electronically versus on paper. Participants were recruited and randomized and then completed the evaluation form after clinic visit completion. Electronic evaluations were completed on a tablet via Qualtrics. Sample size estimate based on a difference of 20% in patient satisfaction, alpha 0.05 and 80% power, was 72 per group.

Results: Among 145 participants, 72 (49.7%) were randomized to electronic versus 73 (50.3%) to paper. Mean age was 62±14. The majority (83%) were comfortable with technology and had a smartphone (88%). Almost all participants (97%) reported ease of use for their randomized method of feedback, and most (93%) were satisfied with the method to which they were assigned. Forty-three percent preferred giving feedback electronically; 35% had no preference; 21% preferred paper. The electronic and paper groups were similar in age (64 vs 61, p = 0.27), race (p = 0.35), education level (0.37), income (p = 0.43), insurance type (p = 0.41), comfort with technology (p = 0.58), email use (p = 0.44), owning a smartphone (p = 0.41), computer use (p = 0.34), and preference of reading on an electronic device (p=0.78). Groups were also similar in finding ease (p = 0.99) and satisfaction with randomized method (p = 0.76). Most patients (62%) randomized to electronic feedback preferred their assigned method, while 10% preferred paper and 28% had no preference. For patients randomized to paper, 34% preferred paper, while 25% preferred electronic and 41% had no preference. Electronic feedback took longer to complete than paper (4.5 min vs 3.4 min, p< 0.001). See Table 1 comparing survey results by age. Older patients took longer to complete the survey (4.5 min vs 3.2 min, p< 0.001). Older patients had less daily internet use and were less likely to own a computer. There were no other differences by age.

Conclusions: Patients were satisfied in completing provider evaluations electronically and on paper, regardless of age or randomization assignment. Surveys were completed quickly during a real-time clinical setting regardless of feedback type or age. Thus, requesting provider feedback from patients via multiple modalities is feasible in a varied patient population.