Patient Comments about Telehealth and In-Person Care at a Federally Qualified Health Center From Patient Experience Surveys Differ in Length,Valence,and Actionability

Abstract

Background:

The COVID-19 pandemic accelerated the integration of telehealth into routine health care, especially within Federally Qualified Health Centers (FQHCs). Few studies have compared patient experiences and/or comments about telehealth versus in-person visits.

Methods:

We compared patient comments about primary care telehealth versus in-person visits. We examined 3,795 comments from patient experience surveys (1,457 telehealth and 2,338 in-person) collected electronically between April 2023 and March 2024 by a large Southern California FQHC. We coded comment valence, content, and actionability.

Results:

Patient comments about telehealth visits were shorter (mean = 13 words) than comments about in-person visits (mean = 30 words) and more positive (85% versus 81%, respectively). Comments about telehealth visits were also less likely to mention specific provider or staff behaviors, resulting in fewer actionable comments: 7% of comments about telehealth and 12% about in-person visits were deemed actionable. Most comments about telehealth and in-person visits focused on overall visit experience, rather than specific aspects of care. References to care setting and staff roles were minimal, particularly in telehealth comments.

Conclusion:

While telehealth visits are generally well-received, patient comments about telehealth provide less detail and contain less actionable information compared to comments about in-person visits. The proportion of actionable comments was considerably lower than prior studies (∼30%). This may pose challenges to using comments to improve telehealth. Understanding differences in how patients respond to the same open-ended patient experience survey question about their telehealth versus in-person visit is critical for optimizing telehealth care delivery and addressing patient needs in under-resourced settings.