title: Provider satisfaction and patient outcomes associated with a statewide prison telemedicine program in Louisiana.
abstract: Health information technology including telemedicine offers potential to improve patient care outcomes. As part of the response to Hurricanes Katrina and Rita in 2005, the Louisiana State University Health Care Services Division expanded its statewide telemedicine program. The aim of this study was to evaluate provider satisfaction and patient outcomes associated with telemedicine when used for the administration of prisoner medical care. Providers completed a survey following each patient encounter in real-time; questions were adapted from standard satisfaction indices. Statistical methods included uni-, bi-, and multivariable including ordinal regression methods to characterize unadjusted and adjusted factors associated with telemedicine use and provider satisfaction, and patient outcomes. Data were collected between December 2007 and May 2008 and were analyzed using SAS and Stata. Out of 737 patient visits, the majority of patients were African American (68.6%), men (92.9%), seen for either infectious disease or mental health (46.2% and 50.2%), with most surveys completed by a physician (63.1%). Most telemedicine encounters were completed (92.8%), a treatment plan was established (97.0%), the provider perceived that the technology was adequate to conduct visit (93.4%), and a follow-up telemedicine appointment was requested (90.8%). Most providers were satisfied with telemedicine for the visit overall (87.0%), believed that telemedicine improved patient prognosis (88.2%), and perceived that the patient was satisfied (83.0%). This study suggests that telemedicine was an effective and accepted method of healthcare provision.
authors.affiliation: Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC 20037, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Glaser
authors.forename: Tom
authors.initials: T
authors.lastname: Winchell
authors.forename: Patty
authors.initials: P
authors.lastname: Plant
authors.forename: Wayne
authors.initials: W
authors.lastname: Wilbright
authors.forename: Michael
authors.initials: M
authors.lastname: Kaiser
authors.forename: Michael K
authors.initials: MK
authors.lastname: Butler
authors.forename: Matthew
authors.initials: M
authors.lastname: Goldshore
authors.forename: Manya
authors.initials: M
authors.lastname: Magnus
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D016001:Confidence Intervals; D003258:Consumer Behavior; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D019538:Health Care Surveys; D006751:Hospital Information Systems / Q000458:organization & administration; D006801:Humans; D008145:Louisiana; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D011329:Prisoners; D011330:Prisons / Q000458:organization & administration* / Q000706:statistics & numerical data; D011379:Prognosis; D016730:Program Development; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000458:organization & administration* / Q000706:statistics & numerical data; D055815:Young Adult