title: Implementation of a Tele-urology Program for Outpatient Hematuria Referrals: Initial Results and Patient Satisfaction.
abstract: To report on results from a new tele-urology pathway for managing hematuria consults, including a survey of patient attitudes and satisfaction with such a program. Recent guideline changes have relaxed the definition of microscopic hematuria and may have significantly increased the number of hematuria evaluations.
  
  
  
  Patients referred to the Atlanta Veterans Administration Medical Center with hematuria were scheduled for a tele-urology clinic encounter utilizing a telephone call to obtain hematuria-related clinical information via a standardized algorithm. At subsequent cystoscopy, patients were evaluated with a 29-question survey regarding overall acceptance and satisfaction of the clinic (8 questions) and impact factors (21 questions).
  
  
  
  One hundred fifty veterans participated in the survey. Median time from consult request to appointment was 12 days and thereafter to cystoscopy was 16 days. Patients reported high acceptance and overall satisfaction with telephone evaluation; mean scores exceeded 9 out of 10 for overall satisfaction, efficiency, convenience, friendliness, care quality, understandability, privacy, and professionalism. When presented with a choice, nearly all patients (98%) preferred telephone-based encounters to face-to-face clinic visits. Underlying negative factors responsible for patients' preferences included transportation-related issues (97%) and logistical clinic issues (65%). Ninety-seven percent of patients reported high-quality evaluation.
  
  
  
  Patients report high acceptance and satisfaction with telephone clinics as a mechanism for expedited hematuria evaluation, primarily due to avoiding barriers related to transportation and clinical operations, as well as a perceived high quality of evaluation. Telephone appointments have potential to positively impact healthcare access and productivity.
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA. Electronic address: isafir@emory.edu.
authors.forename: Ilan J
authors.initials: IJ
authors.lastname: Safir
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Salil
authors.initials: S
authors.lastname: Gabale
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: David
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Huang
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Gerhard
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Pearl
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Lorentz
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA.
authors.forename: James
authors.initials: J
authors.lastname: Baumgardner
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Filson
authors.affiliation: Department of Urology, Veterans Affairs Medical Center, Atlanta, GA; Department of Urology, Emory University School of Medicine, Atlanta, GA.
authors.forename: Muta M
authors.initials: MM
authors.lastname: Issa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000553:Ambulatory Care / Q000592:standards; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D003558:Cystoscopy; D005260:Female; D006417:Hematuria / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016730:Program Development; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000592:standards; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000458:organization & administration* / Q000592:standards; D013689:Telephone; D014186:Transportation; D014481:United States; D014493:United States Department of Veterans Affairs; D014572:Urology