Impact of the transition to telehealth on healthcare providers at a large, urban FQHC in the early COVID-19 pandemic

Context: During the COVID-19 pandemic, healthcare providers were required to rapidly adapt to the needs of their patients and implement precautions associated reducing COVID-19 spread. Federally qualified healthcare centers (FQHCs) faced unique challenges with rapid transition to telemedicine, such as financial technological support restrictions and demographically diverse needs of patients.

Objective: There has been limited research on how the transition to telehealth impacted experiences of healthcare clinicians. This quality improvement initiative characterizes provider telehealth experiences and perceptions of delivery of care at an urban FQHC in the early stages of the COVID-19 pandemic.

Study Design: A total of 46 healthcare providers were surveyed at a multi-site FQHC in Northern California between July and August of 2020.

Setting or Dataset: The study site is the largest FQHC in Northern California serving over 90,000 patients in three counties. Sixty-four percent of patients are Latinx identifying.

Population Studied: All respondents provide primary care services. Respondents were mainly female (48.8%) and MD/DOs (52.2%).

Instrument: A 36 question Google survey tool was sent to all providers and included questions in 3 domains: self-reported telehealth experience before the COVID-19 pandemic, technological telehealth experiences during the COVID-19 pandemic, and perceptions of care provision via telehealth.

Main and Secondary Outcome Measures: Primary outcomes included descriptive statistics and associations between factors related to technological telehealth experience, and provider perceptions of providing care.

Results: There was a statistically significant (p<0.05) relationship between overall satisfaction with telehealth and each of: levels of burnout, perceptions of being able to provide needed care via telehealth, and telehealth impact on overall stress level. There was also a correlation between perceptions of being able to provide care over telehealth and comfort using telehealth. Finally, the most common technical issue was video visit broadband capability.

Conclusions: This study shows that telehealth visits are correlated with the overall satisfaction, stress, and burnout experience of healthcare providers. FQHCs require additional investment and support in establishing mechanisms to support telemedicine visits, such as broadband capabilities, patient education for digital literacy to holistically enhance telehealth experiences.