Patient Satisfaction and Attendance with Virtual Care in a Multidisciplinary Bariatric Program
Lindsay Miamen*, Meghan Ariagno, Amanda Lavasseur, Catherine Page, Ema Barbosa Brown, Yali Lu, Paul Davidson, Scott Shikora, Eric Sheu
Brigham and Women's Hospital, Boston, MA
Objective: The Covid-19 pandemic pivoted care delivery and appointment models saw an acceleration in virtual-visits (VV). Yet, the impact of virtual care in bariatric surgery programs has not been adequately studied. We seek to determine how VV influenced care delivery and receptivity to care in bariatric patients.
Design: Appointment completion data across three time-points: pre-pandemic (1/1/19-3/15/20), pandemic-peak (3/16/20-10/31/21) and current-state (11/1/21-12/31/2022) for surgeons, dieticians, and psychologists in our bariatric program were reviewed. Surveys assessing patient appointment preference were distributed electronically, within 6-weeks post-op at group nutrition and psychology appointments.
Setting: A multi-hospital ambulatory bariatric program.
Patients: All pre-op and post-op appointment data was analyzed for the time-points above. Surveys were accepted from all pre-op and post-op patients who have had at least 1 in-person and 1 virtual appointment with any provider at time of survey competition.
Interventions (if any): Effective March 16, 2020, our bariatric program responded to CDC"™s Covid-19 pandemic guidelines by replacing many routine, in-person appointments with VV. Surveys assessing patient appointment preference were distributed electronically and printed copies at 3 week and 6-week post-op at group nutrition and psychology appointments respectively. Survey completion rate is 14% to-date.
Main Outcome Measure(s): 1) Appointment completion rates and 2) patient reported preferences based on appointment types.
Results: Since the Covid-19 pandemic, program-wide VV increased from < 10% baseline to a current state of 50% for surgeons, 93% nutrition and 94% psychology. Rates for completed VV and no-show rates improved for all providers, with the greatest change for surgeon visits (Table 1). Survey data revealed 89% of patients experience added benefits with VV and > 90% reported their virtual experience as very good. Patient preference for VV varied by provider. While >61% preferred VV with a psychologist or dietitian, only 29.1% preferred VV with a surgeon.
Conclusions: Our findings reveal multi-disciplinary bariatric care can be performed effectively and efficiently in a hybrid fashion. While overall satisfaction with virtual-care is high, a significant proportion of patients continue to prefer in-person visits, particularly for surgeon appointments. Future work is needed to understand the impact of virtual care on bariatric surgery outcomes.
Table 1. Appointment Completion Rates
| Pre-pandemic | Current state | |||
| In-person | Virtual | In-person | Virtual | |
| Completed Appointments | ||||
| Surgeon_PA | 88.8% | 50% | 88.5% | 89.78% |
| Psychology | 83.42% | 72.90% | 70% | 74.9% |
| Nutrition | 82.8% | 58% | 79.14% | 80.5% |
| No-Show Appoinmentments | ||||
| Surgeon_PA | 11.18% | 50% | 11.45% | 10.22% |
| Psychology | 16.58% | 27.10% | 30% | 25.02% |
| Nutrition | 17.2% | 41% | 20.86% | 19.95% |
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