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

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.