Face-to-Face and Virtual Consultations: Comparison of Patient-Perceived Quality and Satisfaction

From the 2021 HVPAA National Conference

Robert Wilson (University of South Carolina School of Medicine- Greenville), Kayla Schilling, Joseph Smith, Alex Ewing, Catherine Bailey, W Patrick Springhart


With increased focus on decreasing cost, coupled with recent pressure from the COVID-19 pandemic, virtual provider visits have undergone a renaissance. Virtual visits would allow for a centralized model of dietetic care delivery, which would increase patient access, decrease related staffing and travel costs, and enable the dietician to see a larger number of patients in a more efficient manner.


The purpose of this study was to show a non-inferiority comparison of virtual versus face-to-face dietician consultation.
Materials and Methods: A total of 96 patients with a previous nephrolithiasis diagnosis participated in a face-to-face evaluation between May 2019-February 2021. These patients were then assigned randomly to a secondary consultation via face-to-face or in-person modality and surveyed following the visit. Patients participating in a virtual visit were asked to complete the Telemedicine Satisfaction Questionnaire (TSQ), on a 5-point Likert scale. Patients who participated in an in-person visit were asked to respond to a modified TSQ, in which questions about technology were removed.


In total, this study had 96 respondents, with 46 patients participating in a virtual visit and 50 patients participating in an in-person visit. Greater than 80% of virtual visit participants reported receiving satisfactory quality of service, met their healthcare needs, and indicated an intention to participate in another virtual visit. Most respondents “agreed” or “strongly agreed” that the virtual visits allowed for better healthcare access and felt the quality of communication with their provider virtually was comparable to an in-person consultation. (Table 1).


Virtual consultations may be a viable alternative to in-person consultation, preserving perceived quality of care delivery and patient satisfaction.

Clinical Implications

Virtual dietician consultations allow more efficient models of care delivery, without any significant change in patient-perceived quality and satisfaction. Implementation of a centralized system in which dietician consultations are offered virtually, would remove the need for site-to-site travel for in-person consultations. This would remove time and financial cost associated with travel, increasing time available to see additional consultations, thus further increasing care availability to patients.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog