Background
Second medical opinions (SOs) can strengthen patients’ certainty in decision-making. Since 2019, statutory health insured German residents have the right to obtain an SO for selected indications according to the SO Directive. Additionally, several health insurers offer SO programs often in cooperation with telemedical SO providers. Telemedical SO programs are mostly based on documents only. Our aim was to analyze the characteristics of people who obtained telemedical SOs, their experiences made during the SO process, and their assessment of SOs in general and of the different routes of SO delivery (personally/by phone/documents only).
Methods
German residents who obtained an SO via an online portal between January 2016 and February 2019 (n=1247) were contacted by post between August and November 2019 up to three times. The results were analyzed descriptively.
Results
The 368 participants (response rate 30%) were 54% male, 95% statutory health insured and 61 years old (median; interquartile range 51-72). Most participants reported having an orthopedic condition (87%) or had been recommended surgery (78%). The most common reason for seeking an SO in general was the need for more information on further treatment recommendations (64%). A telemedical SO was mainly chosen because it was offered by the health insurer (82%). Disagreements between first opinions and SOs occurred in 55% of the participants. Approximately 60% of the participants with disagreements followed the treatment recommendation of the SO. For 67% of the participants, the SO (rather) enhanced the certainty in decision-making. Approximately 75% were (rather) satisfied with obtaining the SO via the online portal, and 95% would seek another SO (irrespective of the online portal). The most preferred route of SO delivery was a personally delivered SO, which 80% would (rather) consider, followed by 70% (rather) considering SOs based on documents only and 48% (rather) considering SOs by phone.
Conclusion
SOs were generally appreciated. Although our results show that SOs (based on documents only) support patients and that patient satisfaction was high, personally delivered SOs were still preferred. Future research on the use of SOs based on documents only (in which patient population and in what situations) is needed.
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Competing interest reported. Within the ZWEIT project, we cooperate with the Medexo GmbH (second opinion provider). Within another project on second opinions, the Institute for Research in Operative Medicine of Witten/Herdecke University received funding from Medexo GmbH.
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Posted 22 Mar, 2021
Invitations sent on 05 Apr, 2021
On 25 Mar, 2021
On 19 Mar, 2021
On 19 Mar, 2021
On 17 Mar, 2021
Posted 22 Mar, 2021
Invitations sent on 05 Apr, 2021
On 25 Mar, 2021
On 19 Mar, 2021
On 19 Mar, 2021
On 17 Mar, 2021
Background
Second medical opinions (SOs) can strengthen patients’ certainty in decision-making. Since 2019, statutory health insured German residents have the right to obtain an SO for selected indications according to the SO Directive. Additionally, several health insurers offer SO programs often in cooperation with telemedical SO providers. Telemedical SO programs are mostly based on documents only. Our aim was to analyze the characteristics of people who obtained telemedical SOs, their experiences made during the SO process, and their assessment of SOs in general and of the different routes of SO delivery (personally/by phone/documents only).
Methods
German residents who obtained an SO via an online portal between January 2016 and February 2019 (n=1247) were contacted by post between August and November 2019 up to three times. The results were analyzed descriptively.
Results
The 368 participants (response rate 30%) were 54% male, 95% statutory health insured and 61 years old (median; interquartile range 51-72). Most participants reported having an orthopedic condition (87%) or had been recommended surgery (78%). The most common reason for seeking an SO in general was the need for more information on further treatment recommendations (64%). A telemedical SO was mainly chosen because it was offered by the health insurer (82%). Disagreements between first opinions and SOs occurred in 55% of the participants. Approximately 60% of the participants with disagreements followed the treatment recommendation of the SO. For 67% of the participants, the SO (rather) enhanced the certainty in decision-making. Approximately 75% were (rather) satisfied with obtaining the SO via the online portal, and 95% would seek another SO (irrespective of the online portal). The most preferred route of SO delivery was a personally delivered SO, which 80% would (rather) consider, followed by 70% (rather) considering SOs based on documents only and 48% (rather) considering SOs by phone.
Conclusion
SOs were generally appreciated. Although our results show that SOs (based on documents only) support patients and that patient satisfaction was high, personally delivered SOs were still preferred. Future research on the use of SOs based on documents only (in which patient population and in what situations) is needed.
Figure 1
Figure 2
Figure 3
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