Feasibility and acceptability of a virtual diagnostic sleep disorders service: A qualitative study.

Introduction: The electronic collection of patient data is used for a large variety of conditions. The boundaries of its use in initial diagnostics and the extent to which it can replace specialist contact, however, remain vague. Our newly developed virtual diagnostic process for common sleep disorders involves digital questionnaire administration, neurophysiological diagnostic studies, and virtual consultation with a sleep specialist. In this study, we evaluated patients' virtual diagnostic process experiences as part of a full evaluation of this process.

Methods: Patients who completed the virtual diagnostic process participated in online semi-structured interviews based on the following criteria: age ≥ 18 years, no obvious cognitive deficits, and access to the internet. Patients who did not complete the virtual diagnostic process were contacted by telephone and given the opportunity to explain why.

Results: Of the 24 patients included, 14 completed the virtual diagnostic process. Most participants understood the concept of the virtual diagnostic process, could navigate the process, and felt that the combined use of a questionnaire and virtual consultation was meaningful. Although participants could provide information as free text, the simplified closed questions, required for diagnostic classification, triggered feelings of insecurity and the inability to sufficiently describe symptoms, thereby evoking concern. All patients deemed the complementary personal contact important.

Discussion: The findings demonstrate that the virtual diagnostic process is feasible and highly accepted by most patients. However, (virtual) personal (telephone or video) contact is mandatory to address patients' concerns. The virtual diagnostic process application evaluated here likely represents the outer limit of the use of electronic data collection in virtual diagnostic procedures.