Physicians' Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study.

COVID-19 United Arab Emirates audio consultation clinical decision-making clinical training communication outpatient department perception telemedicine video consultation

Journal

JMIR medical informatics
ISSN: 2291-9694
Titre abrégé: JMIR Med Inform
Pays: Canada
ID NLM: 101645109

Informations de publication

Date de publication:
01 Jun 2021
Historique:
received: 31 03 2021
accepted: 17 05 2021
revised: 04 05 2021
pubmed: 19 5 2021
medline: 19 5 2021
entrez: 18 5 2021
Statut: epublish

Résumé

To mitigate the effect of the COVID-19 pandemic, health care systems worldwide have implemented telemedicine technologies to respond to the growing need for health care services during these unprecedented times. In the United Arab Emirates, video and audio consultations have been implemented to deliver health services during the pandemic. This study aimed to evaluate whether differences exist in physicians' attitudes and perceptions of video and audio consultations when delivering telemedicine services during the COVID-19 pandemic. This survey was conducted on a cohort of 880 physicians from outpatient facilities in Abu Dhabi, which delivered telemedicine services during the COVID-19 pandemic between November and December 2020. In total, 623 physicians responded (response rate=70.8%). The survey included a 5-point Likert scale to measure physician's attitudes and perceptions of video and audio consultations with reference to the quality of the clinical consultation and the professional productivity. Descriptive statistics were used to describe physicians' sociodemographic characteristics (age, sex, designation, clinical specialty, duration of practice, and previous experience with telemedicine) and telemedicine modality (video vs audio consultations). Regression models were used to assess the association between telemedicine modality and physicians' characteristics with the perceived outcomes of the web-based consultation. Compared to audio consultations, video consultations were significantly associated with physicians' confidence toward managing acute consultations (odds ratio [OR] 1.62, 95% CI 1.2-2.21; P=.002) and an increased ability to provide patient education during the web-based consultation (OR 2.21, 95% CI 1.04-4.33; P=.04). There was no significant difference in physicians' confidence toward managing long-term and follow-up consultations through video or audio consultations (OR 1.35, 95% CI 0.88-2.08; P=.17). Video consultations were less likely to be associated with a reduced overall consultation time (OR 0.69, 95% CI 0.51-0.93; P=.02) and reduced time for patient note-taking compared to face-to-face visits (OR 0.48, 95% CI 0.36-0.65; P<.001). Previous experience with telemedicine was significantly associated with a lower perceived risk of misdiagnosis (OR 0.46, 95% CI 0.3-0.71; P<.001) and an enhanced physician-patient rapport (OR 2.49, 95% CI 1.26-4.9; P=.008). These results indicate that video consultations should be adopted frequently in the new remote clinical consultations. Previous experience with telemedicine was associated with a 2-fold confidence in treating acute conditions, less than a half of the perceived risk of misdiagnosis, and an increased ability to provide patients with health education and enhance the physician-patient rapport. Additionally, these results show that audio consultations are equivalent to video consultations in providing remote follow-up care to patients with chronic conditions. These findings may be beneficial to policymakers of e-health programs in low- and middle-income countries, where audio consultations may significantly increase access to geographically remote health services.

Sections du résumé

BACKGROUND BACKGROUND
To mitigate the effect of the COVID-19 pandemic, health care systems worldwide have implemented telemedicine technologies to respond to the growing need for health care services during these unprecedented times. In the United Arab Emirates, video and audio consultations have been implemented to deliver health services during the pandemic.
OBJECTIVE OBJECTIVE
This study aimed to evaluate whether differences exist in physicians' attitudes and perceptions of video and audio consultations when delivering telemedicine services during the COVID-19 pandemic.
METHODS METHODS
This survey was conducted on a cohort of 880 physicians from outpatient facilities in Abu Dhabi, which delivered telemedicine services during the COVID-19 pandemic between November and December 2020. In total, 623 physicians responded (response rate=70.8%). The survey included a 5-point Likert scale to measure physician's attitudes and perceptions of video and audio consultations with reference to the quality of the clinical consultation and the professional productivity. Descriptive statistics were used to describe physicians' sociodemographic characteristics (age, sex, designation, clinical specialty, duration of practice, and previous experience with telemedicine) and telemedicine modality (video vs audio consultations). Regression models were used to assess the association between telemedicine modality and physicians' characteristics with the perceived outcomes of the web-based consultation.
RESULTS RESULTS
Compared to audio consultations, video consultations were significantly associated with physicians' confidence toward managing acute consultations (odds ratio [OR] 1.62, 95% CI 1.2-2.21; P=.002) and an increased ability to provide patient education during the web-based consultation (OR 2.21, 95% CI 1.04-4.33; P=.04). There was no significant difference in physicians' confidence toward managing long-term and follow-up consultations through video or audio consultations (OR 1.35, 95% CI 0.88-2.08; P=.17). Video consultations were less likely to be associated with a reduced overall consultation time (OR 0.69, 95% CI 0.51-0.93; P=.02) and reduced time for patient note-taking compared to face-to-face visits (OR 0.48, 95% CI 0.36-0.65; P<.001). Previous experience with telemedicine was significantly associated with a lower perceived risk of misdiagnosis (OR 0.46, 95% CI 0.3-0.71; P<.001) and an enhanced physician-patient rapport (OR 2.49, 95% CI 1.26-4.9; P=.008).
CONCLUSIONS CONCLUSIONS
These results indicate that video consultations should be adopted frequently in the new remote clinical consultations. Previous experience with telemedicine was associated with a 2-fold confidence in treating acute conditions, less than a half of the perceived risk of misdiagnosis, and an increased ability to provide patients with health education and enhance the physician-patient rapport. Additionally, these results show that audio consultations are equivalent to video consultations in providing remote follow-up care to patients with chronic conditions. These findings may be beneficial to policymakers of e-health programs in low- and middle-income countries, where audio consultations may significantly increase access to geographically remote health services.

Identifiants

pubmed: 34001497
pii: v9i6e29251
doi: 10.2196/29251
pmc: PMC8171285
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e29251

Informations de copyright

©Noora Alhajri, Mecit Can Emre Simsekler, Buthaina Alfalasi, Mohamed Alhashmi, Majd AlGhatrif, Nahed Balalaa, Maryam Al Ali, Raghda Almaashari, Shammah Al Memari, Farida Al Hosani, Yousif Al Zaabi, Shereena Almazroui, Hamed Alhashemi, Ovidiu C Baltatu. Originally published in JMIR Medical Informatics (https://medinform.jmir.org), 01.06.2021.

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Auteurs

Noora Alhajri (N)

Khalifa University College of Medicine and Health Science, Abu Dhabi, United Arab Emirates.

Mecit Can Emre Simsekler (MCE)

College of Engineering, Khalifa University, Abu Dhabi, United Arab Emirates.

Buthaina Alfalasi (B)

Department of Family Medicine, Zayed Military Hospital, Abu Dhabi, United Arab Emirates.

Mohamed Alhashmi (M)

Khalifa University College of Medicine and Health Science, Abu Dhabi, United Arab Emirates.

Majd AlGhatrif (M)

Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States.

Nahed Balalaa (N)

Department of General Surgery, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.

Maryam Al Ali (M)

Ambulatory Health Services, Zafarana Clinic, Abu Dhabi Healthcare Company, Abu Dhabi, United Arab Emirates.

Raghda Almaashari (R)

Department of Dermatology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

Shammah Al Memari (S)

Abu Dhabi Public Health Center, Department of Health, Abu Dhabi, United Arab Emirates.

Farida Al Hosani (F)

Abu Dhabi Public Health Center, Department of Health, Abu Dhabi, United Arab Emirates.

Yousif Al Zaabi (Y)

Abu Dhabi Public Health Center, Department of Health, Abu Dhabi, United Arab Emirates.

Shereena Almazroui (S)

Abu Dhabi Public Health Center, Department of Health, Abu Dhabi, United Arab Emirates.

Hamed Alhashemi (H)

Department of Health, Abu Dhabi, United Arab Emirates.

Ovidiu C Baltatu (OC)

Khalifa University College of Medicine and Health Science, Abu Dhabi, United Arab Emirates.

Classifications MeSH