'Healthcare Providers’ Experience Using Telehealth During The COVID-19 Pandemic' (Preprint)

BACKGROUND Although telemedicine has been around for the last four decades, many healthcare providers (HCPs) are not familiar with its use. The rise of COVID-19 pandemic has thrusted HCPs to adopt telemedicine instead of the conventional office visit in order to provide ongoing care for their patients. Many HCPs were tested on their technological literacy and conformability. This was further compounded by not only the technological literacy of patients, but their internet accessibility as 1 in 4 Kentucky households do not have access to broadband internet. OBJECTIVE Our study aimed not only to assess HCPs’ experience with using telemedicine during COVID-19, but also to identify its potential benefits for our highly morbid underserved patients. METHODS We conducted an online electronic survey for The Medical Center at Bowling Green HCPs. The survey questionnaire was developed using Qualitrics©, following Dillman’s (2009) Tailored Design Method for internet surveys,12and was optimized for smart phone browsers. The survey was launched on July 20th, 2020 via a bulk invitation email with a direct link to the online questionnaire sent to all 176 HCPs affiliated with the Medical Center Physician’s Group. RESULTS A total of 70 HCPs began the survey. The two most common specialties of respondents were primary care (28%) and cardiologists (12.5%), while the two most common primary practice types were private practice and academic hospital (37.5% each). The majority (81.2%) of HCPs indicated that they had used telehealth during the COVID-19 pandemic. Of HCPs that did not use telemedicine, 31.2% cited that telemedicine was inappropriate for their field, 25% cited they had concerns for privacy issues, and 18.7% cited concerns about not being able to provide appropriate medical care. The majority (82.3%) of HCPs that used telemedicine during the pandemic indicated that they had never used it previously. Similarly, HCPs that used telemedicine indicated that technological issues due to poor internet connectivity (86.2%) and concerns about privacy issues (45.2%) were either a “big” or “somewhat” of a disadvantage to telemedicine. However, approximately 61% of HCPs said they will consider using telemedicine after COVID-19 restrictions are lifted, and 33.3% will consider it in certain situations. Most HCPs (58.8%) generally agreed with the idea that telehealth visits are more time efficient, but approximately half indicated they would feel either “uncomfortable” or “extremely uncomfortable” with patient management using telehealth alone. Overall, HCPs rated their experience with telehealth a 3.90 on a scale of 1 to 5. When compared, there was no statistically significant difference between the cardiologist and non-cardiologist group. CONCLUSIONS Telemedicine was a quickly forced transition on HCPs and a large majority of them did not have much previous experience with it. However, the data we collected seems to indicate that HCPs largely had an above average experience with telemedicine and 94% indicated that they would consider using it in their practice after COVID-19 ended. Broadband connection remains elusive to many Kentucky households. In addition, the average time a patient must travel to-and-fro a doctor’s office in our rural underserved area is approximately 1 hour and 20 minutes. Therefore, telemedicine will be a reasonable option for follow up visits, laboratory results review and/or prescription refills. This will likely increase patient’s compliance and lead to resource conservation such as gas and travel time.