Epidemiological Survey of the Impact of COVID-19 on Telemedicine in the Practice of Foot and Ankle Surgery in the United States

Abstract

In response to loosened telehealth regulations and local restrictions on elective procedures during the COVID-19 pandemic, telemedicine use has dramatically increased. The goal of this study was to analyze patterns in telemedicine use among podiatric physicians during the COVID-19 crisis on a national level. Anonymous responses to a survey of practice metrics as well as subjective impressions of telemedicine efficacy were collected from 246 respondents, representing >1% of practicing podiatrists in the United States. Linear regression was performed to identify variables associated with COVID-19 prevalence and variables associated with higher self-reported likelihood of offering telemedicine visits post-COVID-19. Physicians in areas of lower COVID-19 prevalence were found to dispense DME more frequently in-office and conduct more post-op telemedicine visits, with fewer visits for infections and trauma. Podiatrists in these regions also rated telemedicine more effective for medical and musculoskeletal pathologies. Additionally, fewer of their practices had modified office hours, and more of them advertised telemedicine services. Physicians more likely to offer telemedicine post-COVID-19 had significantly higher new patient volume and increased acuity of cases, with patient admission to the hospital after telemedicine visits. These physicians ranked the effectiveness of telemedicine more highly for every pathology surveyed. Of note, ACFAS region and years in clinical practice were not statistically associated with likelihood of offering telemedicine visits post-COVID-19. This study represents the first systematic national assessment of telemedicine use in podiatry and highlights clinically relevant changes in practice and perception of telemedicine in response to the COVID-19 pandemic.

A scoping review of foot and ankle telemedicine guidelines

“…Depending on the patient's primary chief complaint, various treatment options may be available. In their study, Neville et al 37 did not provide practice guidelines for podiatric telemedicine practice. However, they provided an analysis that revealed podiatrists rated telemedicine as the most effective for prescribing medications and consulting about medical and dermatological issues.…”

Physician Satisfaction With Virtual Ophthalmology Clinics During the COVID-19 Pandemic: A Tertiary Eye Care Center Experience

“…Years of clinical practice play a role in ophthalmologists’ satisfaction with VOCs. An orthopedic study conducted by Neville et al reported that years in clinical practice were not statistically associated with the likelihood of offering telemedicine visits post-COVID-19 [ 22 ]. Similarly, 42.3% of ophthalmologists had less than five years of practice experience in our study.…”

Video Consultations and Their Utilization by Orthopedic and Trauma Surgeons During the COVID-19 Pandemic. A Go-To Technology in the Future or Just a Stopgap?

“…Parisien et al were able to demonstrate that in the United States, the COVID-19 pandemic gave telemedicine services a crucial impetus in academic orthopedic facilities with a positive correlation to the frequency of COVID-19 cases [24]. At 94 %, a dramatic increase in the adoption of telemedicine was also seen among members of the American College of Foot and Ankle Surgeons and the New York State Podiatric Medical Association [25].…”

“…Auch Parisien et al konnten zeigen, dass in den Vereinigten Staaten von Amerika die Coronakrise einen entscheidenden Anstoß für telemedizinische Dienste in akademischen orthopädischen Einrichtungen gehabt hatte mit positiver Korrelation zur Häufigkeit der COVID-19-Erkrankungen 24 . Eine dramatische Steigerung bei der Einführung von Telemedizin war auch unter Mitgliedern des American College of Foot and Ankle Surgeons und der New York State Podiatric Medical Association mit einem Anteil von 94% zu sehen 25 .…”