Evaluation of the use of video consultation in German rheumatology care before and during the COVID-19 pandemic

Abstract

BackgroundThe COVID-19 pandemic led to transformations in healthcare infrastructures and increased use of (innovative) telemedicine (TM) tools. Comparison of the use of video consultation (VC) in rheumatology in the pre-pandemic period and during the pandemic might allow for evaluating this new form of consultancy in healthcare due to changing conditions and possibilities.Materials and methodsCross-sectional nationwide online survey among German rheumatologists and rheumatologists in training between March and May 2021 promoted by newsletters and Twitter posts.ResultsResults refer to 205 participants. The majority was male (59%), older than 40 years (90%). Thirty-eight percent stated to have employed TM before (“digital users”), 27% were using VC as part of their TM expertise (“VC-users”), 10% stated to have experience with TM but not VC (“TM-users”). Those negating the use of any TM (62%) were designated as “digital non-users.” TM-Knowledge was self-rated as 4 [median on a Likert Scale 1 (very high) to 6 (very low)] with a significant difference between digital users (VC-user 2.7 ± 1.2, TM-user 3.2 ± 1.1) and digital non-users (4.4 ± 1.3). The reported significant increase of VC use during the lockdown periods and between the lockdowns compared to the pre-pandemic phase was regarded as a proxy for VC acceptance in the pandemic. Reasons for VC non-use were administrative/technical efforts (21%), lack of technical equipment (15%), time constraints (12%), time required for individual VC sessions (12%), inadequate reimbursement (11%), lack of demand from patients (11%), data security concerns (9%), poor internet connection (8%), and lack of scientific evaluation/evidence (5%). Physicians considered the following clinical situations to be particularly suitable for VC: follow-up visits (VC-user 79%, TM-user 62%, digital non-user 47%), emergency consultations (VC-user 20%, TM-user 33%, digital non-user 20%), and patients presenting for the first time (VC-user 11%, TM-user 19%, digital non-user 8%).ConclusionEven though the pandemic situation, with social distancing and several lockdowns, provides an ideal environment for the implementation of new remote care forms as VC, its use and acceptance remained comparatively low due to multiple reasons. This analysis may help identify hurdles in employing innovative digital care models for rheumatologic healthcare.

Factors Associated With Telemedicine Use Among German General Practitioners and Rheumatologists: Secondary Analysis of Data From a Nationwide Survey

“…Hence, more physicians and likely other subgroups will have tried TM by now [ 23 ], which has led to an increased use and awareness of TM in routine practice. Nevertheless, recent studies suggest that even after the SARS-CoV-2 outbreak, the same barriers continue to prevent widespread TM adoption [ 9 , 10 , 35 , 44 , 45 ]. However, a replication of the initial survey is essential to identify whether and how the identified factors have changed in the surveyed target group.…”

“…With the outbreak of the SARS-CoV-2 pandemic, physicians’ face-to-face consultations declined considerably [ 9 , 10 ]. The possibility of contactless medical care is now more important.…”

“…Hence, TM has received a tremendous upswing worldwide [ 13 ] and regionally [ 9 , 14 ]. Although the pandemic situation, involving social distancing and multiple lockdowns, provided an ideal environment for the implementation of TM, this momentum soon stagnated again [ 10 , 15 ]. Particularly in rheumatology, health care professionals’ use and acceptance of TM fell short of expectations [ 10 ].…”

“…Although the pandemic situation, involving social distancing and multiple lockdowns, provided an ideal environment for the implementation of TM, this momentum soon stagnated again [ 10 , 15 ]. Particularly in rheumatology, health care professionals’ use and acceptance of TM fell short of expectations [ 10 ]. Apparently, other factors may play a role in the willingness to use TM (TM willingness) and actual use of TM (TM use) among general practitioners (GPs) and rheumatologists.…”

Factors Associated With Telemedicine Use Among Patients With Rheumatic and Musculoskeletal Disease: Secondary Analysis of Data From a German Nationwide Survey

“…With the outbreak of the COVID-19 pandemic, face-to-face consultations by physicians decreased significantly [ 9 , 10 ]. The ability to provide noncontact medical care is now more important.…”