Change in Ophthalmic Clinicians' Attitudes Toward Telemedicine During the Coronavirus 2019 Pandemic

Abstract

Background: Ophthalmic clinicians report low confidence in telemedicine-based eye care delivery, but it may have changed given its rapid expansion during the coronavirus 2019 (COVID-19) pandemic. Introduction: The purpose of this study was to determine clinician confidence in telemedicine-based eye care services during COVID-19. Materials and Methods: An electronic survey was sent to clinicians at University of Michigan Kellogg Eye Center (April 17, 2020-May 6, 2020) when nonemergent in-person visits and procedures were restricted. The primary outcome was clinician confidence in using telemedicine-based eye care during COVID-19. Secondary outcomes included telemedicine utilization and its association with clinician confidence using Fisher's exact test. Results: Of the 88 respondents (90.7% response rate; n = 97 total), 83.0% (n = 73) were ophthalmologists and 17.0% (n = 15) were optometrists. Telemedicine utilization increased from 30.7% (n = 27) before the pandemic to 86.2% (n = 75) after the pandemic. Clinicians' confidence in their ability to use telemedicine varied with 28.6% (24/84) feeling confident/extremely confident, 38.1% (32/84) somewhat confident, and 33.3% (28/84) notat-all confident. Most felt that telemedicine was underutilized (62.1%; 54/87) and planned continued use over the next year (59.8%; 52/87). Confident respondents were more likely to have performed three or more telemedicine visits (p = 0.003), to believe telemedicine was underutilized (p < 0.001), and to anticipate continued use of telemedicine (p = 0.009). Discussion: The majority of clinicians were at least somewhat confident about using telemedicine during the pandemic.Clinician confidence was associated with telemedicine visit volume and intention to continue using telemedicine. Conclusions: Policies that foster clinician confidence will be important to sustain telemedicine-based eye care delivery.

Teleophthalmology in the Era of COVID-19: Characteristics of Early Adopters at a Large Academic Institution

“…A study at the Kellogg Eye Center at the University of Michigan found that the majority of their ophthalmic clinicians were at least somewhat confident about using telemedicine during the pandemic. 5 Clinicians with high confidence were more likely to use telemedicine and express interest to continue using telemedicine in the future. 5 Thus, cultivating clinician confidence and interest is imperative to further adoption of teleophthalmology.…”

“…5 Clinicians with high confidence were more likely to use telemedicine and express interest to continue using telemedicine in the future. 5 Thus, cultivating clinician confidence and interest is imperative to further adoption of teleophthalmology. At JHM, a substantial proportion of the ophthalmology faculty (58%) completed at least one telemedicine encounter, reflecting a willingness to provide telehealth services.…”

“…6 Some providers in these subspecialties, however, have been able to overcome many obstacles by instructing and guiding patients on how to selfperform certain portions of eye examinations and supply providers with needed ocular estimates. 5 Although utilization of telehealth by ophthalmology as a whole appreciably lagged behind all other surgical specialties, teleophthalmology uptake varied based on several characteristics, suggesting that there may be ways to expand the use of teleophthalmology. As the COVID-19 pandemic progresses, leaders and innovators in ophthalmology should determine ways to increase access to teleophthalmology care and heighten patient satisfaction through introduction of improved teleophthalmology platforms and perhaps more use of hybrid encounters.…”

Review of Clinical and Operative Recommendations for Ophthalmology Practices During the COVID-19 Pandemic

“…Like other medical specialties, ophthalmology providers are advised to defer many non-urgent or emergent appointments. Many providers have responded by taking advantage of relaxed regulations on telemedicine by expanding virtual services to maintain relationships with patients and preserve continuity of care rather than canceling appointments outright [28][29][30].…”

The impact of COVID-19 “Unlock-I” on L V Prasad Eye Institute Network in Southern India

“…This situation applied to eye hospitals too. [ 3 4 5 6 ] Outpatient services dropped by more than 95%, and a significant number of emergency conditions did not receive adequate care. [ 7 8 ] Subsequently, lockdown was eased to some extent from May 4 to May 31 (lockdown III and IV).…”