Factors influencing use and perceptions of teledermatology: A mixed-methods study of 942 participants

Abstract

Background The protracted COVID-19 pandemic highlights the need for a sustainable telemedicine practice. Objective To understand patient perceptions toward teledermatology. Methods Convergent parallel mixed-methods study of 942 dermatology patients or their caregivers between June 2020 and April 2021. Results Multivariate regression found that youth, increased computer use, willingness to show body areas over photo/video, perceived quality of teledermatology, demand for social distancing and to reduce commute were associated with willingness to use teledermatology. The willingness to use teledermatology declined with the easing of COVID-19 movement restrictions, and 48.5% reported a poorer experience with teledermatology than with in-person consultations. Qualitative data from 26 interviews showed that willingness to use is influenced by pragmatic considerations, emotional factors, and data privacy concerns. These were moderated by the patient's perception of disease severity and need for an accurate diagnosis. Limitations Lack of data prior to the pandemic and during the initial lockdown period. Conclusion The willingness to use teledermatology is influenced by circumstantial factors, technology literacy, views toward teledermatology, and factors driving the purpose of consultation. The declining willingness to use teledermatology with the easing pandemic, lower willingness to pay full in-clinic prices, and poorer experience compared with in-person consultations highlights the need to optimize this mode of delivery.

Factors Impacting Patient Perspectives on Telehealth and Remote Healthcare during COVID-19: A Mixed Methods Study

“…Effective communication, time, and cost significantly impact patient perspectives on telehealth [7] . Cost of living, traveling, and transportation can be added to the price of health services for patients who need to see their doctors face-to-face.…”

“…Factors such as data privacy, emotional factors, and technology culture driving the consultations can influence caregivers' and users’ willingness to use telehealth [7] . For example, Gordon et al [12] emphasized the importance of effective communication with patients during clinical video telehealth appointments to address and answer all patients’ questions as the essential factor influencing their satisfaction with telehealth visits.…”

Factors influencing willingness to pay and show images with teledermatology during the COVID19 pandemic

“…Quantitative and qualitative findings were cross-validated for convergence. 2 We found that the willingness to use teledermatology was strongly correlated with barriers, such as the willingness to show images of the body on photo/video and financial costs. In this letter, we provide secondary analysis to build upon the discussion of barriers in the paper by Linggonegoro et al 1 In our data, females and ethnic Malays (who lean religiously conservative) and each individual's concerns over data security and privacy were associated with lower willingness to show body images over photo/video (Table I).…”

“…We conducted a convergent parallel mixedmethod study to explore the willingness to use teledermatology during the COVID-19 pandemic. 2 Nine hundred forty-two questionnaires and 26 in-depth interviews were administered to dermatology outpatients or their primary caregivers. Questionnaire responses were consolidated and used in multivariable regression analyses, while interview transcripts were coded and analyzed using grounded theory.…”

Patient Factors Associated With Teledermatology Visit Type and Submission of Photographs During the COVID-19 Pandemic: Cross-sectional Analysis

“…During this study period, patient portal enrollment was necessary to submit photographs to dermatologists, and this may also contribute to the differences in photograph submission between Black and White patients after adjusting for internet and computer access levels. More broadly, successful enrollment in the electronic patient portal likely represents a patient's overall familiarity with and frequency of technology use, both of which contribute to patients' willingness to participate in video visits [27]. Additionally, the racial differences we have observed likely represent other socioeconomic and infrastructural barriers, such as stable internet connection and personal smartphone or tablet ownership, that were not directly measurable in our study and prevent equitable participation in teledermatology care.…”