Telemedicine Usage among Urologists during the COVID-19 Pandemic: Cross-Sectional Study

Justin M. Dubin, W. Austin Wyant, Navin C. Balaji, William L.K. Ong, Reda H. Kettache, Malik Haffaf, Skander Zouari, Diego Santillan, Ana Maria Autrán Gómez, Hossein Sadeghi-Nejad, Stacy Loeb, James F. Borin, Juan Gomez Rivas, Jeremy Grummet, Ranjith Ramasamy, Jeremy Y.C. Teoh

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Prior to the COVID-19 pandemic, urology was one of the specialties with the lowest rates of telemedicine and videoconferencing use. Common barriers to the implementation of telemedicine included a lack of technological literacy, concerns with reimbursement, and resistance to changes in the workplace. In response to the COVID-19 pandemic declared in March 2020, the delivery of urological services globally has quickly shifted to telemedicine to account for the mass clinical, procedural, and operative cancellations, inadequate personal protective equipment, and shortage of personnel. Objective: The aim of this study was to investigate current telemedicine usage by urologists, urologists’ perceptions on the necessity of in-person clinic appointments, the usability of telemedicine, and the current barriers to its implementation. Methods: We conducted a global, cross-sectional, web-based survey to investigate the use of telemedicine before and after the COVID-19 pandemic. Urologists’ perceived usability of telemedicine was assessed using a modified Delphi approach to create questions based on a modified version of the validated Telehealth Usability Questionnaire (TUQ). For the purposes of this study, telemedicine was defined as video calls only. Results: A total of 620 urologists from 58 different countries and 6 continents participated in the survey. Prior to COVID-19, 15.8% (n=98) of urologists surveyed were using telemedicine in their clinical practices; during the pandemic, that proportion increased to 46.1% (n=283). Of the urologists without telemedicine experience, interest in telemedicine usage increased from 43.7% (n=139) to 80.8% (n=257) during the COVID-19 pandemic. Among urologists that used telemedicine during the pandemic, 80.9% (n=244) were interested in continuing to use it in their practice. The three most commonly used platforms were Zoom, Doxy.me, and Epic, and the top three barriers to implementing telemedicine were patients’ lack of technological comprehension, patients’ lack of access to the required technology, and reimbursement concerns. Conclusions: This is the first study to quantify the use, usability, and pervading interest in telemedicine among urologists during the COVID-19 pandemic. In the face of this pandemic, urologists’ usage of telemedicine nearly tripled, demonstrating their ability to adopt and adapt telemedicine into their practices, but barriers involving the technology itself are still preventing many from utilizing it despite increasing interest.

Original languageEnglish (US)
Article numbere21875
JournalJournal of Medical Internet Research
Volume22
Issue number11
DOIs
StatePublished - Nov 2020

Keywords

  • Barrier
  • COVID-19
  • Coronavirus
  • Cross-sectional
  • Implementation
  • Perception
  • Technology
  • Telehealth
  • Telemedicine
  • Urology
  • Usability

ASJC Scopus subject areas

  • Health Informatics

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