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To See or Not to See in Telemedicine? A Cross-Sectional Study on Physicians' Attitude Toward Video and Audio Consultation During The COVID-19 Times.

BACKGROUND
BACKGROUND To mitigate the effect of the COVID-19 pandemic, the healthcare systems all over the world implemented telemedicine technologies to respond to the growing need of the healthcare services during these unprecedented times. In the UAE, video and audio consultations have been implemented to deliver health services during the pandemic. OBJECTIVE To evaluate whether differences exist in physician's attitude and perception of video and audio consultation when delivering telemedicine services during the COVID-19 pandemic.


OBJECTIVE
OBJECTIVE To evaluate whether differences exist in physician's attitude and perception of video and audio consultation when delivering telemedicine services during the COVID-19 pandemic.


METHODS
METHODS This was a survey-based study conducted on a cohort of 880 physicians from Abu Dhabi outpatient departments who used telemedicine services during the COVID-19 pandemic between November and December 2020. A total of 623 physicians responded, yielding a response rate of 70.8%. The survey used a 5-point Likert scale to measure physician's attitude and perception of video and audio consultation with reference to the quality of the clinical consultation and the professional working productivity. Descriptive statistics were used to describe physician's sociodemographic characteristics (age, sex, physician's designation, clinical specialty, duration of practice, previous experience with telemedicine) and telemedicine modality (video vs. audio consultation). Regression models were used to describe the association between telemedicine modality and physicians' characteristics with the perceived outcomes of the virtual consultation.


RESULTS
RESULTS When compared to audio consultation, video consultation was associated significantly with physicians' confidence toward managing acute consultations (OR=1.62, 95%CI: 1.2-2.21, p=0.002), and an increased ability to provide patient education during the virtual consultation (OR=2.21, 95%CI: 1.04-4.33, p=0.039). There was no statistically significant difference in physician's confidence toward managing chronic and follow-up consultations when using video or audio consultation (OR= 1.35, 95% CI: 0.88 - 2.08, p=0.17). Video consultation was less likely to be associated with reduced overall consultation time (OR= 0.69, 95% CI: 0.51-0.93, p= 0.016) and reduced patient note documentation time when compared to face-to-face visits (OR= 0.48, 95%CI: 0.36-0.65, p <0.001). Previous experience with telemedicine was associated significantly with lower perceived risk of misdiagnosis (0.46, 95% CI: 0.3 - 0.71, p <0.001), and an increased physician-patient rapport (OR= 2.49, 95% CI: 1.26 - 4.9, p= 0.008).


CONCLUSIONS
CONCLUSION These results indicate that video consultation should be adopted frequently in the remote new clinical consultation. Previous experience with telemedicine was associated with two times higher confidence in treating acute conditions, less than a half of the perceived risk of misdiagnosis, and an increased ability to provide the patient with health education and physician-patient rapport. Additionally, these results show that audio consultation is equivalent to video consultation for providing remote follow-up care to patients with chronic conditions. These findings may be beneficial to policymakers of e-health programs in low- and middle-income countries (LMICs), where audio consultation may significantly increase access to geographically remote health services.


CLINICALTRIAL