Survey of Canadian Ophthalmologists’ Telemedicine Utilization During the COVID-19 Pandemic
Authors:Gareth D. Mercer1, Bonnie He2, Leonard Levin1. 1McGill University, 2University of British Columbia.
Author Disclosure Block:G.D. Mercer: None. B. He: None. L. Levin: None.
describe the uptake and patterns of telemedicine utilization by Canadian
ophthalmologists during the first wave of the Covid-19 pandemic.
Study Design: National, cross-sectional survey.
Methods: A convenience sample of ophthalmologists in practice between March and July, 2020, completed a single online questionnaire assessing basic demographics, clinical practice characteristics and telemedicine utilization prior to and during the pandemic. Standard descriptive statistics were used to estimate the proportion using telemedicine and changes in overall clinical encounter volumes during vs. before the pandemic overall and within subgroups defined by clinical practice characteristics. Agglomerative hierarchical cluster analysis was used to identify groups who varied on the types of visits they offered using telemedicine.
Results: Ophthalmologists from all regions of Canada completed the survey (n=73, gender: female 32%, male 66%; practice type: comprehensive 38%, subspecialty 62%; career stage: early 25%, mid 32%, later 44%; location: urban 80%, rural 10%, both 8%). Eight percent reported using telemedicine prior to the pandemic compared to 86% during. The proportion offering telemedicine visits did not differ by career stage, practice type, or location. The majority (81%) primarily used the telephone for telemedicine visits, whereas 6% primarily used videoconferencing or telemedicine software and 13% used a combination. Overall, visit volumes during the pandemic declined to 39% of pre-pandemic levels (median decrease 85 visits/week, interquartile range = 50 - 132). The decline was smaller for ophthalmologists who used telemedicine than those who did not (median decrease: 85 vs. 142 visits/week, p = 0.03). Four clusters were identified. The first used telemedicine for all visits types assessed (triage, new consultations, routine follow-ups, post-operative follow-ups, and urgent/unplanned follow-ups). The second used telemedicine mainly for triaging and urgent visits, the third primarily for routine visits, and the fourth mostly for triage and post-op visits. The first group was more likely than the others to have used telemedicine software (33% vs. 13%) and to perceive a modest-to-large role for telemedicine in their future practice (61% vs. 38%).
Conclusions: For many Canadian ophthalmologists, integrating telemedicine into clinical practice may have partially offset the disruption to normal clinical activities during the pandemic. While the majority may have seen telemedicine as a temporary solution, a sizeable minority appear to have made considerable use of the technology and see an ongoing role for it once regular clinical activities resume.