Survey of Canadian Ophthalmologists’ Telemedicine Utilization During the COVID-19 Pandemic
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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.
Abstract Body:
Purpose: To
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.