JMIR Publications

ABSTRACT

Background:

Previous studies have demonstrated telemedicine (TM) to be an effective tool to complement rheumatology care and address workforce shortage. With the outbreak of the SARS-CoV-2 pandemic, TM experienced a massive upswing. However, in rheumatology care, the use of TM stagnated again shortly thereafter. Consequently, the factors associated with physicians’ willingness and actual use of TM need to be thoroughly investigated.

Objective:

The study aimed to identify factors that determine the actual use of TM and willingness to use TM among rheumatologists and general practitioners.

Methods:

We conducted a secondary analysis of data from a nationwide cross-sectional survey with rheumatologists and general practitioners. Bayesian univariate and multivariate logistic regression analyses were applied to the data in order to determine which factors were associated with the actual use of TM (TM-use) and willingness to use TM (TM-willingness). Predictor variables (covariates) studied individually included sociodemographic factors (e.g., age, sex), work characteristics (e.g., practice location, medical specialty) and self-assessed knowledge on TM. All the variables positively and negatively associated with TM-use and TM-willingness in the univariate analysis were then considered for Bayesian model averaging analysis (BMA) after a selection based on the variance inflation factor (≤ 2.5). All analyses were stratified by sex.

Results:

Univariate analysis revealed that a total of 36 and 34 variables (out of 83) were positively or negatively associated (region of Practical Equivalence ≤ 5%) with TM-use and TM-willingness, respectively. BMA analysis allowed us to identify 13 and 17 factors of TM-use and TM-willingness, respectively. Among these factors, being a woman, having very poor knowledge of TM, treating less than 500 patients per quarter and not being willing to use TM were negatively associated with TM-use, while having good knowledge of TM and treating more than 1,000 patients per quarter were positively associated with TM-use. In addition, being 51 to 60 years old, thinking that TM is not important for current and future work and not currently using TM were negatively associated with TM-willingness, while owning a smart device and working in an urban area was positively associated with TM-willingness.

Conclusions:

The results point to the close connection between health care professionals’ knowledge on TM and actual TM-use. These results lend support to the integration of digital competencies into medical education, as well as hands-on training for health care professionals. Incentive programs for physicians above the age of 50, practicing in rural areas could further encourage TM-willingness.