JMIR Publications

ABSTRACT

Background:

In recent years, legal and infrastructural conditions were set to improve the adoption of digital applications in healthcare in Germany. The impact of these conditions was amplified by the COVID-19 pandemic. So far, no studies have confirmed this progress in dermatology.

Objective:

The aim of this study was to measure change in knowledge, interest, expectation, and usage of digital applications in healthcare among dermatologists in Germany in 2019 and 2021.

Methods:

A repeated cross-sectional survey was administered among dermatologists in medical practices and clinics in Germany at two timepoints: t1: 2019 (before the COVID-19 pandemic); t2: 2021 (during the COVID-19 pandemic). A standardized questionnaire was used including items on respondents’ knowledge, interest, expectation, and usage of digital applications as well as their demographics. The survey was distributed by mail and email. Data was analyzed descriptively as well as with multiple logistic regressions.

Results:

At t1, 585 (47.6% female, mean age 52.4 years) and at t2, 792 (48.8% female, mean age 54.3 years) dermatologists participated. Interest in digital medicine was higher at t1 than at t2 (65.1% vs. 57.8%, P ≤ .001). Nevertheless, 38.6% used applications more often since the beginning of the pandemic. For example, real-time telemedicine with patients (2.1% vs. 7.6%, P ≤ .001) and other specialists did increase (5.7% vs. 22.8%, P ≤ .001). Almost one third expressed great concerns about digitalization (34.3% vs. 37.5%, P = .21). Spatial analysis revealed higher interest in, more positive expectations towards, and higher usage of digital applications in urban areas in comparison to rural areas. For instance, dermatologists from urban areas assessed the future risk of applications lower (OR = 0.51; 95% CI [0.35,0.76]). The situation was similar with the age groups as e.g., dermatologists < 50 years also expected lower risks (OR = 0.51; 95% CI [0.34,0.77]). There were no gender differences in utilization, but in knowledge and expectation, e.g.; male participants assessed their confidence in using digital applications (OR = 1.44; 95% CI [1.01,2.04]) higher than female participants.

Conclusions:

In the time of the pandemic, the use of digital applications in dermatology increased but still remains on a moderate level. The regional and age-related disparities identified indicate the need of further action to ensure equal access to digital care.