JMIR Publications

ABSTRACT

Background:

Following the emergence of telemedicine (TM) as a major health-delivery mode during the COVID-19 pandemic, Sheba Medical Center (SMC) rapidly transitioned its outpatient clinics to TM. A post-implementation satisfaction study revealed that while nearly 90% of patients reported a positive experience, only 38% of clinicians expressed high satisfaction. SMC soon established Sheba BEYOND, a dedicated virtual hospital. This initiative was accompanied by extensive efforts to improve the TM experience. In 2025, a follow-up survey addressing clinician satisfaction and acceptance was conducted.

Objective:

To explore whether clinician satisfaction improved, and which barriers to clinician engagement persist.

Methods:

An anonymous survey was distributed via a link to the staff of SMC’s outpatient clinics. The survey inquired about user experience with the TM digital platform, integration in workflow, barriers to use, perceived benefit to patients and overall satisfaction. Clinicians that never or rarely perform TM visits were classified as non-users, all others were classified as users. The questionnaire included 21 questions, 2 additional questions for non-users and 5 additional for users. Overall satisfaction was ranked on a 1-10 Likert scale [1]. Descriptive statistics were calculated with Excel (Microsoft, Redmond, WA) and SPSS (IBM version 29.02) software. A chi-square test of independence was used for categorical variables. t-test was two-tailed, with a probability of <0.05 considered statistically significant.

Results:

The survey was sent to 2,735 clinicians and 274 (10%) responded. TM users accounted for 52.5% (144). Among all respondents, 54.4% (149) were physicians, 30.3% (83) were paramedical staff, and 15.3% (42) were nurses. Physician specialties were internal medicine (36; 13%), psychiatry (34; 13%), pediatrics (36; 13%), oncology (31; 11%), and other specialties (137; 50%). A 41.9% increase in overall high level user satisfaction from 37.7%; (61/162) to 53.5% (77/144) was recorded compared the 2020 survey (p=0.006). The increase in satisfaction was largely driven by a significant improvement in the oncology clinic, where high-level satisfaction rose from 23.3% (10/43) to 63.6% (14/22) (p=0.01). 64.4% (176) respondents believed that TM was advantageous for patient care. 66% (95) of users reported that TM reduced their workload. Most clinicians (62.1%; 64) experienced problems in connecting to the patients' network and 32% (33) experienced connectivity problems in SMC. In fact, 80.6% (83) reported that they had to switch to telephone at least once. The vast majority of the non-users (81.6%; 80) stated that they did not perform TM because it was mostly clinically inappropriate.

Conclusions:

This study demonstrates the positive impact of institutional change management strategy in promoting clinician engagement with TM. However, persistent technical barriers and varying engagement highlight opportunities for refinement.