gms | German Medical Science

Background and state of (inter)national research: In the wake of the Covid-19 pandemic, barriers to the use of telemedicine have been removed. This analysis focuses on the use of telemedicine in the outpatient sector, considering the perspective of different disciplines (general medicine, cardiology, gastroenterology, pediatrics, gynaecology, ENT) during the Covid-19 pandemic in Germany.

Question and objectives: How has the use of telemedicine in the outpatient sector changed over the course of the pandemic and what factors (specialty, age, practice location, type of practice and gender) play a role? The results can contribute to the improvement of telemedicine care in the outpatient sector by identifying the need as well as possible influencing factors.

Method or hypothesis: The second wave of the anonymous online survey within the study COVID-GAMS (BMBF, FKZ:01KI2099) was conducted between November and December 2020. For this purpose, general practitioners, resident cardiologists, gastroenterologists, pediatricians, gynecologists, ENT specialists and dentists were purposefully contacted and invited to participate in the survey. At the same time, open recruitment was conducted via the professional societies. The data of 1,531 physicians were statistically analysed using descriptive as well as interference statistical methods.

Results: There is a significant increase in the use of telephone and video consultation comparing before the pandemic to March/April 2020 and of telephone consultation between March/April 2020 and November/December 2020. Regarding the frequency of use, physicians who already used telephone/video consultations in March/April 2020 report an increase in such services. Physicians who use neither telephone nor video consultations cite as the main reasons that telemedicine is not equivalent to face-to-face contact and little demand from patients. Analyses show significant influences of the speciality on the current use of telephone consultation, video consultation, the subjective assessment of the benefit of telemedicine, and the proportion of patient contact that is accounted for by telemedicine. General medicine has a significantly higher impact on these variables than ENT and gynecology. The practice location, as well as the type of practice, have been shown to be further significant influencing factors in the individual models.

Discussion: The Covid-19 pandemic has led to a significant increase in the use of telemedicine. At the same time, the results show that the use of telemedicine has not become established in all specialties and that there are still barriers from the point of view of physicians. Structural factors also seem to be relevant if the use of telemedicine is to be expanded in the long term.

Practical implications: In order to be able to further establish the positive aspects that can arise with the use of telemedicine in the everyday life of physicians, it is important to know more about promoting and inhibiting factors.

Appeal for practice (science and/or care) in one sentence: If it becomes clear that patients benefit from digital services, the hurdles mentioned by physicians must be removed.