Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Meharry Medical College School of Medicine, Nashville, Tennessee, USA.
Telemed J E Health. 2021 Jul;27(7):739-746. doi: 10.1089/tmj.2020.0372. Epub 2020 Oct 16.
COVID-19 led to rapid policy changes to expand telemedicine adoption. We examined rates of early telemedicine adoption among surgical departments at a large academic institution and compared provider characteristics associated with teleophthalmology. With data from departmental and electronic medical records across surgical departments at Johns Hopkins Medicine, we performed a retrospective analysis using the Fisher test and binomial logistic regression. Telemedicine adoption in ophthalmology was disproportionately lower than other surgical departments. Providers who were female [odds ratio, OR, 2.42 (95% confidence interval, CI, 1.03-5.67)], clinical assistants, clinical associates, or instructors [OR 12.5 (95% CI 2.63-59.47)], associate professors [OR 4.38 (95% CI 1.42-13.52)], practiced for ≥36 years [OR 0.20 (95% CI 0.06-0.66)], cornea [OR 0.13 (95% CI 0.04-0.47)], glaucoma [OR 0.18 (95% CI 0.04-0.93)] or retina [OR 0.04 (95% CI 0.01-0.17)] specialists, or had a MD/MBBCh/MBBS [OR 0.30 (95% CI 0.10-0.94)] or second degree [OR 0.28 (95% CI 0.08-0.99)] were significantly more or less likely to adopt. When adjusted, cornea [adjusted OR 0.10 (95% CI 0.02-0.57)] or retina [adjusted OR 0.01 (95% CI 0.002-0.12)] specialists or providers who practiced for 12-18 years [adjusted OR 0.22 (95% CI 0.05-0.91)] or ≥36 years [adjusted OR 0.13 (95% CI 0.03-0.68)] were significantly more or less likely to adopt. Subspecialty among other provider characteristics influences the likelihood of teleophthalmology adoption. As the pandemic continues, strategies to reduce adoption barriers are needed to ensure the provision of health care services.
COVID-19 促使政策迅速变化以扩大远程医疗的应用。我们考察了一家大型学术机构外科科室早期采用远程医疗的比例，并比较了与远程眼科相关的提供者特征。 利用约翰霍普金斯医学中心外科科室的部门和电子病历数据，我们使用 Fisher 检验和二项逻辑回归进行了回顾性分析。 眼科的远程医疗采用率明显低于其他外科科室。女性提供者[比值比（OR），2.42（95%置信区间，CI，1.03-5.67)]、临床助理、临床助理或讲师[OR 12.5（95%CI 2.63-59.47)]、副教授[OR 4.38（95%CI 1.42-13.52)]、执业≥36 年[OR 0.20（95%CI 0.06-0.66)]、角膜[OR 0.13（95%CI 0.04-0.47)]、青光眼[OR 0.18（95%CI 0.04-0.93)]或视网膜[OR 0.04（95%CI 0.01-0.17)]专家，或具有 MD/MBBCh/MBBS[OR 0.30（95%CI 0.10-0.94)]或第二学位[OR 0.28（95%CI 0.08-0.99)]的人更有可能或不太可能采用远程医疗。调整后，角膜[调整后的 OR 0.10（95%CI 0.02-0.57)]或视网膜[调整后的 OR 0.01（95%CI 0.002-0.12)]专家或执业 12-18 年[调整后的 OR 0.22（95%CI 0.05-0.91)]或≥36 年[调整后的 OR 0.13（95%CI 0.03-0.68)]的提供者更有可能或不太可能采用远程医疗。 其他提供者特征中的专业知识会影响远程眼科采用的可能性。随着大流行的继续，需要采取策略来减少采用障碍，以确保提供医疗保健服务。
