The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Orthopedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Telemed J E Health. 2022 Mar;28(3):415-421. doi: 10.1089/tmj.2020.0539. Epub 2021 Jun 15.
With the COVID-19 epidemic ever-expanding, nonemergent access to health care resources has been reduced to decrease the exposure for patients and health care providers. Alternatives to in-office outpatient medical evaluations are necessary. We aimed to analyze how quickly orthopedic surgery providers at a large academic institution adopted telemedicine, and identify any factors that were associated with earlier or "faster" telemedicine adoption. We analyzed the telemedicine activity of 39 providers within the Department of Orthopedic Surgery between March 16, 2020, and May 30, 2020, and constructed logistic regression models to identify characteristics with significant association to earlier or faster telemedicine adoption. No significant predictors of percentage of visits conducted via telemedicine were found. However, increased experience and practice at multiple locations was associated with slower telemedicine adoption time, while Professor level academic rank was associated with a faster time to achieving 10% of pre-COVID visit volumes via telemedicine. Higher pre-COVID visit volumes were also significantly associated with faster telemedicine adoption. Demographic factors, including, age, gender, practice locations, academic degrees, pediatric specialty, and use of physician assistants/nurse practitioners, were not found to have significant associations with telemedicine use. These results indicate that telemedicine has an important role to play within academic orthopedic surgery practices, with a wide and diverse range of orthopedic surgery providers choosing to utilize it during the COVID-19 pandemic. Given the rapid expansion and urgency driving the adoption of telemedicine, these results illustrate the importance of considering provider-side characteristics in ensuring that providers are well equipped to utilize telemedicine.
随着 COVID-19 疫情的不断蔓延，为减少患者和医护人员的暴露风险，非紧急医疗资源的获取受到限制。因此，有必要寻找门诊医疗评估的替代方案。我们旨在分析一家大型学术机构的骨科医生采用远程医疗的速度，并确定与更早或“更快”采用远程医疗相关的因素。我们分析了 2020 年 3 月 16 日至 2020 年 5 月 30 日期间骨科 39 名医生的远程医疗活动，并构建了逻辑回归模型，以确定与更早或更快采用远程医疗相关的特征。未发现通过远程医疗进行就诊的比例有显著预测因素。然而，在多个地点的经验和实践增加与远程医疗采用时间的延长有关，而教授级学术职称与通过远程医疗达到 COVID-19 前就诊量的 10%的时间更快有关。较高的 COVID-19 前就诊量也与更快的远程医疗采用显著相关。人口统计学因素，包括年龄、性别、执业地点、学历、儿科专业以及使用医师助理/护士从业者，与远程医疗的使用没有显著关联。这些结果表明，远程医疗在学术骨科实践中具有重要作用，广泛而多样化的骨科医生在 COVID-19 大流行期间选择使用远程医疗。考虑到远程医疗的快速扩张和紧急性，这些结果说明了考虑提供者特征在确保提供者具备充分利用远程医疗的能力方面的重要性。
