How Dermatologists See Teledermatology Now and After COVID-19

Approximately 70% of dermatologists believe that teledermatology will continue after the COVID-19 pandemic, and 58% intend to continue using it, researchers reported in a study published in JAMA Dermatology.

The investigators sought to assess dermatologists’ perceptions and experiences regarding teledermatology during the COVID-19 pandemic and with recent regulatory changes from the US Centers for Medicare and Medicaid Services. A teledermatology task force from the American Academy of Dermatology (AAD) surveyed AAD members via email in May and June 2020.

A total of 5000 participants of 12,070 practicing US dermatologists in the AAD were selected to receive the survey. Of 4356 responses, 591 dermatologists completed the survey (13.6% response rate). Participants’ mean age was 49.3 years (95% CI, 48.4-50.3), 45.0% practiced in a dermatology-based group (257 of 571), and 24.7% had a solo practice (141 of 571).

Before the COVID-19 pandemic, 82 of 582 (14.1%) dermatologists had used teledermatology vs 572 of 591 (96.9%) during the pandemic. In addition, 323 of 557 (58.0%) responders expect to continue to use teledermatology after the pandemic.

According to the survey results, the most common barriers to implementing teledermatology include low reimbursement (398 of 570, 69.8%), technology and connectivity issues (223 of 570, 39.1%), concerns about malpractice and liability (154 of 570, 27.0%), and government regulations (132 of 570, 23.2%).

Older dermatologists were less likely to have reimbursement concerns (odds ratio [OR], 0.96; 95% CI, 0.94-0.99; P =.02) and malpractice and liability concerns (OR, 0.98; 95% CI, 0.96-0.99; P =.02). Dermatologists who were men were more likely to believe that reimbursement was too low (OR, 1.95; 95% CI, 1.03-3.70; P =.04).

Rural dermatologists were more likely to use platforms that were not compliant with the Health Insurance Portability and Accountability Act (OR, 2.41; 95% CI, 1.04-5.56; P =.04), view government regulations as a barrier to future use (OR, 2.33; 95% CI, 1.11-4.89; P =.03), and report a lack of need for teledermatology (OR, 6.77; 95% CI, 2.08-22.0; P =.002).

Teledermatology experiences before the COVID-19 pandemic were associated with increased satisfaction with the quality of care (OR, 2.05; 95% CI, 1.24-3.39; P =.01) as well as plans to continue its use after COVID-19 (OR, 3.37; 95% CI, 2.08-5.45; P <.001).

Overall, 387 of 554 (70%) dermatologists believe that teledermatology will continue after COVID-19, and 323 of 557 (58%) intend to continue its use.

Study limitations include the 13.6% response rate and the relative over-representation of dermatologists who were women compared with the overall population.

“The future of telemedicine regulation, reimbursement, educational implementation, and technological implementation will greatly affect commonplace use of teledermatology post-COVID-19, and we hope these data can support these efforts,” stated the investigators.

Disclosures: One study author declared affiliations with pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Kennedy J, Arey S, Hopkins Z, et al. Dermatologist perceptions of teledermatology implementation and future use after COVID-19: demographics, barriers, and insights. JAMA Dermatol. Published online March 31, 2021. doi:10.1001/jamadermatol.2021.0195