S1250 Telemedicine Use Among Gastroenterologists During the COVID-19 Pandemic: Recent Experience and Projection for Future Utility

Abstract

INTRODUCTION: Telemedicine has become an essential tool that allowed physicians to continue to provide care during the coronavirus disease 2019 (COVID-19) pandemic. The use of telemedicine among gastroenterologists has peaked recently but questions remain regarding the future implication of this technology within the field. We aimed to evaluate providers' experience with telemedicine in a large academic health system with a broad geographic reach and quantify variations and factors that influenced this experience. METHODS: We developed a 22-item survey instrument based on literature review, conceptual models of physician behavior, pilot testing by colleagues and discussions with academic and community gastroenterologists. The survey was emailed to practicing providers in the Division of Digestive Diseases at a major university-based health system. RESULTS: Thirty-five out of 83 (41%) gastroenterologists responded to the survey within the first week of distribution, of whom 32% were female, and 68% were ≤44 years old. Sixty-four percent practiced general gastroenterology, 59% have been in practice for ≥10 years, and 18% for ≥20 years. The majority reported positive (46%) and very positive (29%) experience, and only 6% reported a negative experience with telemedicine. 63% felt telemedicine was more efficient than traditional visits, and 58% consider adding telemedicine visits between endoscopic procedures. Lack of physical exam was felt to be critical in 27%, and 25% thought in-person visits would change management plan compared to telemedicine. Age or gender were not associated with having a positive providers’ experience {74% for age <45 vs. 73% for age >45, P = 0.940; 82% for female vs. 70% for male; P = 0.68}. Similarly, the importance of physical exam was not associated with age (22% vs. 36%, P = 0.4), gender (18% for female vs. 30% for male, P = 0.6), or years of experience (36% for < 10 years vs. 20% for ≥10 years; P = 0.1). 91% plan to integrate telemedicine into practice after the COVID-19 outbreak; however two-thirds stated they will use it only if appropriate insurance payment, equal to office visits, is provided. CONCLUSION: The emerging use of telemedicine among gastroenterologists is perceived as a positive experience. The vast majority of our survey participants plan to integrate telemedicine into routine practice following the COVID-19 pandemic. Future efforts should focus on improving the technology’s user interface, overcoming billing/payment hurdles, and techniques to compensate for the lack of physical examination.Table 1.: Participants main characteristics and practice patternsTable 2.: Survey items and respondents feedback on clinical aspects of telemedicine use during the COVID-19 pandemicFigure 1.: Providers' overall experience and perceived patients' overall experience with telemedicine use during the COVID-19 pandemic.