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. 2020 Nov 5;22(11):e21875.
doi: 10.2196/21875.

Telemedicine Usage Among Urologists During the COVID-19 Pandemic: Cross-Sectional Study

Justin M Dubin  1 , W Austin Wyant  1 , Navin C Balaji  1 , William Lk Ong  2 , Reda H Kettache  3 , Malik Haffaf  4 , Skander Zouari  5 , Diego Santillan  6 , Ana Maria Autrán Gómez  7   8 , Hossein Sadeghi-Nejad  9   10 , Stacy Loeb  11 , James F Borin  12 , Juan Gomez Rivas  13   14 , Jeremy Grummet  15 , Ranjith Ramasamy  1 , Jeremy Y C Teoh  16
Affiliations

Telemedicine Usage Among Urologists During the COVID-19 Pandemic: Cross-Sectional Study

Justin M Dubin et al. J Med Internet Res. .

Abstract

Background: Prior to the COVID-19 pandemic, urology was one of the specialties with the lowest rates of telemedicine and videoconferencing use. Common barriers to the implementation of telemedicine included a lack of technological literacy, concerns with reimbursement, and resistance to changes in the workplace. In response to the COVID-19 pandemic declared in March 2020, the delivery of urological services globally has quickly shifted to telemedicine to account for the mass clinical, procedural, and operative cancellations, inadequate personal protective equipment, and shortage of personnel.

Objective: The aim of this study was to investigate current telemedicine usage by urologists, urologists' perceptions on the necessity of in-person clinic appointments, the usability of telemedicine, and the current barriers to its implementation.

Methods: We conducted a global, cross-sectional, web-based survey to investigate the use of telemedicine before and after the COVID-19 pandemic. Urologists' perceived usability of telemedicine was assessed using a modified Delphi approach to create questions based on a modified version of the validated Telehealth Usability Questionnaire (TUQ). For the purposes of this study, telemedicine was defined as video calls only.

Results: A total of 620 urologists from 58 different countries and 6 continents participated in the survey. Prior to COVID-19, 15.8% (n=98) of urologists surveyed were using telemedicine in their clinical practices; during the pandemic, that proportion increased to 46.1% (n=283). Of the urologists without telemedicine experience, interest in telemedicine usage increased from 43.7% (n=139) to 80.8% (n=257) during the COVID-19 pandemic. Among urologists that used telemedicine during the pandemic, 80.9% (n=244) were interested in continuing to use it in their practice. The three most commonly used platforms were Zoom, Doxy.me, and Epic, and the top three barriers to implementing telemedicine were patients' lack of technological comprehension, patients' lack of access to the required technology, and reimbursement concerns.

Conclusions: This is the first study to quantify the use, usability, and pervading interest in telemedicine among urologists during the COVID-19 pandemic. In the face of this pandemic, urologists' usage of telemedicine nearly tripled, demonstrating their ability to adopt and adapt telemedicine into their practices, but barriers involving the technology itself are still preventing many from utilizing it despite increasing interest.

Keywords: COVID-19; barrier; coronavirus; cross-sectional; implementation; perception; technology; telehealth; telemedicine; urology; usability.

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Conflict of interest statement

Conflicts of Interest: SL reports reimbursed travel to the Prostate Cancer Foundation Retreat from Sanofi, consulting fees from Lumenis and Bayer, and equity in Gilead. SL is supported by the Prostate Cancer Foundation and the Edward Blank and Sharon Cosloy-Blank Family Foundation. RR reports the following: Acerus Pharmaceuticals (consultant), Aytu Pharmaceuticals (consultant, grant recipient), Boston Scientifice (consultant, grant recipient), Coloplast (consultant, grant recipient), Direx (investigator), Endo Pharmaceuticals (consultant, grant recipient), and Nestle Health (consultant). NCB reports a consultantship with Molekule Consulting.

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