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Pediatric Primary Care Clinicians' Perspectives on Telemedicine Use, 2020 Versus 2021
Kelsey Schweiberger1, Alejandro Hoberman1,2, Jennifer Iagnemma2
1Division of General Academic Pediatrics, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Insights
Pediatric clinicians believe telemedicine offers quality care for mental health and coordination, but usability perceptions declined after one year. Satisfaction remained high despite challenges with ease of use and reliability.
Area of Science:
- Pediatric primary care
- Telemedicine
- Health services research
Background:
- Telemedicine adoption surged in pediatric primary care following the COVID-19 pandemic.
- Understanding clinician attitudes towards telemedicine is crucial for optimizing its integration into routine practice.
Purpose of the Study:
- To evaluate changes in pediatric primary care clinician attitudes and perceptions regarding telemedicine after one year of its use.
- To assess how clinician views on telemedicine's quality, usability, and impact evolved over time.
Main Methods:
- A survey was administered to pediatric primary care clinicians in Pennsylvania in 2020 and 2021.
- Linked survey responses from 101 clinicians using deterministic and probabilistic matching.
- McNemar's test was used to compare changes in perceptions between the two survey periods.
Main Results:
- Clinician agreement that telemedicine provides high-quality care for mental health and care coordination remained stable, but declined for acute and preventive care.
- Perceptions of telemedicine usability, including ease of use and reliability, significantly worsened over the study year.
- Despite declining usability perceptions, overall clinician satisfaction with telemedicine use remained high (62%) at both time points.
Conclusions:
- Pediatric primary care clinicians largely maintained positive views on telemedicine's capacity for specific care types but experienced diminished usability perceptions.
- Addressing usability challenges is essential for sustained and effective telemedicine integration in pediatric primary care.
- While clinicians anticipated benefits for equity and timeliness, perceived impacts on child health and clinician experience did not change significantly.
Abstract:
Objective: We examined the change in pediatric primary care clinician attitudes and perceptions about telemedicine after one year of telemedicine use. Methods: We administered a survey to pediatric primary care clinicians across 50 primary care practices in Pennsylvania in 2020 and 2021. Surveys were linked using a combination of deterministic and probabilistic matching. We used McNemar's test to compare change in responses from 2020 to 2021. Results: Among pediatric primary care clinicians surveyed in 2020 and 2021 (n = 101), clinicians agreed that telemedicine could always or usually deliver high-quality care for mental health (80% in 2020 and 78% in 2021), care coordination (77% in 2020 and 70% in 2021), acute care (33% in 2020 and 34% in 2021), or preventive care (25% in 2020 and 18% in 2021) and this did not significantly change. Clinician perceptions of usability, while high, declined over time with fewer endorsing ease of use (93% in 2020 and 80% in 2021) and reliability (14% in 2020 and 0% in 2021) over time. Despite this, 62% of clinicians agreed that they were satisfied with their use of telemedicine at both time points. Respondents anticipated positive impact on equity and timeliness of care from telemedicine use but did not anticipate positive impact across child health, health care delivery, or clinician experience. Perceptions across these domains did not change over time. Conclusions: With one year of telemedicine experience, primary care clinicians maintained beliefs that telemedicine could deliver high-quality care for specific clinical needs but had worsening perceptions of usability over time.
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