DAQ OH1, YW YEO2, CC OH2, SM PANG2, HY LEE2, KJL CHOO2
MOH Holdings Pte Ltd (MOHH)1, Singapore General Hospital2
The COVID-19 pandemic has changed care provision models with a rapid increase in the adoption rate of telemedicine to reduce and/or replace in-person visits. Though there are many benefits to teledermatology, there are factors that hinder widespread adoption. We aim to identify and explore patients views to identify barriers to teledermatology.
A prospective study was conducted in an academic medical tertiary hospital in Singapore from 15 June to 14 Aug 2020. Patients were invited to complete a questionnaire in the outpatient dermatology clinic via direct approach by clinical staff or through posters pasted at the door of every consult room.
294 patients (29.5%) were keen to change their next appointment to teledermatology, 166 patients (16.6%) were unsure and 537 patients (53.9%) decline to change their subsequent visit to teledermatology. Patient factors that were significant for declining teledermatology consult were the lack of prior exposure to videoconferencing ((OR 4.67 (3.16- 6.9)) and lower education level (OR 2.228 (1.41- 4.34) p =0.019)). Patients also raised concerns on the ability of teledermatology to address medical concerns (32.1%) and preference for face-to-face consultation (29.7%).
Addressing patient concerns, IT literacy and prior usage of teleconferencing are modifiable factors that influence the patient decision on teledermatology adoption. Targeted strategies such as careful patient selection, a dedicated tele-consult workflow and the use of a novel ‘teledermatology patient journey’ that includes a walkthrough in clinic at the first visit, as well as intuitive audio enabled user interface, are needed to improve patient perception and adoption of teleconsultation service.