Factors Influencing Use and Perceptions of Teledermatology - A Mixed Methods Study of 942 participants. (Supplementary Files)

Background: The protracted COVID-19 pandemic highlights the need for a sustainable telemedicine practice.

Objective: To understand patient perceptions toward teledermatology.

Methods: Convergent parallel mixed methods study of 942 dermatology patients or their caregivers between June 2020 and April 2021.

Results: Multivariate regression found that youth, increased computer use, willingness to show body areas over photo/video, perceived quality of teledermatology, demand for social distancing and to reduce commute were associated with willingness to use teledermatology. Willingness to use declined with easing of COVID-19 movement restrictions. 48.5% reported a poorer experience with teledermatology compared to in-person consults.

Qualitative data from 26 interviews showed that willingness to use is influenced by pragmatic considerations, emotional factors, and data privacy concerns. These were moderated by the patient’s perception of disease severity and need for an accurate diagnosis.

Limitations include lack of data prior to the pandemic and during the initial lockdown period.

Conclusion: The willingness to use teledermatology is influenced by circumstantial factors, IT literacy, views towards teledermatology and factors driving the purpose of consult. The declining willingness to use with the easing pandemic, lower willingness to pay and poorer experience compared to in-person consults highlight the need to optimize this mode of delivery.

背景：持续蔓延的新型冠状病毒肺炎（COVID-19）大流行凸显了构建可持续远程医疗实践体系的必要性。
研究目的：探明患者对远程皮肤病学（teledermatology）的认知与态度。
研究方法：于2020年6月至2021年4月期间，针对942名皮肤病患者或其照护者开展收敛型平行混合方法研究。
研究结果：多变量回归分析显示，青年群体、更高的计算机使用频率、愿意通过照片或视频展示身体部位、对远程皮肤病学诊疗质量的正向感知、社交距离需求以及减少通勤的诉求，均与患者使用远程皮肤病学诊疗的意愿显著相关。随着COVID-19疫情防控出行限制的放宽，患者的使用意愿呈下降趋势。48.5%的受访者表示，远程皮肤病学诊疗的体验相较于线下门诊更差。
针对26例访谈的质性数据显示，患者的使用意愿受实用考量、情感因素及数据隐私顾虑的影响，且上述影响会因患者对疾病严重程度的认知及精准诊断需求产生调节作用。
本研究的局限性在于，缺乏疫情暴发前及疫情初期封控阶段的相关数据。
研究结论：远程皮肤病学诊疗的使用意愿受情境因素、信息科技素养、对远程诊疗的认知态度以及就诊动机驱动因素的影响。随着疫情形势缓和，患者使用意愿下降、付费意愿降低，且相较于线下门诊体验更差，上述问题均凸显出优化该诊疗服务模式的必要性。