Experience with telemedicine amongst rheumatology clinicians during the COVID-19 pandemic: an international survey

Abstract Objective To assess rheumatology clinicians’ perceptions of telemedicine as well as their experiences before and during the COVID-19 pandemic. Methods We conducted a cross-sectional online survey and collected responses from rheumatology clinicians worldwide between November 2020 and February 2021, regarding use and perceptions of telemedicine in rheumatology. We summarized data with descriptive statistics and qualitative analysis for free-text responses. Results The survey was completed by 349 rheumatology clinicians from 49 countries; 59% were female and one-third were 30–50 years old. Academic affiliations were held by 55% of participants and 44% were from North America. Prior to the pandemic, 24% of participants had experience with telemedicine, while about three-quarters used telemedicine for the first time during the pandemic. Overall, 56% thought they provided less adequate care with telemedicine. More than half of clinicians felt that telemedicine was adequate for evaluating crystalline arthritis, inflammatory arthritis, and lupus flares. Telemedicine was felt to be inadequate for flares of myositis, vasculitis, and scleroderma. Technical problems were reported in 29% of telemedicine encounters and were most commonly related to patient-encountered difficulties. Conclusion . Most rheumatology clinicians used telemedicine for the first time during the pandemic. The quality of care provided was thought to be inferior to that provided in-person for specific clinical situations. Additional efforts are needed to address barriers to effective telemedicine such as patient-related technology issues, challenges with building rapport, and performing a physical examination and to define the appropriate scope of clinical scenarios conducive to telemedicine.