Acceptance of telemedicine by specialists and general practitioners in cardiology care: a cross-sectional survey study (Preprint)

Abstract

In the coming years, telemedicine (TM) will play a key role in healthcare. Especially in rural areas with weak infrastructure, TM could be crucial to provide adequate and personalized medical care.

Therefore, we investigated the acceptance and preferences for the use of TM.

Between May 2021 and February 2022, an online survey was conducted with cardiologists, internists and general practitioners focusing on cardiac care, working predominantly in outpatient and inpatient settings. Participants were contacted via their professional email addresses, via QR code published in a regional health journal, and via twitter. To classify survey participants based on their attitudes to telecardiology, multidimensional scaling (MDS) and a subsequent K-means clustering with the Kruskal-Wallis-test were used.

Overall, 929 physicians were contacted. A total of 112 (12.1%) completed questionnaires were recorded. Participants were 56% male (54/97), 29% female (28/97), and 2% (2/97) diverse. The median age was 50 years. More than half of the participants (54.6%) did not use TM. Reported barriers to implementation were mostly administration (26.8%, 26/97), inadequate reimbursement (25.8%, 25/97) and the purchase of technology equipment (23.7%, 23/97). After exclusion of questionnaires with missed values, participants could be divided into three clusters (C1, C2, C3) based on different attitudes towards TM. Attitudes toward TM in clinical activities were closely related to the number of patients being treated per annual quarter: C3 (Median= 1350), vs. C1 (Median=750) and C2 (Median=500). The differences between clinical caseloads of C1-C3 members were significant: C1 vs C2 (P=.0271), C1 vs C3 (P=.0174), C2 vs C3 (P=.0001). Most participants (77.1 %) would like to expand TM approaches in the future. In the field of cardiology, the participants reported a high suitability of TM. Willingness to train in TM is high to very high in > 50% of the participants.

Our results indicate generally moderate use, but positive attitudes towards TM among participating physicians with a higher clinical caseload. The lack of a structural framework seems to be a barrier to the effective implementation of telecardiology.

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