Patient Perceptions and Satisfaction With Teledermatology During the COVID-19 Pandemic: A Survey-Based Study

February 2021 | Volume 20 | Issue 2 | Original Article | 178 | Copyright © February 2021


Published online January 14, 2021

Samuel Yeroushalmi BS*a, Sarah H Millan BS*a, Kamaria Nelson MDa, Andrew Sparks MSb, Adam J Friedman MD FAADa

aDepartment of Dermatology, The George Washington School of Medicine and Health Sciences, Washington, DC
bDepartment of Surgery, George Washington University School of Medicine and Health Sciences/Medical Faculty Associates,Washington, DC

*Both authors contributed equally to this manuscript.

Abstract
Background: The COVID-19 pandemic has drastically changed the practice of dermatology as social distancing guidelines have led to a shift from in-office care to virtual telehealth (teledermatology). We aimed to determine patient satisfaction, perceived barriers, as well as indications for teledermatology appointments during the COVID-19 pandemic.
Methods: A survey was sent out via SurveyMonkey's online platform to patients of the George Washington Medical Faculty Associates' Dermatology department who attended telehealth appointments during the COVID-19 pandemic.
Results: Out of 894 invitations sent, 168 patients completed our survey.The most common reasons for making a telehealth appointment were for a new rash (11.6%), eczema (9.8%), and psoriasis (9.1%). The most common reasons respondents liked telehealth were because of time efficiency (81.1%), not requiring transportation (74.2%), and maintaining social distancing (73.6%). The most common reasons respondents did not like telehealth were due to lack of physical touch (26.8%) and feeling they received an inadequate assessment (15.7%). Very few patients reported that they were unlikely to undertake another telehealth visit (9.94%) or recommend a telehealth visit to others (6.92%).
Conclusion: Dermatology patients likely perceive telehealth visits as a convenient and safe method for quality care during the COVID-19 pandemic. The lack of physical touch, inability to provide close inspection and/or procedural intervention can be frustrating for patients and therefore meaningful selection of appropriate cases for telehealth visits can optimize the patient experience. Overall, telemedicine represents an effective and safe vehicle for delivering care especially during a global pandemic.

J Drugs Dermatol. 2021;20(2):178-183. doi:10.36849/JDD.2021.5714

INTRODUCTION

The novel coronavirus disease-19 (COVID-19) pandemic has drastically changed many aspects of our society, particularly our healthcare system. Social distancing guidelines and “stay-at-home” orders have led to a shift from in-office care to virtual telehealth care in order to reduce disease transmission as well as protect patients and healthcare workers from exposure. The CDC reported a 154% increase in telehealth visits during the last week of March 2020 compared to the same time one year prior.1 The impact of COVID-19 on telehealth use specifically in dermatology has yet to be reported.

Dermatology has already seen continuous growth in the usage of telehealth modalities over the past decade. For instance, Flaten et al. found that the number of dermatology mobile applications increased by 80.8% from 2014 to 2018 to a total of 526, paralleling the increasing prevalence of mobile phone ownership in the United States.2 Telehealth in dermatology, or teledermatology, boasts a number of benefits including increased access to care, cost benefits for patients, convenience, and perhaps most importantly during the COVID-19 pandemic: absence of physical contact.3 A systematic review of 204 studies found teledermatology to be a reliable consultation tool and that telehealth services in dermatology were widely accepted as valid for patient care.4

There are a number of barriers which limit teledermatology, however. These include, but are not limited to, issues with provider reimbursement, privacy and security concerns, appropriate image acquisition, appropriate provider training, and challenges with integration into patients’ official medical records.5 The federal government has made telehealth services easier to implement and access for providers and patients during the COVID-19 public health emergency, suggesting the benefits of widespread telehealth usage far outweigh the risks and pitfalls.6

In order to evaluate patient satisfaction of teledermatology during the COVID-19 pandemic, we released an online