Ugochi T Aguwa1, Chibuzo J Aguwa2, Michael Repka3, Uma Srikumaran4, Fasika Woreta3, Eric L Singman3, Sabrina G Jenkins4, Divya Srikumaran3. 1. Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 2. Meharry Medical College School of Medicine, Nashville, Tennessee, USA. 3. Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA. 4. Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Abstract
Introduction: COVID-19 led to rapid policy changes to expand telemedicine adoption. We examined rates of early telemedicine adoption among surgical departments at a large academic institution and compared provider characteristics associated with teleophthalmology. Methods: With data from departmental and electronic medical records across surgical departments at Johns Hopkins Medicine, we performed a retrospective analysis using the Fisher test and binomial logistic regression. Results: Telemedicine adoption in ophthalmology was disproportionately lower than other surgical departments. Providers who were female [odds ratio, OR, 2.42 (95% confidence interval, CI, 1.03-5.67)], clinical assistants, clinical associates, or instructors [OR 12.5 (95% CI 2.63-59.47)], associate professors [OR 4.38 (95% CI 1.42-13.52)], practiced for ≥36 years [OR 0.20 (95% CI 0.06-0.66)], cornea [OR 0.13 (95% CI 0.04-0.47)], glaucoma [OR 0.18 (95% CI 0.04-0.93)] or retina [OR 0.04 (95% CI 0.01-0.17)] specialists, or had a MD/MBBCh/MBBS [OR 0.30 (95% CI 0.10-0.94)] or second degree [OR 0.28 (95% CI 0.08-0.99)] were significantly more or less likely to adopt. When adjusted, cornea [adjusted OR 0.10 (95% CI 0.02-0.57)] or retina [adjusted OR 0.01 (95% CI 0.002-0.12)] specialists or providers who practiced for 12-18 years [adjusted OR 0.22 (95% CI 0.05-0.91)] or ≥36 years [adjusted OR 0.13 (95% CI 0.03-0.68)] were significantly more or less likely to adopt. Discussion: Subspecialty among other provider characteristics influences the likelihood of teleophthalmology adoption. As the pandemic continues, strategies to reduce adoption barriers are needed to ensure the provision of health care services.
Introduction: COVID-19 led to rapid policy changes to expand telemedicine adoption. We examined rates of early telemedicine adoption among surgical departments at a large academic institution and compared provider characteristics associated with teleophthalmology. Methods: With data from departmental and electronic medical records across surgical departments at Johns Hopkins Medicine, we performed a retrospective analysis using the Fisher test and binomial logistic regression. Results: Telemedicine adoption in ophthalmology was disproportionately lower than other surgical departments. Providers who were female [odds ratio, OR, 2.42 (95% confidence interval, CI, 1.03-5.67)], clinical assistants, clinical associates, or instructors [OR 12.5 (95% CI 2.63-59.47)], associate professors [OR 4.38 (95% CI 1.42-13.52)], practiced for ≥36 years [OR 0.20 (95% CI 0.06-0.66)], cornea [OR 0.13 (95% CI 0.04-0.47)], glaucoma [OR 0.18 (95% CI 0.04-0.93)] or retina [OR 0.04 (95% CI 0.01-0.17)] specialists, or had a MD/MBBCh/MBBS [OR 0.30 (95% CI 0.10-0.94)] or second degree [OR 0.28 (95% CI 0.08-0.99)] were significantly more or less likely to adopt. When adjusted, cornea [adjusted OR 0.10 (95% CI 0.02-0.57)] or retina [adjusted OR 0.01 (95% CI 0.002-0.12)] specialists or providers who practiced for 12-18 years [adjusted OR 0.22 (95% CI 0.05-0.91)] or ≥36 years [adjusted OR 0.13 (95% CI 0.03-0.68)] were significantly more or less likely to adopt. Discussion: Subspecialty among other provider characteristics influences the likelihood of teleophthalmology adoption. As the pandemic continues, strategies to reduce adoption barriers are needed to ensure the provision of health care services.
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