Advantages and disadvantages of telemedicine during the COVID-19 pandemic era among physicians in Taif, Saudi Arabia

Discussion

In 2020, due to the COVID-19 pandemic, the usefulness of telemedicine and its ability to deliver high-quality care are becoming more evident worldwide.4

Regarding the advantages of telemedicine, most responders believe that telemedicine can improve the effectiveness of therapeutic intervention, enhance the quality of care, provide psychological support to the patient, improve compliance, and help patients save time, and money. An Indian study in 2020 showed that telemedicine can enhance learning skills, case handling strategies, and help in providing different medical services.3 We believe that the rapid transition to telemedicine in this time of crisis and beyond, offers a new way of accessing our patients, as telemedicine can greatly enhance medical services. It can improve productivity and allows the patients and families to have more time to express their thoughts and feelings, which perhaps is more important now than before the COVID-19 pandemic.13

The main disadvantages telemedicine noted by respondents is that it was difficult to make a diagnosis throughout the virtual clinic due to the lack of physical examination and inability to use their hands-on expertise. Furthermore, the fear of sudden practice changes caused by the COVID-19 pandemic is one of the disadvantages noted by our respondents. This is mostly due to the dramatic shift to virtual clinics owing to the national lockdown and social isolation imposed by the Saudi government during the pandemic. Furthermore, physicians are still not convinced that their patients would use telemedicine technology because the patients are mostly elderly people with limited technological skills. Some patients may not be aware of telemedicine as a choice and do not know how to access it.14

Many physicians in our sample described telemedicine as transmitting patient information through interactive video and as a consultation with a specialist or subspecialist. Other responders chose one of the following definitions of telemedicine, namely, continuing education programs, examining patients through telemedicine, and a 2-way television set-up. We believe in the usefulness of scientific meetings, talking with colleagues, and internet browsing to build a good background about telemedicine basics. Telemedicine is described by the centers for medicare and medicaid services (CMS) as 2-way, live contact between the patient and provider at a distant location, including audio and video devices.5

Our study showed that more than half of the respondents used telemedicine only during the COVID-19 pandemic, and the remaining participants used it before and during the pandemic. We believe that telemedicine adoption was one solution that practitioners used to continue patient care while reducing COVID-19 exposure or transmission. Most of our respondents were consultants, and most of them used telemedicine weekly. The specialists used it occasionally. Half of the resident’s respondents used it monthly. This result was obtained possibly because they had more clinical experience to appropriately analyze patient’s complaints and concerns.

Concerning internet-based technologies, the findings showed that telephone and video were the communication devices used by interviewees, and that they were the preferred resources. The use of video visits in New York, United States, has shown its efficacy, satisfaction in promoting social distancing during the pandemic.15 We believe that video visits typically convey more information than email and other devices. Following the institution COVID-19 pandemic restrictions on in-person clinical encounters, at KASH, a survey was conducted on the number of patients visiting the virtual clinic in one week. At first, the number of remote visits was limited to approximately 75 per week and then considerably increased incredibly to approximately 196 per week within 4 weeks. The reason for the increase in the number of virtual clinics visits in this study was possibly due to the adequate information and training provided to the communities on how the system works, which led to increased telemedicine use.

Our physicians reported that telemedicine should continue after the COVID-19 pandemic as an adjunct tool for the doctors and patients in many ways. The use of this technology is believed to allow improved communication with practitioners and their patients during the pandemic. Over half of our doctors agreed that telemedicine could increase the level of patient care quality. The increase in the use of telemedicine will minimize waiting lists for patients who need in-person interactions during the pandemic.7 This study is affected by several factors like limited virtual clinic numbers in our study area and small sample size. The reason was the national lockdown imposed by the Saudi government during the pandemic, we carried out this study by telephone interviews that lead to difficulty in reaching out to all doctors. The results can not be extrapolated to all physicians in KSA or the western region. Not including patients or caregivers is a limitation too. More sample size and including other cities, patients, and their caregivers are recommended for future research that will give more reliable results. Also, adding important questions to assessing telemedicine satisfaction for both physicians and patients during the pandemic should be included.

In conclusion, telemedicine is a helpful tool during consultations for many medical and surgical conditions, in the psychological field, medical reports, laboratory follow ups, medication refills, and communication with other facilities and other specialties. But, it is not a substitution for the physician’s hands-on expertise.