Clinician Experience With Telemedicine At A Safety-Net Hospital Network During Covid-19: A Cross-Sectional Survey

Objective. The COVID-19 pandemic prompted unprecedented expansion of telemedicine services. We sought to describe clinician experiences providing telemedicine to publicly-insured, low-income patients during COVID-19. Methods. Online survey of ambulatory clinicians in an urban safety-net hospital system, conducted May 28, 2020-July 14, 2020. Results. Among 311 participants (response rate 48.3%), 34.7% (n=108/311) practiced in primary/urgent care, 37.0% (n=115/311) medical specialty, and 7.7% (n=24/311) surgical clinics. A large majority (87.8%, 273/311) had conducted telephone visits, 26.0% (81/311) video. Participants reported observing both technical and non-technical patient barriers. Clinicians reported concerns about the diagnostic safety of telephone (58.9%, 129/219) vs. video (35.3%, 24/68). However, clinician comfort with telemedicine was high for telephone (89.3%, 216/242) and for video (91.0%, 61/67), with many clinicians (92.1%, 220/239 telephone; 90.9%, 60/66 video) planning to continue telemedicine after COVID-19. Conclusions. Clinicians in a safety-net health care system report great comfort with and intention to continue telemedicine after the pandemic, despite safety concerns and patient challenges.