Barriers and facilitators to physicians’ telemedicine uptake during the beginning of the COVID-19 pandemic
Jack D. Watson, Bridget Xia, Mia E. Dini, Alexandra L. Silverman, Bradford S. Pierce, Chi-Ning Chang, Paul B. Perrin
Abstract
Despite decades of low utilization, telemedicine adoption expanded at an unprecedented rate during the COVID-19 pandemic. This study examined quantitative and qualitative data provided by a national online sample of 228 practicing physicians (64% were women, and 75% were White) to identify facilitators and barriers to the adoption of telemedicine in the United States (U.S.) at the beginning of the COVID-19 pandemic. Logistic regressions were used to predict the most frequently endorsed (20% or more) barriers and facilitators based on participant demographics and practice characteristics.
Introduction
The World Health Organization (WHO) declared a pandemic related to a new strain of the coronavirus (COVID-19) in mid-March of 2020. Government entities, businesses, and other institutions (e.g., healthcare systems) sought ways to prevent the spread of infection, keep their employees and patrons safe, and comply with new pandemic-related regulations for social distancing and lockdowns. One key strategy adopted by many institutions was a rapid shift to online technologies; much of what was once done in person was now conducted virtually.
Methods
The study was approved by the Virginia Commonwealth University Institutional Review Board (IRB) under protocol HM20019315 to ensure it was conducted ethically and in compliance with all federal, state, and local regulations concerning research involving human participants. Because the study was designated exempt by the IRB, an information form was presented to participants rather than an informed consent document.
Results
The sample included 228 physicians who were an average of 46.14 years old (SD=10.12). A greater proportion of the physicians were women (64%), identified as White (75%), and were practicing in urban and suburban settings (92.5%). There was low racial/ethnic diversity among physicians and a low percentage of physicians working in rural areas.
Discussion
This study examined quantitative and qualitative data provided by 228 practicing physicians in the U.S. to identify barriers and facilitators to the adoption of telemedicine at the beginning of the COVID-19 pandemic. The top five endorsed barriers were: (1) lack of patient access to technology, (2) insufficient insurance reimbursement, (3) diminished doctor-patient relationship, (4) inadequate video/audio technology, and (5) diminished quality of delivered care. The top five endorsed facilitators were: (1) better access to care, (2) increased safety, (3) efficient use of time, (4) lower cost for patients, and (5) effectiveness.
Conclusion
This study examined quantitative and qualitative data provided by 228 practicing physicians in the U.S. to identify barriers and facilitators to telemedicine uptake during the beginning of the COVID-19 pandemic. Physicians endorsed lack of patient access to telemedicine technology as the primary barrier to telemedicine use and increased access to care as the primary facilitator.
Citation: Watson JD, Xia B, Dini ME, Silverman AL, Pierce BS, Chang C-N, et al. (2025) Barriers and facilitators to physicians’ telemedicine uptake during the beginning of the COVID-19 pandemic. PLOS Digit Health 4(4): e0000818. https://doi.org/10.1371/journal.pdig.0000818
Editor: Calvin Or, The University of Hong Kong, HONG KONG
Received: July 29, 2024; Accepted: March 8, 2025; Published: April 8, 2025
Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Data Availability: Data are publicly available as a supplementary attachment to this manuscript.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
