Telemedicine Use during the COVID-19 Pandemic: Results of an International Survey.

 The aim of the study is to survey hand surgeons' perspectives on telemedicine during the coronavirus disease 2019 (COVID-19) pandemic and intended applications after the pandemic.  Online surveys were sent to 285 Canadian and American surgeons in late April and early May 2020.  Response rate was 63% (180)-84% (152) American and 16% (28) Canadian. Forty-three percent (76) of respondents were in private practice, 36% (64) academics, 13% (24) privademics, and 6% (12) hospital employed. The most common telemedicine platform was Zoom. During the pandemic, 42% of patient visits were conducted via telemedicine; however, 37% required a subsequent in-person office visit. The most common complaint by surgeons was the inability to provide routine in-office procedures. The most beneficial feature was ease of use, and the most frustrating feature was connectivity difficulty. Time spent was similar to in-person visits, and surgeons were likely to recommend their platforms. Surgeons were neutral about using telehealth in the future and were most likely to use it for follow-up visits. New patient visits for traumatic injuries or fractures were of limited value. Canadians used telemedicine for a greater proportion than Americans (50 vs. 40%, <0.05) and spent more time than in-person visits (7/10 vs. 5/10, <0.05). Americans were more likely to use telemedicine for postoperative follow-up visits (6/10 vs. 4/10, <0.05) and in mornings before clinic opens (4/10 vs. 2/10, <0.05). Private practices were more likely to use telemedicine for future allied health provider visits than all other practice types ( <0.05).  Telemedicine comprised nearly half of patient encounters during the COVID-19 pandemic, but limitations remain.