Does it get better? An ongoing exploration of physician experiences with and acceptance of telehealth utilization.

Introduction: COVID-19 forced health systems to rapidly implement telehealth for routine practice, often without sufficient training or standards. We conducted a longitudinal survey of physicians to explore changes in their perceptions of the challenges and benefits of telehealth and identify recommendations for future practice.

Methods: An anonymous online survey was distributed to a cohort of internal medicine physicians in May to June 2020 and March to June 2021. Changes in responses between 2020 and 2021 and by site (private vs. public) were described. These findings, along with those of a thematic analysis of open-ended responses to questions on telehealth experiences, informed a set of recommendations.

Results: The survey response rate was 111/391 in 2021 compared to 122/378 in 2020. Fewer physicians reported that telehealth was more difficult than in person with regards to taking a history (49% in 2020, 33% in 2021, = 0.015), maximizing patient adherence (33% in 2020, 19% in 2021,  = 0.028), and maintaining patient relationships (31%, 25%,  = 0.009) in 2021. Similar proportions of physicians reported continued challenges with building new patient relationships (75%, 77%,  = 0.075), educating patients (40%, 32%,  = 0.393), and working collaboratively with their team (38%, 41%,  = 0.794). Physicians reported increased satisfaction with tele-visits over in-person visits (13%, 27%,  = 0.006) and less worry over doing future tele-visits (45%, 31%,  = 0.027). Physicians' open-ended responses identified recommendations for further improving the design and use of telehealth.

Discussion: Results suggest that physician experience with telehealth improved but opportunities for training and improved integration remain. Longitudinal assessment can deepen understanding of the evolution of telehealth care.