Factors Influencing Use and Perceptions of Teledermatology - A Mixed Methods Study of 942 participants. (Supplementary Files)

Background: The protracted COVID-19 pandemic highlights the need for a sustainable telemedicine practice. Objective: To understand patient perceptions toward teledermatology. Methods: Convergent parallel mixed methods study of 942 dermatology patients or their caregivers between June 2020 and April 2021. Results: Multivariate regression found that youth, increased computer use, willingness to show body areas over photo/video, perceived quality of teledermatology, demand for social distancing and to reduce commute were associated with willingness to use teledermatology. Willingness to use declined with easing of COVID-19 movement restrictions. 48.5% reported a poorer experience with teledermatology compared to in-person consults. Qualitative data from 26 interviews showed that willingness to use is influenced by pragmatic considerations, emotional factors, and data privacy concerns. These were moderated by the patient’s perception of disease severity and need for an accurate diagnosis. Limitations include lack of data prior to the pandemic and during the initial lockdown period. Conclusion: The willingness to use teledermatology is influenced by circumstantial factors, IT literacy, views towards teledermatology and factors driving the purpose of consult. The declining willingness to use with the easing pandemic, lower willingness to pay and poorer experience compared to in-person consults highlight the need to optimize this mode of delivery.