Factors influencing use and perceptions of teledermatology: A mixed-methods study of 942 participants

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. The willingness to use teledermatology declined with the easing of COVID-19 movement restrictions, and 48.5% reported a poorer experience with teledermatology than with in-person consultations. 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: Lack of data prior to the pandemic and during the initial lockdown period. CONCLUSION: The willingness to use teledermatology is influenced by circumstantial factors, technology literacy, views toward teledermatology, and factors driving the purpose of consultation. The declining willingness to use teledermatology with the easing pandemic, lower willingness to pay full in-clinic prices, and poorer experience compared with in-person consultations highlights the need to optimize this mode of delivery.