Factors Driving Rapid Adoption of Telemedicine in an Academic Orthopedic Surgery Department

Introduction: With the COVID-19 epidemic ever-expanding, nonemergent access to health care resources has been reduced to decrease the exposure for patients and health care providers. Alternatives to in-office outpatient medical evaluations are necessary. We aimed to analyze how quickly orthopedic surgery providers at a large academic institution adopted telemedicine, and identify any factors that were associated with earlier or "faster"telemedicine adoption. Methods: We analyzed the telemedicine activity of 39 providers within the Department of Orthopedic Surgery between March 16, 2020, and May 30, 2020, and constructed logistic regression models to identify characteristics with significant association to earlier or faster telemedicine adoption. Results: No significant predictors of percentage of visits conducted via telemedicine were found. However, increased experience and practice at multiple locations was associated with slower telemedicine adoption time, while Professor level academic rank was associated with a faster time to achieving 10% of pre-COVID visit volumes via telemedicine. Higher pre-COVID visit volumes were also significantly associated with faster telemedicine adoption. Demographic factors, including, age, gender, practice locations, academic degrees, pediatric specialty, and use of physician assistants/nurse practitioners, were not found to have significant associations with telemedicine use. Conclusions: These results indicate that telemedicine has an important role to play within academic orthopedic surgery practices, with a wide and diverse range of orthopedic surgery providers choosing to utilize it during the COVID-19 pandemic. Given the rapid expansion and urgency driving the adoption of telemedicine, these results illustrate the importance of considering provider-side characteristics in ensuring that providers are well equipped to utilize telemedicine.