Making It Work: Physicians' Perspectives on the Rapid Transition to Telemedicine.

Background: Telemedicine is a major pillar in the health care system's response to the coronavirus disease 2019 (COVID-19) pandemic. However, the rapid implementation of telemedicine is not without its challenges. We examined the strategies primary care physicians (PCPs) used to make the transition to telemedicine during the pandemic. Methods: A qualitative study was conducted to explore the perspectives of PCPs working at a Midwestern Academic Medical Center (AMC) who used telemedicine during the COVID-19 pandemic. Semistructured interviews with 20 PCPs were conducted 3 months following the rapid increase in the use of telemedicine across the AMC. Interview questions asked about physicians' challenges using telemedicine, the changes they had to make to use telemedicine, and what had helped them deliver care through telemedicine. All interviews were recorded, transcribed, coded, and rigorously analyzed using deductive thematic analysis. Results: According to PCPs, a successful transition to telemedicine involved three key elements: (1) maintaining flexibility in the context of constant change; (2) recognizing the need to upgrade their home office spaces; and (3) seeking opportunities to continue collaborating and sharing knowledge with peers. These strategies enabled physicians to rapidly pivot to deliver care through telemedicine when stay-at-home orders took effect. Physicians also described how frequent leadership communication and the rapid dissemination of telemedicine training supported their use of this care modality. Conclusions: Successful adoption of telemedicine requires that physicians adapt their care delivery practices. Considering these facilitators of telemedicine use can help both physicians and health care organizations with this important transition.