Attitudes towards telemedicine in ophthalmology: a population-based online survey in Germany

Despite the increasing impact of telemedicine services on global healthcare provision, little data on acceptance and preference for telemedicine services at the population level are available to date. This is especially important for telemedicine in ophthalmology, where commercial telemedical applications are regularly offered outside of the state-funded health care system. Our study investigates the acceptability of tele-ophthalmology to the German population and associated sociodemographic factors. We conducted a cross-sectional survey via an online panel to assess attitudes towards telemedicine. In this survey, 1,008 individuals, demographically representative of the adult German population, were asked about their attitudes toward the acceptance of remote consultations and remote screening/monitoring in ophthalmology, as well as the motivators for telemedicine adoption. Associations with sociodemographic factors, including age, sex, household income and level of education, were investigated based on logistic regression models. The mean age of the sample was 50 ± 16 years (range: 18–86 years). The acceptance of remote screening / monitoring (49.8%) was slightly higher than of remote consultations (45.7%). Younger age, higher income and reported visual difficulties were independent determinants favoring the acceptance of tele-ophthalmology. More than two in three participants (70.5%) reported easier or more flexible scheduling as motivators for the use of telemedicine, while fewer participants were motivated by cost savings (32.0%) or feedback reports (15.7%). Our survey suggests that one in two people in Germany has positive attitudes towards telemedicine in ophthalmology. Though next steps including a thorough technology acceptance assessment need to be performed, telemedicine services at the population level may need to specifically target older individuals, women and low-income populations to enable healthcare equity within telemedicine provision.