Real-World Utilization and Patient Acceptance of Telemedicine in Otorhinolaryngology: A Single-Center Observational Study

Background: Telemedicine may improve access to care and streamline patient pathways, but real-world uptake in otorhinolaryngology remains uncertain. This single-center study evaluated an online appointment module with an option for video consultation at ENT University Hospital Freiburg and compared real-world utilization with patients’ hypothetical willingness to use telemedicine. Materials and Methods: The online module was implemented from March to June 2021. We recorded symptom category, age, gender, distance to the clinic, insurance status, type of consultation requested, and preference for video versus face-to-face consultation. Video consultations were evaluated separately in March and April. In addition, an independent survey was conducted in February 2021 among patients presenting with otological symptoms to assess hypothetical willingness to substitute an equivalent telemedical consultation for an in-person visit. Results: Of 7435 outpatient contacts, 507 (6.8%) used the online appointment module. Among these, 35 (6.9%) requested a video consultation and 472 (93.1%) requested a face-to-face appointment; video requests therefore represented 0.47% of all outpatient contacts. By contrast, 35 of 55 survey respondents (63.6%) stated that they would forgo an in-person visit if equivalent telemedical care were available. In March and April, 29 video consultations were scheduled or requested after telephone counseling, of which 11 were completed. Nine of the 11 completed video consultations (81.8%) did not require a subsequent in-person visit, whereas two (18.2%) required additional audiometry or nasal endoscopy. Because only 11 video consultations were completed, these findings are descriptive and exploratory. Conclusions: Hypothetical willingness to use telemedicine was substantially higher than real-world video consultation utilization. This gap indicates that stated acceptance does not necessarily translate into actual use and may reflect clinical suitability, awareness, organizational or technical barriers, or patient preference. ENT departments considering telemedicine should therefore use targeted patient selection and pre-consultation triage, particularly for follow-up visits, counseling, and second opinions that do not require immediate examination or diagnostic testing. Generalizability is limited by the single-center design, the short observation period, the small number of completed video consultations, and the COVID-19 pandemic context.