Abstract
INTRODUCTION: The pandemic of COVID-19 accelerated the implementation of telemedicine and promoted the use of online consultations. This study aims to investigate the nationwide trends of online consultations over 10 years in China. METHODS: This is a sequential cross-sectional study to evaluate the usage of online consultations among clinicians from different specialities between 2014 and 2023. Stratified random sampling was applied to invite participants according to the geographical distribution of registered clinicians. The basic demographic information on gender, age, career levels, the specialities of practice, hospital levels across the region and city, and time spent on work-related online activities was collected. The average time spent on online consultations per week was the main outcome. Univariate and multivariable analyses were conducted to compare the profile differences of using mobile health applications. RESULTS: A total of 65 305 clinicians from 39 clinical specialities in 31 provinces of China were interviewed anonymously through online surveys. On average, clinicians spent 36·5 hours per week on online activities in 2023 which increased from 20·7 hours per week in 2014. Time spent on online consultations has increased over the past 10 years from 1·1 to 2·9 hours with an average annual growth rate of 26%. Primary care and paediatric clinicians were the top-ranked in 2023. A general trend of increased time spent on online consultations can be observed with a particular spike during COVID-19. Mobile health has become popular for online consultations on portable devices. WeChat is the most common platform used (81·5%). In the multivariable analysis, clinicians with younger ages, senior career levels or from the department of surgery were more likely to use traditional websites for online consultation, but the interaction effect was observed between age and career levels. CONCLUSIONS: Online consultations have become popular across different clinical disciplines in China over the past 10 years. There is a good acceptance of using mobile health for online consultations, and it may further enhance the accessibility of healthcare services, especially for patients who live in rural areas. Corresponding guidelines should be established to regulate the quality of online consultations for the future development of virtual healthcare.