Healthcare Professionals and Telehealth Usability during COVID-19


  • Jing Xu Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida
  • Hanadi Y. Hamadi Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida
  • Kristen K. Hicks-Roof Department of Nutrition & Dietetics Brooks College of Health, University of North Florida, Jacksonville, Florida
  • Robert J. Zeglin Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, Florida
  • Chloe E. Bailey Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida
  • Mei Zhao Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida



COVID-19, Florida, Health Professionals, Telehealth, Telehealth Usability, Telemedicine


Objective: During the coronavirus disease 2019 (COVID-19) pandemic, many other health providers needed to rapidly adopt telehealth services to ensure continuity of patient care, without the opportunity to extensively evaluate the usability of the adopted technology. Therefore, this study aims to examine health professionals’ telehealth usability during COVID-19 in Florida.

Design: This cross-sectional study employed the Telehealth Usability Questionnaire (TUQ) to licensed healthcare providers in Florida in June 2020.

Setting and Participants: A total of 399,660 selected health professionals with Florida licensure were recruited from open-access Florida healthcare to participate in a Qualtrics web-based survey. A total of 1,868 health professionals completed the survey. Multiple linear and mixed regression models were applied to analyze the overall and subdomain scores from TUQ.

Main Outcome Measures: Telehealth usability.

Results: The analysis of the overall TUQ score showed younger, female healthcare professionals, and participants who reported an increase in telehealth usage during pandemic had a significantly higher overall TUQ score. Compared with the score from physicians and nurses, the scores from the mental health group and social work group were significantly higher, while the score rehabilitation group was significantly lower. Analysis of the subdomain scores was consistent with the overall scores.

Conclusion: The findings from this study indicate that the health professionals’ telehealth usability is related to age, gender, and the change of telehealth usage during the COVID-19 pandemic. While pandemics represent only one possible impetus for the healthcare system to swiftly switch to telehealth platforms, each profession should consider providing adequate resources to accommodate the need for change.


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Li H, Liu S-M, Yu X-H, Tang S-L, Tang C-K. Coronavirus disease 2019 (COVID-19): Current status and future perspective. Int J Antimicrob Agents. 2020;55(5):105951.

World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020. 2020. Accessed 7 October 2021.

Gostin LO, Wiley LF. Governmental public health powers during the COVID-19 pandemic: Stay-at-home orders, business closures, and travel restrictions. JAMA. 2020;323(21):2137–8.

Sen-Crowe B, Sutherland M, McKenney M, Elkbuli A. The Florida COVID-19 mystery: Lessons to be learned. Am J Emerg Med. 2020; 46: 661–3. Accessed 7 October 2021

Fu SJ, George EL, Maggio PM, Hawn M, Nazerali R. The consequences of delaying elective surgery: Surgical perspective. Ann Surg. 2020;272(2):e79–e80.

Elster E, Potter BK, Chung K. Response to COVID-19 by the surgical community. Surgery. 2020;167(6):907–908.

Donley G, Chen B, Borrero S. The legal and medical necessity of abortion care amid the COVID-19 pandemic. J Law Biosci. 2020;7(1):Isaa013.

Bloem BR, Dorsey ER, Okun MS. The coronavirus disease 2019 crisis as catalyst for telemedicine for chronic neurological disorders. JAMA Neurol. 2020;77(8):927–928.

Stachura ME, Bolch EB, Piette KF, Ebberwein JF. Chronic condition management using remote monitoring and telehomecare. Chronic illness and long-term care: Breakthroughs in research and practice: IGI global; 2019. p. 669–86.

Lu JF, Chi MJ, Chen CM. Advocacy of home telehealth care among consumers with chronic conditions. J Clin Nurs. 2014;23(5–6):811–19.

Mehrotra A, Jena AB, Busch AB, Souza J, Uscher-Pines L, Landon BE. Utilization of telemedicine among rural Medicare beneficiaries. JAMA. 2016;315(18):2015–16.

Nouri S, Khoong EC, Lyles CR, Karliner L. Addressing equity in telemedicine for chronic disease management during the Covid-19 pandemic. NEJM Catalyst Innov Care Deliv. 2020;1(3). Accessed 7 October 2021.

Ward MM, Merchant KA, Carter KD, Zhu X, Ullrich F, Wittrock A, et al. Use of telemedicine for ED physician coverage in critical access hospitals increased after CMS policy clarification. Health Aff. 2018;37(12):2037–44.

The Agency For Health Care A. Florida report on telehealth utilization and accessibility tallahassee [Internet]. FL: The Agency For Health Care Administration; 2016. Available from:

Robinson KT, Bergeron CD, Mingo CA, Meng L, Ahn S, Towne Jr SD, et al. Factors associated with pain frequency among adults with chronic conditions. J Pain Symp Manag. 2017;54(5):619–27.

United Health Foundation. Explore multiple chronic conditions—Ages 65+ in Florida | 2020 Senior Health: United Health Foundation [Internet]; 2019. Available from:

Orozco-Beltran D, Sanchez-Molla M, Sanchez JJ, Mira JJ, ValCronic Research G. Telemedicine in primary care for patients with chronic conditions: The valCronic quasi-experimental study. J Med Internet Res. 2017;19(12):e400.

Moore MA, Coffman M, Jetty A, Klink K, Petterson S, Bazemore A. Family physicians report considerable interest in, but limited use of, telehealth services. J Am Board Fam Med. 2017;30(3):320–30.

Ensina LA, Lee HD, Takaki WSR, Maciejewski NAR, Spolaôr N, Wu FC. Heuristics-based responsiveness evaluation of a telemedicine computational web system. IEEE Latin Am Trans. 2019;17(03):444–52.

Nord G, Rising KL, Band RA, Carr BG, Hollander JE. On-demand synchronous audio video telemedicine visits are cost effective. Am J Emerg Med. 2019;37(5):890–4.

U.S. Bureau of Labor Statistics. Economic news release: Employment situation summary. 2020. Accessed 7 October 2021.

Perrin PB, Pierce BS, Elliott TR. COVID-19 and telemedicine: A revolution in healthcare delivery is at hand. Health Sci Rep. 2020;3(2):e166.

Gadzinski AJ, Gore JL, Ellimoottil C, Odisho AY, Watts KL. Implementing telemedicine in response to the COVID-19 pandemic. Philadelphia, PA: Wolters Kluwer; 2020.

Miner H, Fatehi A, Ring D, Reichenberg JS. Clinician telemedicine perceptions during the COVID-19 pandemic. Telemed e-Health. 2020;27(5):508–12.

Abran A, Khelifi A, Suryn W, Seffah A. Usability meanings and interpretations in ISO standards. Softw Qual J. 2003;11(4):325–38.

Klaassen B, van Beijnum BJ, Hermens HJ. Usability in telemedicine systems—A literature survey. Int J Med Inform. 2016;93:57–69.

Narasimha S, Agnisarman S, Chalil Madathil K, Gramopadhye A, McElligott JT. Designing home-based telemedicine systems for the geriatric population: An empirical study. Telemed J E Health. 2018;24(2):94–110.

Parmanto B, Lewis Jr AN, Graham KM, Bertolet MH. Development of the telehealth usability questionnaire (TUQ). Int J Telerehabilitation. 2016;8(1):3.

Florida Health. Health care practitioner data portal 2020 [Internet]. Available from:

SAS Institute. Base SAS 9.4. Cary, NC: SAS Institute Inc; 2013.

Kenward MG, Roger JH. Small sample inference for fixed effects from restricted maximum likelihood. Biometrics. 1997;53:983–97.

Harper SG. Counseling and the internet. Couns Hum Dev. 1999;32(1):1.

Nickelson DW. Telehealth and the evolving health care system: Strategic opportunities for professional psychology. Prof Psychol Res Pract. 1998;29(6):527.

Stamm BH. Clinical applications of telehealth in mental health care. Prof Psychol Res Pract. 1998;29(6):536.

Dopp AR, Wolkowicz NR, Mapes AR, Feldner MT. Implementation of telepsychology services in a university training clinic: Process and lessons learned. Behav Ther. 2017.

McKay JC, Vásquez ÁR, Chipp CL, Ford TJ, Robinson RV, Sharma DKB, et al. Divided by miles, connected by purpose: Telepsychology technology in a graduate training program. Train Educ Prof Psychol. 2013;7(3):166.

Council for Accreditation of Counseling and Related Educational Programs. CACREP Standards 2015 [Internet]. Available from:

Ramalho R, Adiukwu F, Gashi Bytyci D, El Hayek S, Gonzalez-Diaz JM, Larnaout A, et al. Telepsychiatry and healthcare access inequities during the COVID-19 pandemic. Asian J Psychiatr. 2020;53:102234.

Hicks-Roof KK, Xu J, Zeglin RJ, Bailey CE, Hamadi HY, Osborne R. Covid-19 impacts on Florida’s healthcare professionals. Hosp Top. 2021:1–12.

McCord CE, Saenz JJ, Armstrong TW, Elliott TR. Training the next generation of counseling psychologists in the practice of telepsychology. Couns Psychol Q. 2015;28(3):324–44.

McClellan MJ, Florell D, Palmer J, Kidder C. Clinician telehealth attitudes in a rural community mental health center setting. J Rural Ment Health. 2020;44(1):62.

Hilty DM, Ferrer DC, Parish MB, Johnston B, Callahan EJ, Yellowlees PM. The effectiveness of telemental health: A 2013 review. Telemed e-Health. 2013;19(6):444–54.

Dinesen B, Nonnecke B, Lindeman D, Toft E, Kidholm K, Jethwani K, et al. Personalized telehealth in the future: A global research agenda. J Med Internet Res. 2016;18(3):e53.

Lokken TG, Blegen RN, Hoff MD, Demaerschalk BM. Overview for implementation of telemedicine services in a large integrated multispecialty health care system. Telemed e-Health. 2020;26(4):382–7.

Hong Y-R, Lawrence J, Williams Jr D, Mainous III A. Population-level interest and telehealth capacity of US hospitals in response to COVID-19: Cross-sectional analysis of Google search and national hospital survey data. JMIR Public Health Surveill. 2020;6(2):e18961.

Grundstein MJ, Sandhu HS, Cioppa-Mosca J. Pivoting to telehealth: The HSS experience, value gained, and lessons learned. HSS Journal®. 2020;16(1_Suppl):1–6.

Truter P, Russell T, Fary R. The validity of physical therapy assessment of low back pain via telerehabilitation in a clinical setting. Telemed e-Health. 2014;20(2):161–7.

Richardson BR, Truter P, Blumke R, Russell TG. Physiotherapy assessment and diagnosis of musculoskeletal disorders of the knee via telerehabilitation. J Telemed Telecare. 2017;23(1):88–95.

Tanaka MJ, Oh LS, Martin SD, Berkson EM. Telemedicine in the era of COVID-19: The virtual orthopaedic examination. J Bone Joint Surg Am. 2020;102(12):e57.

Spivak S, Spivak A, Cullen B, Meuchel J, Johnston D, Chernow R, et al. Telepsychiatry use in US mental health facilities, 2010–2017. Psychiatr Serv. 2020;71(2):121–7.

Kannarkat JT, Smith NN, McLeod-Bryant SA. Mobilization of telepsychiatry in response to COVID-19—Moving toward 21 st century access to care. Admin Policy Ment Health Ment Health Serv Res. 2020;47(4):489–91.

Eddy N. Nearly half of physicians using telehealth, up from just 18% in 2018: Healthcare IT News [Internet]. 2020. Available from:

Reed ME, Huang J, Graetz I, Lee C, Muelly E, Kennedy C, et al. Patient characteristics associated with choosing a telemedicine visit vs office visit with the same primary care clinicians. JAMA Network Open. 2020;3(6):e205873-e.

Helou S, El Helou E, Abou-Khalil V, Wakim J, El Helou J, Daher A, et al. The effect of the COVID-19 pandemic on physicians’ use and perception of telehealth: The case of Lebanon. Int J Environ Res Public Health. 2020;17(13):4866.

Connolly SL, Miller CJ, Lindsay JA, Bauer MS. A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clin Psychol Sci Pract. 2020;27(2):e12311.

Koonin LM, Hoots B, Tsang CA, Leroy Z, Farris K, Jolly B, et al. Trends in the use of telehealth during the emergence of the COVID-19 pandemic—United States, January–March 2020. Morb Mortal Wkly Rep. 2020;69(43):1595.



How to Cite

Xu, J. ., Hamadi, H. Y., Hicks-Roof, K. K., Zeglin, R. J., Bailey, C. E., & Zhao, M. (2021). Healthcare Professionals and Telehealth Usability during COVID-19. Telehealth and Medicine Today, 6(3).



Original Clinical Research