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Telemedicine is the use of technology to deliver healthcare services from a distance. In some countries, telemedicine became popular during the COVID-19 pandemic. Its increasing popularity provides new research opportunities to unveil users’ perceptions toward its adoption and continued use. Existing studies have provided limited information and un...
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Context 1
... factors-FNR1, TNR1, TNR3, PRR1, and PVR1-were deleted from the CFA to test reliability and validity (Table 3) due to the lower value of factor loadings (the number is the question number). After excluding these, convergent validity and discriminant validity were employed to assess the validity of the model. ...Similar publications
The COVID-19 pandemic exposed the space of Delhi health policy, which needs to re-invent whole systems and create plans for a new dimension of health policy under the concern with the pandemic situation. The method used by the Delhi government to estimate healthcare spending in the city's budget by surveying a large sample of the socioeconomic stat...
Citations
... Relatedly, perceived usefulness and ease of use have also been found to influence telemedicine adoption substantially [22]. The adoption of technologies in health care brings uncertainties, particularly related to data security and privacy [23,24]. Such uncertainties often lead to perceived risks that pose significant barriers to adoption intentions [25,26]. ...
Background
Telemedicine is transforming health care by enabling remote diagnosis, consultation, and treatment. Despite rapid adoption during the COVID-19 pandemic, telemedicine uptake among health care professionals (HCPs) remains inconsistent due to perceived risks and lack of tailored policies. Existing studies focus on patient perspectives or general adoption factors, neglecting the complex interplay of contextual variables and trust constructs influencing HCPs’ telemedicine adoption. This gap highlights the need for a framework integrating risks, benefits, and trust in telemedicine adoption, while addressing health care’s unique dynamics.
Objective
This study aimed to adapt and extend the extended valence framework (EVF) to telemedicine, deconstructing factors driving adoption from an HCP perspective. Specifically, it investigated the nuanced roles of perceived risks, benefits, and trust referents (eg, technology, treatment, technology provider, and patient) in shaping behavioral intentions, while integrating contextual factors.
Methods
We used a qualitative research design involving semistructured interviews with 14 HCPs experienced in offering video consultations. The interview data were analyzed with deductive and inductive coding based on the EVF. Two coders conducted the coding process independently, achieving an intercoder reliability of 86.14%. The qualitative content analysis aimed to uncover the nuanced perspectives of HCPs, identifying key risk and benefit dimensions and trust referents relevant to telemedicine adoption.
Results
The study reveals the complex considerations HCPs have when adopting telemedicine. Perceived risks were multidimensional, including performance risks such as treatment limitations (mentioned by 7/14, 50% of the participants) and reliance on technical proficiency of patients (5/14, 36%), privacy risks related to data security (10/14, 71%), and time and financial risks associated with training (7/14, 50%) and equipment costs (4/14, 29%). Perceived benefits encompassed convenience through reduced travel time (5/14, 36%), improved care quality due to higher accessibility (8/14, 57%), and operational efficiency (7/14, 50%). Trust referents played a pivotal role; trust in technology was linked to functionality (6/14, 43%) and reliability (5/14, 36%), while trust in treatment depended on effective collaboration (9/14, 64%). Transparency emerged as a critical antecedent of trust across different referents, comprising disclosure, clarity, and accuracy. In addition, the study highlighted the importance of context-specific variables such as symptom characteristics (10/14, 71%) and prior professional experience with telemedicine (11/14, 79%).
Conclusions
This study expands the EVF for telemedicine, providing a framework integrating multidimensional risks, benefits, trust, and contextual factors. It advances theory by decomposing trust referents and transparency into actionable subdimensions and emphasizing context-specific variables. Practically, the findings guide stakeholders: policy makers should prioritize transparent regulations and data security, health care organizations should provide training and support for HCPs, and technology developers must design telemedicine solutions aligning with trust and usability needs. This understanding equips health care to address barriers, optimize adoption, and leverage telemedicine’s potential for sustainable clinical integration.
... On the other hand, financial risk is still significant compared to other risks like the cost of technology investment, operating costs, and uncertainty around revenue generation. 13,38,40 Government support is essential for reducing anxiety and costs, alleviating perceived threats, and enhancing perceived controllability in telemedicine. Effective implementation of telemedicine relies heavily on governmental assistance and regulation. ...
Telemedicine’s adoption has been effective in certain contexts despite being controversial in certain settings because of its tendency to cause misdiagnosis and concerns about data privacy. This study aimed to synthesize the research findings on the factors leading to the adoption of telemedicine among developing economies. The study utilized Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology to analyze 27 related literature and the Unified Theory of Acceptance and Use of Technology to map out the factors considered enablers and barriers in adopting telemedicine. Results showed that performance expectancy, effort expectancy, social influence, and facilitating conditions were significant predictors. However, the study also underscored that the lack of information and communications technology support, lack of resources, lack of organizational effectiveness, lack of quality care, lack of motivation, lack of trustworthiness, and lack of user satisfaction were predominant hindrances at both individual and organizational levels. This analysis on the enablers and barriers of telemedicine adoption hopes to contribute strategic recommendations that practitioners in public health, decision-makers in global health policy, technology developers, and future research may explore to expand the existing knowledge on the optimal adoption of telemedicine in developing economies.
... This could affect medication adherence in terms of access to medications and healthcare services. The use of technology in healthcare, such as telemedicine and remote monitoring, may be more prevalent in some Western countries than in Taiwan [43,44], which could affect medication adherence interventions. ...
Background
This pilot study aimed to investigate medication nonadherence among Taiwanese patients with diabetes, hypertension, and hyperlipidemia using the Chinese version of the Two-Part Medication Nonadherence Scale (C-TPMNS) and the National Health Insurance (NHI) Medicloud system. The study revealed insights into the factors contributing to nonadherence and the implications for improving patient adherence to medications for chronic conditions. However, the small sample size limits the generalizability of the findings. Additionally, the study identified the need for further research with larger and more diverse samples to validate the preliminary findings.
Methods
The study conducted surveys individuals in central Taiwan who received three-high medications and those who returned expired medications from chain pharmacies. A structured questionnaire including the C-TPMNS was administered, and additional data on medical history and HbA1c, LDL, and blood pressure levels were collected from the NHI Medicloud system. Data analysis was performed using multiple ordered logistic regression and Wald test methods. Setting interpretation cutoff point to determine medication nonadherence.
Results
The study found that 25.8% of participants were non-adherent to prescribed medications. Non-adherent individuals had significantly higher systolic blood pressure (SBP ≥ 140 mmHg) than adherent participants. Non-adherence was also associated with factors such as lower education, single status, living alone, abnormal glucose postprandial concentration, and triglyceride levels. The C-TPMNS demonstrated good reliability (Cronbach’s alpha = 0.816) and validity (area under the ROC curve = 0.72).
Conclusion
The study highlighted the complexity of medication nonadherence with diverse determinants and emphasized the importance of tailored interventions. The findings underscored the need for region-specific research to comprehensively address medication nonadherence, especially focusing on adherence to medications for hypertension, hyperlipidemia, and diabetes. The study also identified the need for larger, more diverse studies to validate and expand upon the initial findings and emphasized the importance of pharmacist interventions and patient empowerment in managing chronic conditions and improving overall health outcomes.
... In Taiwan, the rapid adoption of telemedicine during the COVID-19 pandemic has highlighted challenges related to regulatory frameworks, system flexibility, and costeffectiveness [6,7]. Overcoming these hurdles requires strategic planning to integrate telemedicine into existing medical processes while ensuring the delivery of high-quality care and fostering patient trust [8]. ...
Telemedicine technology has emerged as a pivotal solution to enhance the accessibility and efficiency of healthcare services. This study investigates the factors influencing the acceptance of telemedicine technology among healthcare professionals in Taiwan. Employing a quantitative research approach, we utilized a survey instrument adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Data were collected from 325 healthcare professionals across diverse medical fields. The results indicate that perceived usefulness, ease of use, social influence, and convenience significantly influence intention to use telemedicine. Moreover, age moderates the relationship between perceived usefulness and usage intention. These findings underscore the importance of addressing both technological and social factors in promoting the adoption of telemedicine among healthcare professionals. Policy implications and recommendations for enhancing telemedicine implementation are discussed based on the study findings. Specifically, our findings highlight that perceived usefulness, ease of use, social influence, and convenience significantly impact the intention to use telemedicine technology. Age significantly moderates the relationship between perceived usefulness and usage intention. These results not only theoretically support the UTAUT model but also provide practical strategies to advance the application of telemedicine technology.
... 47 Perceived risk has been shown to be a common barrier and precedent to the acceptance and adoption of technology and virtual healthcare services. 48 Measures of risk to be included are based on Cunningham's 49 major dimensions of perceived risk, plus additional categories appropriate to technology and service adoption. 48 These categories are financial, performance, technological, psychological, social, physical, privacy, provider, and time. ...
... 48 Measures of risk to be included are based on Cunningham's 49 major dimensions of perceived risk, plus additional categories appropriate to technology and service adoption. 48 These categories are financial, performance, technological, psychological, social, physical, privacy, provider, and time. The three-item provider report of sustainment scale 40 will be integrated into part 4 of the survey to assess sustainment. ...
Background
Virtual healthcare solutions are proposed as a way to combat the inequity of access to healthcare in rural and remote areas, and to better support the front-line providers who work in these areas. Rural provider-to-provider telehealth (RPPT) connects rural and remote clinicians to a ‘hub’ of healthcare specialists who can increase access to emergency and specialised healthcare via an integrated model. Reported benefits for the place-based provider include enhanced knowledge, expanded professional development opportunities, improved scope of practice, and increased confidence in treating more complex cases. These reported benefits could have implications for supporting and futureproofing our health workforce in terms of productivity, burnout, recruitment, and retention.
Methods
The research uses an explanatory sequential mixed methods approach across multiple phases to evaluate the current implementation of Western Australia Country Health Service's (WACHS) Command Centre (CC) services and explore factors associated with their differential use. The primary population of interest and participants in this study are the place-based providers in country Western Australia (WA). Patient data constitutes the secondary population, informing the access and reach of CC services into country WA. Data collection will include service data, an online survey, and semi-structured interviews with the primary population. The data will be interpreted to inform evidence-based strategies and recommendations to improve the implementation and sustainment of RPPT.
Discussion
Innovative and sustained workforce models and solutions are needed globally. Virtual healthcare, including provider-to-provider models, demonstrate potential, especially in rural and remote areas, designed to increase access to specialised expertise for patients and to support the local workforce. This research will generate new data around behaviour, perceptions, and value from the WACHS rural and remote workforce about provider-to-provider telehealth, to explore the implementation and investigate strategies for the long-term sustainment of RPPT services.
... Consequently, increasing psychological risk decreases patients' willingness to use telemedicine. Kamal et al. (2020) and Wu and Ho (2023), for example, found that patients are less likely to use telemedicine with increased levels of fear of using technology. Thus, we propose: ...
Telemedicine has the potential to address considerable challenges in the efficient provision of health care services. However, this will not be realized until a high acceptance rate among patients is achieved. We address the research gap that arises from the need to explore the interplay of different trust referents (physician, technology, treatment) and perceived risk dimensions (performance, privacy, time, psychological) in patients’ telemedicine adoption considering two different symptom types (physical vs. mental). We conducted a scenario-based online survey and performed t -tests, scenario-specific structural equation modeling, and multi-group analysis. T -tests and multi-group analysis do not indicate differences in perceptions and path coefficients between the symptoms. Furthermore, scenario-specific structural equation modeling reveals that for both scenarios, trust in physician is less important for trust transfer effects and intention to use than trust in technology and trust in treatment. Trust in treatment has similar effects for all risk dimensions, while only performance risk relates to use intention. Moreover, the results indicate a considerable intention-behavior gap. We advance IS research by emphasizing the relevance of considering multiple trust referents, trust transfer effects, and a multidimensional perspective on perceived risk.
... While lower costs and higher ease of access had long been recognized in the biomedical literature [2,3], telemedicine did not come into widespread use until the 2020 pandemic caused by SARS-CoV-2. Public health recommendations to use telemedicine greatly expanded its use and created opportunities for expanded research measuring stakeholder satisfaction, as well as barriers and facilitators [4,5]. Given the profound increase in use, it is necessary to understand whether patient preferences, experiences, and needs related to telemedicine have changed. ...
Background
A 2017 survey of patient perspectives showed overall willingness and comfort to use telemedicine, but low actual use. Given recent growth and widespread exposure of patients to telemedicine, patient preferences are likely to have changed.
Objective
This study aimed to (1) identify demographic trends in patient preferences and experiences; (2) measure ease of use and satisfaction of telemedicine; and (3) measure changes in telemedicine use, willingness, and comfort since 2017.
Methods
We replicated a 2017 study with a nationwide survey of US adults. The survey, an extended version of the previous study, measured patient health care access as well as knowledge, experiences, and preferences regarding telemedicine encounters. We recruited participants using SurveyMonkey Audience in July 2022. We used descriptive statistics and generalized estimating equations to measure change and identify trends.
Results
We accrued 4577 complete responses. Patient experience with telemedicine was substantially higher in 2022 than in 2017, with 61.1% (vs 5.3%) of participants aware that their primary care provider offered telemedicine and 34.5% (vs 3.5%) reporting use of telemedicine with their primary care provider. This study also reported ease of use and satisfaction rates to be similar to in-person visits, while overall willingness and comfort in using telemedicine increased from 2017. Individuals at the poverty line were significantly less likely to report satisfaction with telemedicine visits. We found increased interpersonal distance in a patient and health care professional relationship significantly reduced patient ease of use, willingness, and comfort in using telemedicine.
Conclusions
This study identified an association between income and patient satisfaction, conveying the importance of understanding telemedicine in relation to health care access and equity. Telemedicine ease of use and satisfaction were comparable to in-person visits. Individuals reported greater use and higher positive perceptions of telemedicine willingness and comfort since 2017.
Background
Healthcare transportation, particularly the transportation of patients to access healthcare services, is a significant source of carbon emissions. This study aims to estimate the carbon emissions of patient transportation among patients receiving cancer care at an urban community safety net hospital.
Materials and Methods
We conducted a retrospective study of patients seen at the oncology clinic of an urban community safety net hospital between 1 July 2022 and 30 June 2023. Patients with at least one in-person visit in 1 year, documented home addresses, and oncologic diagnoses were included in the study. The distance between each patient's home address and the hospital was calculated using the Google Map API key and a macro to calculate distance in metres. The total estimated carbon emissions were calculated using the EPA equivalencies calculator. The primary outcome was carbon emissions from patients' round-trip travel from home to hospital.
Results
From 1 July 2022 to 30 June 2023, 13,970 visits were made to the oncology clinic. Of these, 8,235 visits made by 1,080 patients met the criteria for inclusion in the final analysis. Of the 8,235 visits recorded, 5,095 (61.8%) were follow-up/laboratory visits. The 1,080 patients who attended the clinic had a mean age of 63.8 years; 700 (64.8%) were male, and 525 (48.6%) were Black or African-American. Breast cancer was the most common diagnosis, accounting for 423 (39.2%) of cancer diagnoses. Each patient travelled 4.8 (0.3–149.3) miles for a one-way trip and 9.6 (0.7–298.6) miles for a round trip to receive cancer care. Approximately 1,520 (280–119,440) g carbon were emitted per patient visit. A total of 79,582 round-trip miles was calculated for the 8,235 visits made by all patients within 1 year, which corresponds to 31,832 kg CO2 emissions equivalent to 35,658 pounds of coal burned, 1,462 propane cylinders used for a home, or 3,872,250 smartphones charged.
Conclusion
Travel to receive cancer care is associated with significant carbon emissions and poses a climate and public health risk. Efforts to decrease the overall carbon footprint of cancer treatment are needed to minimise the contributions of cancer treatment to climate change.
There are several difficulties in evaluating interventions seeking to promote public health policies. In this article, we analyzed the promotion of the use of telemedicine during COVID-19 in Brazil. Using the random promotion method with instrumental variables, we showed that the policy of promoting telemedicine was adequate, with intense use of this type of care. Our results showed that telemedicine works if it is encouraged in the population. We contributed to the discussion of public health policies and their impact on the population’s health in times of health crisis, such as during the COVID-19 pandemic.
