Article

Addressing telehealth's foremost barrier: Provider as initial gatekeeper

Center for Healthcare Engineering, Purdue University, 100 N. University Street, Beering Hall Rm. 214, West Lafayette, IN 47907-2098, USA.
International Journal of Technology Assessment in Health Care (Impact Factor: 1.31). 02/2005; 21(4):517-21. DOI: 10.1017/S0266462305050725
Source: PubMed

ABSTRACT

During the past decade, telehealth has enjoyed a plethora of public funding and publication outlets around the world. Yet, rhetoric appears to be outpacing the actual diffusion and utilization of telehealth technologies for patient care. Several barriers, such as reimbursement and legal/regulatory issues, are commonly cited as impeding the successful deployment of this innovation. However, two separate studies carried out in Michigan that controlled for these barriers point out a more significant initial gatekeeper to the deployment of telehealth, namely providers.
Multiple data collection strategies were used in both the telehospice and telepsychiatry projects, including utilization logs, surveys, telehospice nursing notes, cost frame data collection, patient interviews, caregiver interviews and focus groups, and videotaped visits.
This study summarizes data from the two studies to support the hypothesis that the provider is the most important initial gatekeeper for telemedicine.
The implications from this conclusion have important consequences for health system deployment strategies. Specifically, telemedicine project managers must keep providers' needs (ease of use and incentives) in mind when designing a telemedicine system.

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    • "In hindsight, including clients in the development process rather than only in the evaluation process could have better guaranteed that the system answered the computer literacy and information needs of clients. However, it may be even more important to involve audiologists because clinicians are known to act as gatekeepers for telehealth uptake (Whitten & Mackert, 2005).[hemuppgifter], such as viewing the results of audiologic assessment or filling in the COSI, can be selected. "
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    • "In hindsight, including clients in the development process rather than only in the evaluation process could have better guaranteed that the system answered the computer literacy and information needs of clients. However, it may be even more important to involve audiologists because clinicians are known to act as gatekeepers for telehealth uptake (Whitten & Mackert, 2005). "
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    • "Without staff advocating the use of ICTs, most WCs will not have access to these systems (Whitten & Mackert, 2005). Actions to support staff in technical and related ethical aspects are therefore important for the overall care and support of older people and their WCs (European Commission, 2010) as well as in specific ICT-based support interventions (Whitten & Mackert, 2005; Magnusson & Hanson, 2012). "
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