Primary Care Professionals' Acceptance of Medical Record-Based, Store and Forward Provider-to-Provider Telemedicine in Catalonia: Results of a Web-Based Survey.

Josep Vidal-Alaball,Gloria Sauch Valmaña,Anna Ruiz-Comellas,Gemma Flores Mateo,Francesc López Seguí,Francesc García Cuyàs,Josep Lluís Garcia Domingo,Francesc X Marín-Gomez

doi:10.3390/ijerph17114092

Abstract

While telemedicine services enjoy a high acceptance among the public, evidence regarding clinician’s acceptance, a key factor for sustainable telemedicine services, is mixed. However, telemedicine is generally better accepted by both patients and professionals who live in rural areas, as it can save them significant time. The objective of this study is to assess the acceptance of medical record-based, store and forward provider-to-provider telemedicine among primary care professionals and to describe the factors which may determine their future use. This is an observational cross-sectional study using the Catalan version of the Health Optimum questionnaire; a technology acceptance model-based validated survey comprised of eight short questions. The online, voluntary response poll was sent to all 661 primary care professionals in 17 primary care teams that had potentially used the telemedicine services of the main primary care provider in Catalonia, in the Central Catalan Region. The majority of respondents rated the quality of telemedicine consultations as “Excellent” or “Good” (83%). However, nearly 60% stated that they sometimes had technical, organizational or other difficulties, which might affect the quality of care delivered. These negatively predicted their declared future use (p = 0.001). The quality of telemedicine services is perceived as good overall for all the parameters studied, especially among nurses. It is important that policymakers examine and provide solutions for the technical and organizational difficulties detected (e.g., by providing training), in order to ensure the use of these services in the future.

Highlights

Aside from emerging evidence on the clinical impact of telemedicine, which has shown that it can provide effective health services at a lower cost [1,2,3], telemedicine services enjoy a high degree of acceptance among the public, as studies show that it saves them significant time [4,5,6,7]
They mostly rated the technical quality of telemedicine consultations as good
When comparing the quality of care delivered by the telemedicine service with the quality of traditional care, nearly half of the respondents stated that the quality was about the same; around

Summary

Introduction

Aside from emerging evidence on the clinical impact of telemedicine, which has shown that it can provide effective health services at a lower cost [1,2,3], telemedicine services enjoy a high degree of acceptance among the public, as studies show that it saves them significant time [4,5,6,7]. Other evidence suggested a subtle/nuanced effect: services are generally well accepted by professionals, they express concerns regarding the increased workload that this might entail [14,15]. Such concerns appear to be more prevalent among primary care physicians than among nursing staff, who express a fear that telemedicine could potentially undermine their professional autonomy [16]. While some studies suggest that telemedicine is better accepted by patients who live in rural areas [17], professionals in these fields are more satisfied with the service as it facilitates contact with hospital specialists, improving their professional development [18,19]. Other studies show the benefits of telemedicine for professionals in terms of professional development [20,21], as well as suggesting that it enabled them to approach their patients with greater knowledge [22]

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