Telemedicine Policy Availability and Awareness: Directions for Improvement

Ear, Nose, and Throat Complaints in Primary Care: Assessing from a Remote Perspective

Abstract AimTo assess the awareness, attitude and perception of Trinidad and Tobago population towards telemedicineMethodA cross-sectional study was conducted using a structured questionnaire on patients that visited health centres in the North Central region. A systematic random sampling method was used to select participants. Descriptive statistics including mean and standard deviation were used to calculate categorical and continuous variables. Comparison between the categorical groups of the demographic variables for each of the three main outcome variables were analysed through one-way analysis of variance (ANOVA). Statistical significance was defined as P<0.05.ResultsA total of 528 participated in the study. Most (60%) of them were female, and aged 21 to 40 years (62.1%). Awareness of telemedicine was 34.4%, but the majority (82.5%) had never used telemedicine before. About half (51.3%) acknowledged the necessity of telemedicine but few (36.4%) were satisfied with the services. Most (64%) were willing to try mobile-based healthcare apps. Concerns over lack of familiarity with telemedicine platforms (44.5%) and result accuracy (15.5%) were the major barriers to using telemedicine. Awareness of telemedicine was significantly associated with being female (P < 0.001), a medical profession (P = 0.004), familiarity in use of computers (P = 0.004) and frequent interaction with doctors online (P < 0.001). Positive attitude towards telemedicine was associated with having a diploma, being a medical professional, being computer literate and frequent interaction with doctor online. Positive perception towards telemedicine was associated with marital status (Single or Previously Married) (P = 0.011), one’s ability to use the computer (P = 0.009), their level of competency in computer usage (P = 0.002), and frequency of interacting with doctors online (P < 0.002).ConclusionThe study revealed that although the level of telemedicine awareness is low, the majority of respondents demonstrated positive attitude and perception towards telemedicine. The findings suggest the need to educate the public on the benefits of telemedicine and create awareness of its use in T&T.

Healthcare in the third millennium is largely delivered through systems involving the use of the technological devices and services, foremost among them telemedicine. For the adequate delivery of digital medicine services, however, it is necessary for users to be digitally literate, that is, able to consciously make use of technology. In order to understand how relevant digital literacy is in determining the effectiveness of e-Health services, we performed a traditional literature review on 3 major databases by combining the terms “Digital Literacy” and “Computer Literacy” with the terms “Telemedicine” and “Telehealth”. Starting from an initial library of 1,077 papers, we selected 38 articles. At the outcome of the search, we found that digital literacy is a pivotal element in conditioning the effectiveness of telemedicine and digital medicine services in general, however, with some limitations.

This study aimed to determine the rate of telemedicine (TM) use and the levels of awareness, knowledge, attitude, and skills of TM among primary healthcare (PHC) providers. In a cross-sectional study, 104 PHC providers were subjected to a validated AKAS scale via Survey Monkey. The tool consists of 4 parameters that users can respond to using a 4-point Likert scale to assess their awareness (12 statements), knowledge (11 statements), attitude (11 statements), and skills (13 statements) on TM. Total and percentage mean scores (PMS) were calculated for each parameter. Participants were categorized in each parameter into three categories: low (≤ 49% score), average (50-70% score), and high (≥ 71% score) levels. The association of AKAS levels with personal characteristics and TM use was investigated. The significance was set at p<0.05. One-half of participants (51%) reported current use of TM, and two-thirds (63.5%) reported a high level of AKAS, with a PMS of 72.9±14.7, 95% CI: 70.1-75.7. There were significant associations between the following: years of experience and levels of knowledge (Χ2LT = 6.77, p= 0.009) and skills (Χ2LT = 4.85, p = 0.028), respectively; and total household income and levels of skills (Χ2LT = 6.91, p= 0.009). The rate of TM use was significantly associated with awareness levels (Χ2LT = 6.14, p = 0.013). Lack of training ranked as the first barrier (45.5%), followed by connection problems and tools' unavailability (35.1% each). The participants recommended providing TM training (41.1%) and stabilization of connection and networking signals (30.1%). Despite their high level of TM awareness, the rate of TM use by PHC providers is less than satisfactory. Establishing standardized TM training and supporting the network signals are recommended. A large-scale study on the impact of TM integration with PHC services is necessary.

Technology and telemedicine are needed to provide the necessary solutions for public health in rural areas. Lack of stable internet access and digital literacy hinders the effective use of telemedicine. Governments and service providers can work together to extend coverage, increase internet speed in rural areas, and provide training and education to ensure adequate digital literacy.