Telemedicine Issues Research Articles

Remote mobile health monitoring frameworks and mobile applications: Taxonomy, open challenges, motivation, and recommendations

Advancements in mobile technology have propelled the rapid progress of remote health monitoring, particularly in the domain of mobile health (mHealth). This progress is underscored by sophisticated smart health monitoring applications designed for mobile devices. mHealth monitoring, a standout area within remote health monitoring, excels in providing continuous health monitoring for patients and enabling remote observation by physicians. These applications cater to ambulatory patients with chronic diseases, offering essential features such as Telemedicine services, doctor availabilitys, and emergency ambulance services. Despite the development of various frameworks for mHealth monitoring, existing review papers often fall short in addressing critical parameters and issues related to Telemedicine. Many reviews provide a broad overview but lack the depth needed to dissect intricate aspects like implementation challenges in Telemedicine, nuances in decision-making applications, and the dynamics of mobility for both patients and healthcare providers. Patient rescue protocols, especially in diverse locations, are also underexplored. To fill this gap, our research delves into these dimensions, providing a nuanced understanding of challenges and opportunities in mobile health monitoring, particularly within the Telemedicine context. Leveraging a comprehensive literature review, we meticulously selected over 100 research articles from reputable databases like ScienceDirect, IEEE Xplore, and Springer. We have assessed and ranked the significance of each article. The study aims to address open issues in telemedicine, contributing valuable insights to enhance remote health monitoring.

Clinicodemographic Profile and Clinical Outcome of Children Presenting to Telemedicine Center at Institute of National Importance of India: A Prospective Observational Study.

There is a global shortage of healthcare professionals, especially in developing countries, leading to disparities in access to healthcare, worsened by the pandemic. Telemedicine is emerging as a solution, with growing adoption worldwide due to advancements in technology and increased awareness. Research Problem. The establishment of telemedicine depends on resources, infrastructure, and knowledge about healthcare needs. Further studies are needed to monitor and address evolving issues in telemedicine. The Overall Purpose of the Study. Rural health disparities stem from multiple factors, like limited healthcare access, workforce shortages, lifestyle choices, and lower socioeconomic status, leading to higher mortality and chronic diseases. Addressing these challenges is vital for rural community well-being. Telemedicine centers present a promising solution, bridging gaps, and improving healthcare outcomes for underserved remote populations. Methodology. Objective: This study assessed the clinicodemographic profile and clinical outcome of children presenting to the telemedicine center at the Institute of National Importance in India. Design: Prospective observational study. Setting: A single-center tertiary care level. Participants: This study included 79 children aged up to 18 years. Major Findings and Summary of Interpretations. In our study, 79 children using telemedicine found a near-equal gender distribution. 8.9% needed emergency care, with common complaints being respiratory issues, fever, abdominal pain, and vomiting. After two weeks, 83.5% showed improvement, emphasizing telemedicine's effectiveness in pediatric care. Our study underscores telemedicine's positive impact on pediatric healthcare, emphasizing its potential to enhance access, outcomes, and cost-efficiency. Wider telemedicine adoption can reduce morbidity and mortality, support preventive care, and streamline posttreatment services, alleviating pressure on specialized facilities. While our focus was pediatrics, the telemedicine model is adaptable to various age groups and conditions, but it should be seen as a valuable supplement to, not a total substitute for, in-person healthcare visits.

Telemedicine in Neurology: Lessons Learned During the COVID-19 Pandemic (P6-7.002)

<h3>Objective:</h3> Describe barriers and facilitators to telemedicine in neurology, and to examine the impact of telemedicine on neurologists’ job satisfaction. <h3>Background:</h3> Telemedicine facilitates patients access to specialized care and lowers patients physical and financial burden of traveling to appointments. But telemedicine is underutilized in neurology. Thus, little is known about neurologists’ experiences with telemedicine. Increased patients’ access via telemedicine may increase workload on neurologists, leading to increased stress and burnout. Exploring neurologists’ experiences with telemedicine will inform optimizing telemedicine in neurology. <h3>Design/Methods:</h3> A cross sectional study via a survey examined telemedicine related technological difficulties, need for technological support (IT), administrative support, neurologists’ motivation for work, change in work-life balance, and issues to improve telemedicine in neurology. Descriptive statistics were reported as percentages. <h3>Results:</h3> 110 neurologists participated. Specialties were stroke (21.82%), epilepsy (19.09%), movement disorders (14.55%), and headache (14.55%). (50.91%) of neurologists encounter technological issues in 1%–20% of telemedicine visits. And 94.55% of neurologists rated patient-related technological issues in setting up telemedicine visit is the most common difficulty encountered. Furthermore, 57.27% of neurologists required IT support in 1%–20% of telemedicine visits. 39.09% of neurologists rated improving administrative support, 37. 27% rated integration of video-telephone calls in EMR and 27.27% of neurologists rated facilitating ordering tests as the most important issues in telemedicine in neurology. On motivation for work, 48.18% of neurologists reported no change in their motivation, 30.91% of neurologists reported somewhat decreased motivation, and only 10.00% reported somewhat increased motivation. On work-life balance, 30.00% of neurologists stated it remained the same, 26.36% stated it somewhat decreased and 23.64% stated somewhat improved work-life balance. <h3>Conclusions:</h3> Technological difficulties in telemedicine are common. Improving administrative support and integration of virtual platforms in EMR are potential areas to optimize telemedicine visits. More studies are needed to examine the impact of telemedicine on neurologists’ burnout. <b>Disclosure:</b> Dr. Al-Faraj has nothing to disclose. Mr. Mohtar has nothing to disclose. Mr. Chen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for ParaDocs Health. Mr. Jha has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for ParaDocs Health. Miss LeClair has received research support from The National Institute of General Medical Sciences (NIGMS) Interdisciplinary Training Grant for Biostatisticians (T32 GM74905).

Telemedicine issues: problems of study in medical universities

Telemedicine issues: problems of study in medical universities

Resident Education and Virtual Medicine: A Faculty Development Session to Enhance Trainee Skills in the Realm of Telemedicine.

COVID-19 accelerated the use of telemedicine. Subsequently, clinical sites began conducting virtual visits. Academic institutions implemented telemedicine for patient care and simultaneously had to teach residents the logistics and best practices. To meet this need, we developed a training session for faculty focused on telemedicine best practices and teaching telemedicine in the pediatric realm. We designed this training session based on institutional and society guidelines and faculty experience with telemedicine. Objectives included telemedicine documentation, triage, counseling, and ethical issues in telemedicine. We conducted all sessions in a 60-minute or 90-minute format over a virtual platform for small and large groups using case scenarios with photos, videos, and interactive questions. A novel mnemonic ABLES (awake-background-lighting-exposure-sound) was created to guide providers during the virtual exam. Following the session, participants completed a survey evaluating content and presenter effectiveness. We presented the training sessions between May 2020 and August 2021 to 120 participants. Participants included pediatric fellows and faculty, reaching 75 participants locally and 45 nationally (at Pediatric Academic Society and Association of Pediatric Program Directors meetings). Sixty evaluations (response rate: 50%) showed favorable results for general satisfaction and content. This telemedicine training session was well received by pediatric providers and addressed the need for training faculty to teach telemedicine. Future directions include adapting the training session for medical students and developing a longitudinal curriculum that applies telehealth skills learned with patients in real time.

ANALYSIS OF THE NEED FOR LEGAL PROTECTION FOR DOCTORS IN TELECONSULTATION SERVICES TOWARDS THE COVID-19 ENDEMIC IN INDONESIA

Teleconsultation is a form of telemedicine that has developed rapidly during the COVID-19 pandemic. Clinical teleconsultation provides remote clinical consultation services to assist in establishing a diagnosis, and/or providing treatment considerations/advice. There are several issues in telemedicine, including ethical and legal issues. This study aims to find ethical and legal issues related to teleconsultation services after the COVID-19 pandemic. This research uses normative legal research methods. The laws and regulations that are reviewed by the researcher are those that are still valid in the Republic of Indonesia until June 2022. Researchers compare teleconsultation regulations and laws that were in effect during the pre-pandemic COVID-19 period with those that were in effect during the pandemic. Moreover, researchers examine ethical and legal issues that will arise during the COVID-19 endemic period. In conclusion, if the regulations during the pre-pandemic period are reimplemented during the endemic period, ethical and legal issues will arise. The issues vary from teleconsultation can only be provided by medical facilities like hospitals instead of direct consultation between doctor and patients. Furthermore, the applications must be legally issued and registered by the government, particularly from the ministry of health. Diagnosis enforcement does not follow professional standards in terms of physical examinations is also an issue. Besides, there are more issues such as electronic prescription is not allowed and doctors must be able to prove that there are no intentional factors in the cases of patients’ data leakage and medical record hacking. In this way, the government is expected to make basic changes in the existing teleconsultaion laws and regulations or to make specific teleconsultation laws and regulations with the purpose of providing legal protections for doctors.

Current Issues of Telemedicine for Dysphagia Patients

在宅の要介護高齢者の半数以上は摂食嚥下障害の疑いがあるとされ，超高齢社会の日本で「要介護高齢者の食事」は看過できない問題をはらむ．摂食嚥下関連医療資源は地域偏在しており，Information and Communication Techonology（ICT）を用いた遠隔診療は有用な解決策の1つである．しかし，遠隔診療のみでは医療資源偏在の解決は難しく，同時に地域医療のボトムアップを図る必要性がある．本稿では，遠隔診療による摂食嚥下リハビリテーション医療の実際とわれわれが取り組んでいる地域自立型摂食嚥下支援モデル構築を目的としたオンライン研修プログラム「TabeYou（食べよう）」を紹介する．

Non-use of telemedicine: A scoping review.

Many telemedicine interventions fail to be implemented in medical care with non-use and discontinued use by patients being among the major reasons. The aim of this scoping review was to provide an overview of barriers associated with non-use and discontinued use of telemedicine. An electronic search was conducted in Pubmed in October 2019 and updated in November 2020, followed by a hand search in the beginning of 2021. All potential articles were screened by two independent reviewers based on predefined inclusion and exclusion criteria. A qualitative content analysis according to Mayring was carried out. The topics 'intervention', 'context of use' and 'user' were chosen as overarching themes. Out of 1377 potentially relevant articles, 73 were included. User-related barriers were mentioned in most of the analysed studies, followed by barriers related to the intervention. The analysis provides the basis for overcoming non-use issues in telemedicine.

Mapping Telemedicine in German Private Practice Urological Care: Implications for Transitioning beyond the COVID-19 Pandemic

Background: There are limited data on the use and concern of telemedicine among German urologists, and thus, there are no established guidelines for telemedical diagnosis, treatment, and prevention of urological indications. Methods: An anonymized survey was conducted among German private practice urologists during the 2019 coronavirus disease (COVID-19) pandemic. The χ² test, Mann-Whitney U-test, and Kruskal-Wallis test were used for statistical analysis. Results: 257 urologists were included in the final analysis. Thirty-five (14.0%) of urologists had used telemedicine as part of their consultation, and 221 (86.0%) had not used telemedicine. There was no difference between telemedicine adoption rates between rural and urban settings. Telemedicine users were significantly more satisfied with the information they had received regarding telemedicine issues. Users saw the greatest barrier to telemedicine that patients do not take up the offer of telemedicine. Nonusers were most concerned with unclear indications for telemedicine followed by lesser reimbursements during telemedicine than in-person visitations. Users were significantly more likely to use telemedicine beyond the COVID-19 pandemic. Urologists, who wanted to use the service in the future, wanted an active support by the German society of urology and guidelines for telemedicine. Last, users and nonusers preferred telemedicine for non-acute chronic diseases and follow-up visitations. Conclusion: Despite the COVID-19 pandemic, telemedicine remains a rarely used service among German private practice urologists. Ultimately, to overcome the current challenges, urologists require an active support for the service through the German Society of Urology and telemedical guidelines.

Addressing COVID-19 challenges in a randomised controlled trial on exercise interventions in a high-risk population

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic is a threat to ongoing clinical trials necessitating regular face-to-face, in-person meetings, particularly in participants with a high risk of complications. Guidance on how to handle and safely continue such trials is lacking. Chronically ill elderly individuals require—in addition to protection from infection—regular physical exercise and social contact to remain healthy. Solutions on how to handle these conflicting necessities are needed.The ENTAIER-randomised controlled trial was investigating the influence of mindful movements on fall risk, fear of falling, mobility, balance, life quality, and other outcomes. The study population was planned to comprise of 550 chronically ill elderly individuals with a high risk of falling. The movements were regularly performed in coached groups over 6 months. After the trial began, COVID-19 lockdowns stopped all in-person meetings, and it was expected that the limitations of this pandemic would continue for a long term. Therefore, the exercise programme, which involved complex movements and was typically conducted face-to-face in groups, had to be substituted by a telemedicine programme within a short timeframe. The objectives, therefore, were to identify challenges and tasks that could to be resolved and steps that could to be taken to achieve high-quality, efficacy, safety, and enable human encounter and motivation.MethodsWe proceeded with four steps: 1) A literature review on the quality and feasibility issues of telemedicine in general, and specifically, in exercise training in elderly individuals. 2) Participation in two international telemedicine task forces on integrative medicine, particularly, mind–body medicine. 3) Interviews with study therapists, (for practical purposes, eurythmy therapists and Tai Chi teachers are summarized here as therapists) personnel, and international experts on providing mindful movement exercises and other physiotherapies via live telecommunication technology, and with scientists and patient representatives. 4) Final evaluation by the core trial team and subsequent planning and implementation of changes in the trial organisation.ResultsVarious tasks and challenges were identified: for the technical equipment for therapists and patients; for the ability of therapists and trial participants to adequately manage the technology and telemedicine intervention; the reservations and concerns about the technology among therapists and participants; safety and data protection in using the technology; and study design. The two major options found on how to continue the trial in the COVID-19 situation were a complete switch to telemedicine and a partial switch in the form of risk management implemented into the former design.ConclusionsThe management of an ongoing clinical trial in a national or international crisis with a minimum of available time and extra financial resources, alongside with two checklists on steps and procedures for trial continuation and telemedicine implementation, may be informative for other researchers or healthcare providers faced with similar challenges and making similar decisions in the current situation or similar future scenarios.Trail registrationwww.drks.de. DRKS00016609. Registered July 30, 2019.

A Safe and Secured Medical Textual Information Using an Improved LSB Image Steganography

Safe conveyance of medical data across unsecured networks nowadays is an essential issue in telemedicine. With the exponential growth of multimedia technologies and connected networks, modern healthcare is a huge step ahead. Authentication of a diagnostic image obtained from a specialist at a remote location which is from the sender is one of the most challenging tasks in an automated healthcare setup. Intruders were found to be able to efficiently exploit securely transmitted messages from previous literature since the algorithms were not efficient enough leading to distortion of information. Therefore, this study proposed a modified least significant bit (LSB) technique capable of protecting and hiding medical data to solve the crucial authentication issue. The application was executed and established by utilizing MATLAB 2018a, and it used a logical bit shift operation for execution. The investigational outcomes established that the proposed technique can entrench medical information without leaving a perceptible falsification in the stego image. The result of this implementation shows that the modified LSB image steganography outperformed the standard LSB technique with a higher PSNR value and lower MSE value when compared with previous research works. The number of shifts was added as a new performance metric for the proposed system. The study concluded that the proposed secured medical information system was evidenced to be proficient in secreting medical information and creating undetectable stego images with slight entrenching falsifications when likened to other prevailing approaches.

A novel chaotic IWT-LSB blind watermarking approach with flexible capacity for secure transmission of authenticated medical images

Nowadays, secure medical data transmission is an essential issue in telemedicine through unsecured channels. Watermarking methods are widely used to provide optimal security for medical image transmission. In this method, a secure and blind watermarking algorithm based on Integer Wavelet Transform (IWT), Least Significant Bit (LSB), and chaotic sequences (ILC) with a high capacity for grayscale medical and non-medical images is ILC. In this scheme, the high-level security is achieved by chaotic sequences that are applied for watermark encryption and determining the location of host blocks and host coefficients in the embedding process. At first, the cover medical image is divided into two distinct parts: the region of interest (ROI) and the region of non-interest (RONI) areas. Due to the high sensitivity of the ROI data in disease diagnosis, no embedding is done in this area. An ROI integrity check data (ICR), produced by some significant features from ROI, to detect tampered blocks inside this area. The main watermark, which is the encryption of ICR along with the patient’s personal and medical information, is embedded in the middle-frequency at the first and second levels of IWT sub-bands. Furthermore, to verify the watermark, integrity check data (ICW) is produced and sent along with other essential data to the receiver. For identifying authentication purposes, the physician’s signature is embedded at the third level (LL3) sub-band of IWT which has the highest energy and robustness. Moreover, the algorithm is flexible for using different sizes of text watermarks and it guarantees a high payload capacity. It is noteworthy the maximum lengths of text watermarks used in the method for 512×512 and 1024×1024 images are 47,784 and 164,620 bits, respectively. Although the size of the embedded watermark increases with the size of the ROI area, the image transparency remains almost constant and also the watermark is extracted with a bit error rate of zero. By doing various analyses, the experimental results represent superior imperceptibility by an average PSNR value of 75 dB. This method provides high imperceptibility and robustness against various attacks compared with state-of-the-art algorithms.

Telemedicine: an Essential Requirement for the Health Care Providers, with Emphasis on Legal Aspects

Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. These technologies allow communications between patient and medical staff with convenience as well as the transmission of medical, imaging and health informatics data from one site to another. It is also used to save lives in critical care and emergency situations. Although telemedicine systems have many advantages, including the distribution of high quality medical services to remote areas, failure to comply with infrastructure will reduce the efficiency and quality of their services. Issues such as building the infrastructure of the medical information industry, including the legal infrastructure, and thus providing a suitable platform for the legal and ethical issues of Telemedicine, as well as obtaining the necessary permits and requirements, will play an important role in the successful implementation of a Telemedicine system. The purpose of this study was to become more familiar with the field of Telemedicine and its services, as well as to review some legal issues in the field of e-health. Telemedicine is not able to solve the problems of the health and social systems, but the problems of the health and social systems cannot be solved without Telemedicine.

Telemedicine adoption issues in the United States and Brazil: Perception of healthcare professionals.

Telemedicine has recently garnered more attention from healthcare professionals because it provides access to health services to patients in rural areas while making patient healthcare information more vulnerable to security breaches. The objective of this research is to identify factors that play a critical role in possible adoption of telemedicine in the United States and Brazil. A model with eight hypotheses was used to establish a research framework. A survey was conducted involving healthcare professionals in the aforementioned countries. The results show that telemedicine adoption is influenced by policies and culture in both countries and influenced by security and privacy in the United States. It can be inferred from the research that perceptions of the American and Brazilian healthcare professionals are similar in telemedicine issues covered in this research. These healthcare professionals, however, disagree on how patients' privacy should be preserved in the two countries.

Telemonitoring systems for respiratory patients: technological aspects

This review introduces the reader to the available technologies in the field of telemonitoring, with focus on respiratory patients. In the materials and methods section, a general structure of telemonitoring systems for respiratory patients is presented and the sensors of interest are illustrated, i.e., respiratory monitors (wearable and non-wearable), activity trackers, pulse oximeters, environmental monitors and other sensors of physiological variables. Afterwards, the most common communication protocols are briefly introduced.In the results section, selected clinical studies that prove the significance of the presented parameters in chronic respiratory diseases are presented. This is followed by a discussion on the main current issues in telemedicine, in particular legal aspects, data privacy and benefits both in economic and health terms.

Telemedicine in the era of COVID-19: The East and the West

Introduction: Telemedicine implies the application of clinical medicine by telephone, internet, or any other such networks for the purpose of consulting or performing various examinations or medical procedures. The present pandemic of COVID-19 is the ideal time to evolve telemedicine and increase its utilization for the well-being of humankind. Historical Background: Electrocardiogram transmission over telephone lines is the oldest record of telemedicine in the first half of the 20th century. Teleradiology commenced in India in 1996. The National Telemedicine Taskforce was set up by the Government of India, in 2005. The Arizona State Legislature established the Arizona Telemedicine Program in 1996. Medical devices to capture images were developed in the 1990s. Present Scenario in the East: Besides implementing various national-level projects, India has extended telemedicine services to South Asian and African countries. The Apollo Telemedicine Networking Foundation has grown to 115 centers, including 9 overseas. Recently, the Government of India has launched telemedicine solutions in the form of Social Endeavour for Health and Telemedicine and eSanjeevani. Comprehensive guidelines on telemedicine have also been issued during the COVID-19 pandemic. The Indian Navy is in the process of establishing teleconsultation centers on board several ships, submarines, remote locations, islands, and naval hospitals. Present Scenario in the West: Telestroke is the largest care provider for patients with stroke in the country. The field of dermatology is particularly suited for telemedicine. Telemedicine at sea is an integral part of rescue procedures. One of the fundamental components of medical assistance at sea is the Telemedical Maritime Assistance Service. Socioethical and Legal Considerations: Legal and regulatory measures will be a challenge with the rapidly spreading telemedicine network. Conflicting laws of different nations are some of the other legal issues in telemedicine. There exists an urgent need for specific legislation on telemedicine in India. In the USA, telemedicine covers various legal and regulatory issues at the state and federal levels. Limitations: Limited reimbursement or restrictions on reimbursement from insurance providers, quality of the patient–physician relationship, the quality of the examination, and the quality of care are a few barriers to telemedicine. The social limitation is probably the biggest limitation of telehealth. Conclusion: Despite several barriers, telehealth has shown remarkable growth during the COVID-19 pandemic. India with its large medical and IT manpower and expertise is emerging as a global leader in the field of telemedicine. The COVID-19 pandemic has made telemedicine more relevant than ever.

Telemedicine: The Concept and Legal Regulation in Russia, Europe, and USA

This article is devoted to a comparative legal analysis of the concept and legal regulation of telemedicine in Russia, Europe (on the example of the EU), and the USA. Telemedicine, the problems of using telemedicine technologies in the provision of medical care are relevant objects of scientific research and discussion both for medicine and law (medical law, civil law). Telemedicine issues have become especially significant in connection with the introduction of Federal Law No. 242-FZ of July 29, 2017 “On Amending Certain Legislative Acts of the Russian Federation on the Use of Information Technologies in the Field of Health Protection”, which legalized the use of telemedicine in Russia. In the framework of this comparative study of the concept of telemedicine, the article analyzes the definitions of this term, enshrined in the laws of these countries, as well as the definitions available in science and practice. Attention is also being paid to the definition of “telemedicine” given by the World Health Organization. The analysis of the legal regulation of telemedicine considers the relevant sources of legal regulation in Russia, the EU, and the USA, and allows drawing conclusions about the existing problems of legal regulation and gaps in the legislation.

Legal Perspectives on Telemedicine Part 2: Telemedicine in the Intensive Care Unit and Medicolegal Risk.

Tele-intensive care unit (tele-ICU) implementation has been shown to improve clinical and financial outcomes. The expansion of this new care delivery model has outpaced the development of its accompanying regulatory framework. In the first part of this commentary we discussed legal and regulatory issues of telemedicine in general and expanded on tele-ICU implementation in particular. Major legal and regulatory barriers to expansion remain, including uncertainty regarding license portability and reimbursement. In this second part we discuss the effects of telemedicine implementation on the various aspects of medicolegal risk and risk mitigation, with a particular focus on tele-ICU. There is a paucity of legal data regarding the effect of tele-ICU implementation on medicolegal risk. We will therefore systematically discuss the effects of tele-ICU on the various root causes of medical error. Given the substantial capital and operational investment that must be undertaken to build and run a tele-ICU, any reduction in risk adds to the financial return on investment and further decreases barriers to implementation.

An insight into the bilateral readiness towards telemedicine

The primary purpose of this study is to profile and explore the technological and behavioral readiness of the physicians and patients towards telemedicine, supplemented by a secondary objective of getting additional insight about the status quo of technological readiness regarding the telemedicine in Dhaka city of Bangladesh. Structured questionnaire-based survey responses from 600 patients/individuals and 100 physicians are analyzed by using descriptive (i.e., Frequency Distribution) and inferential (i.e., Contingency Table of Association, Partial Least Square – Structural Equation Modeling, Factor Analysis) statistical tools for meeting the defined objectives of this study. Findings show favorable technological readiness of the respondents compared to behavioral readiness which is unfavorable. Gender diversity has a significant association with the different levels of access to elementary technology by the patients/individuals, whereas education level fails to prove to have any association. Different levels of skill at using technology by the individuals significantly influence their behavioral readiness and intention to accept telemedicine in Bangladesh. However, behavioral readiness is mostly defined by patients/individuals’ expectation from telemedicine regarding the effectiveness, easiness, reliability, need, and satisfaction. The issue of the implication of this study can be enlightened from two perspectives. First, the findings of this study will provide the interested parties a greater insight in terms of telemedicine through addressing the perplexing situation of Bangladesh about to arise whenever someone going to introduce a new system or way doing anything as an alternative of the conventional way doing or thinking. It is usual to face a barrier in changing anything. That is why it is also essential to know the sources of the barrier, what they think and expect. So, in this study, the researchers try to address these issues of telemedicine.

Information Assurance and Security Issues in Telemedicine — Future Directions

One of the challenges in healthcare is to provide equitable access to services, given that the provider and the patient are traditionally expected to be physically present in the same place [1], [2], [3]. Technological advancements have been made to overcome obstacles to equitable healthcare services and enable convenient access to quality healthcare for consumers throughout the world. The field of digital healthcare, which is known as telemedicine [2], [3], [4], [5], is rapidly making its way globally across the healthcare services domain. It allows the transfer of images and video through telecommunication technology, giving physicians the ability to evaluate, diagnose, and in certain cases, treat patients remotely [6]. Patients can visit providers over live video without travelling for immediate care and for follow up treatment. Not only does it give patients the ability to schedule appointments with local physicians via live video communication without having to leave home, but it also allows them to consult with distant healthcare professionals and avail their services remotely.