Telemedicine Regulations Research Articles

Ethical considerations in telehealth and artificial intelligence for work related musculoskeletal disorders: A scoping review.

Artificial Intelligence (AI) refers to the simulation of human intelligence in machines that are programmed to perform tasks that typically require human intelligence. The integration of AI and telehealth applications in healthcare raises ethical concerns such as bias, transparency, data privacy, and accountability for errors. Several studies have assessed this topic, particularly with regard to musculoskeletal disorders, which will be the focus of this manuscript. We will examine key ethical concepts including informed consent, data protection, confidentiality, physician malpractice, liability, and telemedicine regulations. Ethical issues pertaining to the topic were explored through a review paper. The primary objective of this scoping review was to map and synthesize the existing literature concerning ethical considerations in telehealth and AI for work-related musculoskeletal disorders. Research demonstrates that medication effectiveness, patient and physician satisfaction, and accessibility costs are higher with telemedicine and AI methods compared to in-person approaches, particularly for work-related musculoskeletal disorders. Therefore, addressing ethical issues, including patient data privacy and security, is crucial in this field. By considering these factors, the adoption of emerging AI and telemedicine applications, especially for work-related musculoskeletal disorders, is likely to increase. AI and telemedicine offer significant advantages, particularly in addressing work-related musculoskeletal disorders. However, ethical and legal issues surrounding their practice require standardized rules to ensure equitable access, quality care, sustainable costs, professional liability, patient privacy, data protection, and confidentiality. Further practical research studies are needed to address these considerations more effectively.

A global survey of telemedicine use in epilepsy care – practices before, during and after the COVID-19 pandemic

PurposeTelemedicine was widely adopted for epilepsy care during the COVID-19 pandemic. Its role extends beyond preventing disease transmission, offering an efficient and high-quality care alternative. To understand the global scenario, an international group conducted a survey comparing telemedicine practices in epilepsy care before, during, and after the pandemic. MethodsThe survey included 26 questions on demographics, telemedicine use for epilepsy care, regulations, reimbursement mechanisms, and tools used. Responses were collected via an online survey platform from June to October 2023. ResultsTwo hundred eighty-five respondents from 60 countries participated. The average telemedicine use in daily practice was 0 %, 0–10 % (median, IQR) before the pandemic, 65 %, 30–90 % during the pandemic, and 20 %,10–50 % after the COVID pandemic. Female respondents reported higher telemedicine use than males after the pandemic (25 %, 10–50 % vs 15 %, 5 %-30 %, p = 0.002). According to respondents' perceptions, post-pandemic telemedicine regulations flexibilities were reported as expanded by 36.8 %, restricted by 17.2 %, and unchanged by 46 %. Reimbursement for telemedicine increased during the pandemic but decreased afterward (Cochran's Q test, p < 0.001). Voice calls were the most used telemedicine platform (46.6 %). Privacy issues were reported by 49 respondents (18.3 %). ConclusionTelemedicine use for epilepsy care increased during the pandemic and remained higher than pre-pandemic levels. However, improvements are needed in telemedicine applications, regulations, reimbursement, and patient privacy. International collaboration and experience sharing can enhance telemedicine's acceptance and practice globally.

Stability of telemedicine legislation: current issues

The main features and problems of the development of legislative regulation of telemedicine in the Russian Federation are considered. The stages of such development are identified and analyzed: the existence of a concept, the existence of detailed regulation, the establishment of the possibility of deregulation within the framework of a legal experiment, the beginning of a legal experiment. The correlations between changes in the telemedicine services market and changes in legislation and regulated public relations are considered. The probable reasons that prompted the legislative bodies to establish detailed regulation of relations in the field of telemedicine have been identified, given that the provision of telemedicine services has never been prohibited (encouraging participants in civil turnover to use this legal institution, public interest in regulated public relations). The aim of the work was to formulate the problems of non-systemic changes in legislation on telemedicine, their determinants and further optimal development vectors. The research methodology is based on historical and teleological methods that allow us to consider the problems of legal regulation of telemedicine, based on the peculiarities of the formation of legislation in this area. The paper analyzes statistical data, regulations and materials of judicial practice; using the comparative legal method, general and various trends with the development of other legislative institutions are identified. It is concluded that regular changes in legislation on telemedicine, undermining its stability and predictability of legal regulation, have their reasons for the lack of conditionality of reforms with the current concept of development of legislation on telemedicine, as well as the redundancy of the adopted regulatory regulation. Taking into account the absence of civil law litigation on the provision of telemedicine services, it is proposed to expand deregulation in this area beyond the legal experiment: extending its provisions to the current legislation as a whole. This need is indirectly confirmed by statistical data on a significant increase in the provision of telemedicine services after their legislative consolidation, with its subsequent decrease and the introduction of a legal experiment on deregulation after that. The study is financially supported by the Russian Science Foundation, project No. 23-78-10175, https://rscf.ru/project/23-78-10175/.

Legal Protection of Patients in Telemedicine Services in Indonesia

The Health Law in regulating the use of telemedicine/telemedicine is much more general than the regulations in the Kepmenkes and Permenkes. Because the Health Law is much more general and only mentions a few provisions in the mechanism of running telemedicine, namely only related to definitions, health efforts, and health service facilities. Based on the three rules described above, none of the provisions regulate the rights of patients or the legal protection of patients who use the utilization of telemedicine. The type of research used in this study is normative juridical research. Furthermore, the research approach in this study uses a stata approach. This research is descriptive, which makes a systematic description, regulation of telemedicine and patient protection in telemedicine services. The author concludes, first, Based on the three rules, no one mentions the existence of legal protection regarding patient rights in using telemedicine, but the legal protection referred to in the Health Law is only to patients in general. Second, the vagueness regarding the protection of these rights specifically in the implementation of telemedicine. So that the regulation related to the protection of patients' rights in the implementation of telemedicine still has several gaps that need to be regulated further.

Telepsiquiatria no Brasil: construção, validação e aplicação de questionário de Conhecimento, Atitude e Prática

ABSTRACT Introduction: Telepsychiatry, defined as the use of electronic communication to provide or support remote psychiatric care, has gained prominence during the COVID-19 pandemic and the emergence of telemedicine regulations in Brazil. This study aims to assess the adoption of telepsychiatry among Brazilian psychiatrists, employing KAP (Knowledge, Attitude, and Practice) questionnaires to understand their knowledge, attitudes, and practices related to this field. Objective: Constructing, validating, and applying a questionnaire to determine the level of knowledge, attitude, and practice of Brazilian psychiatrists regarding telepsychiatry in the past year and identifying factors associated with adequate knowledge, attitude, and practice. Method: A methodological study was conducted to construct and validate the instrument, followed by a cross-sectional study with an analytical KAP questionnaire. After the questionnaire development, psychiatry experts validated the instrument using the Delphi method. Subsequently, the questionnaire was distributed to psychiatrists across Brazil through social networks and the Brazilian Psychiatric Association. Data analysis was performed using the Stata 12.1 software, employing multivariate Poisson analyses. Results: The KAP questionnaire was validated with a high degree of agreement among the experts. Among the participants, 68.3% demonstrated adequate knowledge, 80.1% had an adequate attitude, and 81.2% exhibited adequate practices concerning telepsychiatry. The multivariate analysis revealed significant associations, such as adequate attitudes being linked to not practicing in medical offices and providing care to children, while adequate practices were associated with providing care to both the elderly and adolescent patients. Conclusion: The study concludes that the KAP questionnaire is valid and can be applied in future research. It underscores the significance of telepsychiatry in the practices of Brazilian psychiatrists, with notable differences in adequate attitudes and practices based on the age groups of treated patients. These findings indicate the need to consider these variables when implementing telepsychiatry, contributing to guiding mental health policies and specific clinical practices for different age groups.

Legal Challenges and Considerations in Implementing Telemedicine Services

Through this paper, I examine the legal and ethical issues surrounding telemedicine in India, with the goal of helping to develop a robust and compliant telemedicine framework. I analyzed the current legal framework in India, based on the Telemedicine Practice Guidelines, Medical Council Act, and Information Technology Act. The study found gaps regarding licensing, liability, credentialing, and data privacy without comprehensive data protection laws. Ethical issues were also explored, including informed consent, equitable healthcare access, patient privacy, and maintaining care quality in virtual consultations. The research identified a significant gap in existing literature on the legal and ethical complexities of telemedicine specifically in the Indian context. Recommendations were proposed to address these challenges, such as improving data protection laws, establishing a clear liability framework, harmonizing telemedicine regulations across jurisdictions, and promoting public-private partnerships. Leveraging advanced technologies like blockchain was highlighted to expand telemedicine services while ensuring patient data security. This study aims to guide policymakers, healthcare providers, and telemedicine platforms in developing an ethical, secure, and accessible telemedicine ecosystem in India, thereby improving healthcare quality while safeguarding patient privacy and data security.

Medical authority in Indonesian clinical : An app-based telemedicine program

Background : Doctors who practice through application-based telemedicine do not have a clear legal regarding the services they provide. Telemedicine regulations that exist in Indonesia are still inadequate to cover all actions in telemedicine transactions, especially for legal protection for doctors who are legal subjects in this transaction. Given that until now, every telemedicine transaction must be under a Health Service Facility or an Online Doctor Consultation Service Provider. Thus, the doctor here as a provider of consulting services is actually not the main person who makes this transaction possibleMethod: Normative juridical approach, namely research conducted byhow to examine theories, concepts, legal principles and legislation related to this researchResults: Article 50 of law number 29 of 2004 concerning medical practice explains that a doctor has the right to obtain legal protection as long as his actions are in accordance with professional standards and standard operating procedures. In terms of application-based telemedicine, doctors do not have a practice permit, but during the COVID-19 pandemic, telemedicine was developed massively, the pandemic was considered an emergency, so the KKI regulation NUMBER 74 of 2020 concerning clinical authority and medical practice through telemedicine was issued during the COVID-19 period. The limit of clinical authority for application-based telemedicine practice is limited to consultation, not including medical action and administration of hard drugs.Conclusion: A doctor who has pocketed the STR is authorized to provide health services in accordance with his competence. The authority obtained by a doctor who has an STR is a form of recognition given by the government to the doctor concerned that he is worthy to provide health services in the form of medical practice. The limit of clinical authority for application-based telemedicine practice is limited to consultation, not including medical action and administration of hard drugs.

Legal Formulation of Telemedicine Implementation as the Prevention of Malpractice Risk for Patients

This study aims to determine the practice of implementing telemedicine in Indonesia and legal reformulation in telemedicine implementation as a prevention of malpractice risks to patients. This study used normative juridical research, with the statute approach, conceptual approach, and comparative approach. The data used is secondary data consisting of primary legal materials, secondary legal materials, and tertiary legal materials. The results of this study indicate that Indonesia does not yet have regulations that specifically regulate the use of telemedicine. Regulation of the Minister of Health Number 20 of 2019 is not sufficient to guide the implementation of telemedicine in Indonesia. Thus, the use of telemedicine has the potential to cause various legal problems. If referring to the principles of medical practice, telemedicine can pose a risk of malpractice to patients because doctors do not examine patients directly. Not only that, current regulations also do not specifically regulate the concept of administering electronic medical records in telemedicine, thus increasing the risk of malpractice in the form of leakage of electronic medical record data and resulting in legal uncertainty in proving in the event of malpractice. Therefore, it is necessary to reformulate the law by issuing telemedicine regulations whose substance regulates the relationship between doctors and patients, the rights and obligations of the parties, protection of electronic medical records, criminal sanctions, and an independent supervisory institution.&#x0D; Keywords: Legal Reformulation, Malpractice, Telemedicine.

Indonesian Telemedicine Regulation to Provide Legal Protection for Patient

The objective of this study is to identify the underlying factors contributing to the absence of legal safeguards for patients in Indonesia with respect to Telemedicine arrangements. Additionally, this research endeavors to develop an optimal framework for Telemedicine arrangements in Indonesia that would ensure legal protection for patients. The present study constitutes a normative legal research. The author posits that in order to provide legal protection for optimal patients, it is necessary to regulate telemedicine services. This can be achieved by implementing a system that guarantees measurable and certified competence in telemedicine services. The proposed framework includes several key components. Firstly, it emphasizes the importance of clearly defining domain areas. Secondly, it underscores the obligation to record telemedicine service practices and protect such recordings. Thirdly, it outlines regulations pertaining to informed consent. Fourthly, it incorporates arrangements for dispute resolution in the context of health services provided to patients via telemedicine.

Telemedicine and YouTube™: Video quality analysis before and after COVID-19 pandemic

To assess the quality content of YouTube™ videos on telemedicine during COVID-19 pandemic. First, the frequency of worldwide YouTube™ and Google™ searches for telemedicine was analyzed. Second, we queried YouTube™ with telemedicine-related terms. Third, the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT A/V), the Global Quality Score (GQS), and the Misinformation tool were used for the quality assessment. According to selection criteria, 129 videos were collected for the analysis. From January 2018 to January 2022, the peak relative interest on YouTube™ and Google™ occurred in March 2020. Of all, 27.1 and 72.9% were uploaded before (Jan 2018-Feb 2020) and after (Mar 2020-Mar 2022) the COVID-19 outbreak, respectively. According to the PEMAT A/V, the overall median understandability and actionability was 50.0% (33.3 [IQR 0-66.7] vs 50.0 [27.1-75], p = 0.2) and 66.7% (63.6 [IQR 50.0-75.7] vs 67.9 [50.0-79.2],p = 0.6), respectively. According to GQS, 3.9%, 17.8%, 24.0%, 26.4% and 27.9% were classified as excellent, good, medium, generally poor, and poor-quality videos, respectively. The highest rate of poor-quality videos was recorded in videos uploaded before COVID-19 pandemic (37.1 vs 24.5%). According to overall misinformation score, a higher score was recorded for the videos uploaded after COVID-19 pandemic (1.8 [IQR 1.4-2.3] vs 2.2 [1.8-2.8], p = 0.01). The interest in telemedicine showed a significant peak when the COVID-19 pandemic was declared. However, the contents provided on YouTubeTM were not informative enough. In the future, official medical institutions should standardize telemedicine regulation and online content to reduce the widespread of misleading information.

Challenges to and Regulation of Telemedicine in South Africa

Telemedicine is a component of the greater field of eHealth which entails the use of information communication technology for health and may be broadly understood as the provision of healthcare over distances making use of these information and communication technologies. Despite early resistance to telemedical practices, mHealth and eHealth have become omnipresent and as such the value of this form of healthcare service delivery can no longer be denied. However, medical service delivery cannot be unfettered and it is important that the implementation and practice of telemedicine be properly regulated. In order to do so, cognisance of the local environment and the specific challenges that the environment brings needs to be taken. Once the challenges are known, the appropriate remedies may be provided for in regulatory instruments. As such, this article attempts to identify the legal challenges posed to telemedicine in South Africa and to examine if, and if so, how these challenges are addressed by various regulatory instruments including legislation and ethical guidelines.

The Telemedicine Experience in Primary Care Practices in the United States: Insights From Practice Leaders.

The need to rapidly implement telemedicine in primary care during the coronavirus disease 2019 (COVID-19) pandemic was addressed differently by various practices. Using qualitative data from semistructured interviews with primary care practice leaders, we aimed to report commonly shared experiences and unique perspectives regarding telemedicine implementation and evolution/maturation since March 2020. We administered a semistructured, 25-minute, virtual interview with 25 primary care practice leaders from 2 health systems in 2 states (New York and Florida) included in PCORnet, the Patient-Centered Outcomes Research Institute clinical research network. Questions were guided by 3 frameworks (health information technology evaluation, access to care, and health information technology life cycle) and involved practice leaders' perspectives on the process of telemedicine implementation in their practice, with a specific focus on the process of maturation and facilitators/barriers. Two researchers conducted inductive coding of qualitative data open-ended questions to identify common themes. Transcripts were electronically generated by virtual platform software. Twenty-five interviews were administered for practice leaders representing 87 primary care practices in 2 states. We identified the following 4 major themes: (1) the ease of telemedicine adoption depended on both patients' and clinicians' prior experience using virtual health platforms, (2) regulation of telemedicine varied across states and differentially affected the rollout processes, (3) visit triage rules were unclear, and (4) there were positive and negative effects of telemedicine on clinicians and patients. Practice leaders identified several challenges to telemedicine implementation and highlighted 2 areas, including telemedicine visit triage guidelines and telemedicine-specific staffing and scheduling protocols, for improvement.

Chinese herbal medicine treatment in five mild COVID-19 cases: South African case studies

In December 2019, the initial reports of a novel coronavirus epidemic emerged in China. Despite South Africa demonstrating determined political efforts to handle the outbreak within its borders, there is currently no established effective treatment for mild cases. The sharing of clinical experiences could prove beneficial in managing emerging infectious diseases. Given the successful management of COVID-19 in China, Traditional Chinese Medicine (TCM) might present a potential solution for mild cases in South Africa, potentially lowering the likelihood of mild cases progressing to severe stages and expediting the recovery process. Data were retrieved from an identified clinic in South Africa between 12 June 2020 to 26 June 2020. All cases were consulted under the regulation of telehealth and telemedicine by using online video consultation. It can be inferred that TCM is efficacious in hastening the recovery process and diminishing the instances of mild cases progressing to severe stages. The utilisation of Chinese herbal medicine proves applicable in treating mild cases of COVID-19, irrespective of variations in geography, climate, and racial factors. This study was constrained in its examination of patients from a single clinic, lacking a comparative aspect. It is advisable that future studies be conducted in more extensive settings to provide a broader perspective.

Musculoskeletal Telemedicine Trends Preceding the COVID-19 Pandemic and Potential Implications of Rapid Telemedicine Expansion.

Telemedicine was rapidly deployed at the onset of the COVID-19 pandemic. Little has been published on telemedicine in musculoskeletal care prior to the COVID-19 pandemic. This study is aimed at characterizing trends in telemedicine for musculoskeletal care preceding the COVID-19 pandemic. This retrospective study used insurance claims from the Truven MarketScan database. Musculoskeletal-specific outpatient visits from 2014 to 2018 were identified using the musculoskeletal major diagnostic category ICD-10 codes. Telemedicine visits were categorized using CPT codes and Healthcare Common Procedure Coding Systems. We described annual trends in telemedicine in the overall dataset and by diagnosis grouping. Multivariable logistic regression modeling estimated the association between patient-specific and telemedicine visit variables and telemedicine utilization. There were 36,672 musculoskeletal-specific telemedicine visits identified (0.020% of all musculoskeletal visits). Overall, telemedicine utilization increased over the study period (0% in 2014 to 0.05% in 2018). Orthopedic surgeons had fewer telemedicine visits than primary care providers (OR 0.57, 95% CI 0.55-0.59). The proportion of unique patients utilizing telemedicine in 2018 was higher in the south (OR 2.28, 95% CI 2.19-2.38) and west (OR 5.58, 95% CI 5.36-5.81) compared to the northeast. Those with increased comorbidities and lower incomes and living in rural areas had lower rates of telemedicine utilization. From 2014 to 2018, there was an increase in telemedicine utilization for musculoskeletal visits, in part due to insurance reimbursement and telemedicine regulation. Despite this increase, the rates of telemedicine utilization are still lowest in some of the groups that could derive the most benefit from these services. Establishing this baseline is important for assessing how the roll-out of telemedicine during the pandemic impacted how/which patients and providers are utilizing telemedicine today.

TELEPERÍCIA EM PERÍCIAS MÉDICAS JUDICIAIS: SITUAÇÃO ATUAL, APÓS A REGULAMENTAÇÃO DA TELEMEDICINA NO BRASIL

Introduction: In the context of disagreement between different fields of medicine, law, justice, legislation, doctrines and complementary sciences regarding telemedicine, the need to carry out this study became evident. Objective: to discuss the relationship between the current legislation in force in October 2022, after the regulation of telemedicine in Brazil, with the possibility of using technologies, in judicial medical expertise or telemedicine in that country. Methodology: This theoretical and qualitative work has a descriptive and explanatory nature, through bibliographic research, searching in databases, as well as analyzing doctrines, legislation and related jurisprudence, and through an ontological hermeneutic approach, relating the variables, advantages and risks , with the historical, theoretical, doctrinal and scientific technical basis. Discussion: Resolution number 317, of the National Council of Justice (CNJ) and national jurisprudence on the use of medical teleexpertise, contrast with the position of the national medical community, through the Federal Council of Medicine (CFM), whose understanding remains evident through opinions and resolutions, regarding the inoperability of such a practice currently. Conclusion: The contemporary national situation of teleexpertise is rudimentary, abstaining from scientific substrate, tools or other methodologies that allow its ethical, fair, legal implementation, free from external influences, under current conditions. Keywords: Expert Testimony, Telemedicine, Health Law, Health’s Judicialization, Remote Consultatio, Telediagnostics.

The regulation of telemedicine: a Latvian–EU perspective

The article aims to study the nature of the legal framework of telemedicine. With the onset of the COVID-19 pandemic, epidemiological safety in Latvia was determined by minimising human contact in all possible sectors, including healthcare. This was followed by service restrictions in accordance with the COVID-19 Infection Management Act. Although these restrictions were in effect, it was impossible, throughout their duration of operation, not to provide health services, as even a temporary discontinuation of these could pose a threat to patient health security; accordingly, it was necessary to take steps to avoid any interruption in the provision of medical treatment, thereby ensuring that the continuity in the treatment process would not be affected, which is important because such continuity is clearly defined by the right to health protection, as well as to a minimum of medical assistance, guaranteed by the State to everyone.

Perception of Saudi undergraduate medical students on telemedicine training and its implementation.

The use of telemedicine has increased considerably in healthcare delivery, especially during this time of the coronavirus disease 2019 (COVID-19) pandemic. It has, therefore, become necessary to train medical students to better equip them for this new means of healthcare delivery. The aim of the present study was to assess the perception of undergraduate medical students on telemedicine training. A cross-sectional study was conducted on a total of 521 undergraduate medical students studying in the Eastern Region of Saudi Arabia. Data were collected via a self-administered pretested questionnaire comprising two main sections: demographics and knowledge and opinions regarding telemedicine training. About 73% students think that the use of telemedicine for patient care will increase in the future, and 59.3% think that the medical students should be trained in telemedicine. Majority of the students (78%) opined that telemedicine training should be optional and 58% said it should be taught during the clinical phase of the undergraduate curriculum. The best telemedicine training course learning objectives medical students opined to be included were: telemedicine practical skills (70.2%), legal aspects of telemedicine practice (68.3%), and potential positive and/or negative use of telemedicine tools and methods (67.6%). Telemedicine skills students would like to learn how to effectively engage patients, knowledge about telemedicine regulations and the consequences of breaching them. Medical students are aware of the importance of incorporating telemedicine training into the medical curriculum. Training these students is vital to ensure their competence as physicians in their future clinical careers, that is make them a digitally health-literate future workforce.

ЭКСПЕРИМЕНТАЛЬНЫЕ ПРАВОВЫЕ РЕЖИМЫ В ОБЛАСТИ ТЕЛЕМЕДИЦИНЫ

With the achievement of scientific and technological progress and the emergence of new needs in society, medical activity begins to improve technologically. If the traditional provision of medical care is a personal visit of a patient to a medical institution, telemedicine is now being developed. The problem is that the existing legal regulation of telemedicine is imperfect and has a certain number of contradictions. The purpose of the study is to determine the content and significance of experimental legal regimes in the field of telemedicine. The application of experimental legal regimes in the field of telemedicine will solve the existing legal problems and improve the quality of medical services provided.

Issues of Legal Regulation of Telemedicine in the Republic of Uzbekistan

An overview of the development of e-health in Uzbekistan, as well as the legal regulation of telemedicine, both at the global and national levels, is provided in this article. It identifies existing barriers and problems that need to be solved, analyzes the international documents that form the basis of global digital health, and examines the best practices of countries like Japan and the USA. A review of Uzbekistan's experience in developing digital health, as one of the branches of the state's digital economy, is presented, as well as recommendations for improving the regulatory framework. Based on a legal and political framework, practical proposals have been developed for the development of an integrated digital health system, which identifies and eliminates gaps and barriers.

The acceptance of telemedicine by physicians in Brazil: An institutional theory view

AbstractTelemedicine comprises different health services held at a distance and is a promising practice for inclusive health care. However, there is still no consensus in the literature about the factors that influence the acceptance and dissemination of these practices. Thus, this study analyzes the factors that influence the acceptance of telemedicine, more specifically, of teleconsultations, by physicians, and seeks to understand how institutional factors act to disseminate or prevent their acceptance. An exploratory and qualitative study was carried out in Brazil, through interviews with physicians from different specialties and documents analyzes. We analyzed documents from public hearings on the regulation of telemedicine, and reports, discussions, and videos about teleconsultations. We conducted two coding cycles of data and we identified 12 factors influencing the acceptance of telemedicine/teleconsultations. Seven of these factors had previously been identified in the literature, namely: Regulatory Factors, Level of Instruction and Preparation of Users, Resistance to Change, Technological Infrastructure, Value Perception, Organizational Characteristics, and Financial Support. Five other acceptance factors emerged from our empirical data: Corporatism, Possibilities by Medical Specialization, In‐Person Physical Examination, Commoditization of Telemedicine, and Previous Doctor–Patient Relationship. Based on Institutional Theory, we associated all the acceptance factors identified to the three institutional pillars, as in the study by Scott in 2014: Regulative, Normative, and Cultural Cognitive, also identifying main themes to which these factors are related, in each one of the three institutional pillars, respectively: regulation, structure, and lack of knowledge.