Barriers and Facilitators That Influence Telemedicine-Based, Real-Time, Online Consultation at Patients’ Homes: Systematic Literature Review

Abstract

Background Health care providers are adopting information and communication technologies (ICTs) to enhance their services. Telemedicine is one of the services that rely heavily on ICTs to enable remote patients to communicate with health care professionals; in this case, the patient communicates with the health care professional for a follow-up or for a consultation about his or her health condition. This communication process is referred to as an e-consultation. In this paper, telemedicine services refer to health care services that use ICTs, which enable patients to share, transfer, and communicate data or information in real time (ie, synchronous) from their home with a care provider—normally a physician—at a clinical site. However, the use of e-consultation services can be positively or negatively influenced by external or internal factors. External factors refer to the environment surrounding the system as well as the system itself, while internal factors refer to user behavior and motivation. Objective This review aims to investigate the barriers and the facilitators that influence the use of home consultation systems in the health care context. This review also aims to identify the effectiveness of Home Online Health Consultation (HOHC) systems in improving patients’ health as well as their satisfaction with the systems. Methods We conducted a systematic literature review to search for articles—empirical studies—about online health consultation in four digital libraries: Scopus, Association for Computing Machinery, PubMed, and Web of Science. The database search yielded 2518 articles; after applying the inclusion and exclusion criteria, the number of included articles for the final review was 45. A qualitative content analysis was performed to identify barriers and facilitators to HOHC systems, their effectiveness, and patients’ satisfaction with them. Results The systematic literature review identified several external and internal facilitators and barriers to HOHC systems that were used in the creation of a HOHC framework. The framework consists of four requirements; the framework also consists of 17 facilitators and eight barriers, which were further categorized as internal and external influencers on HOHC. Conclusions Patients from different age groups and with different health conditions benefited from remote health services. HOHC via video conferencing was effective in delivering online treatment and was well-accepted by patients, as it simulated in-person, face-to-face consultation. Acceptance by patients increased as a result of online consultation facilitators that promoted effective and convenient remote treatment. However, some patients preferred face-to-face consultation and showed resistance to online consultation. Resistance to online consultation was influenced by some of the identified barriers. Overall, the framework identified the facilitators and barriers that positively and negatively influenced the uptake of HOHC systems, respectively.

Telemedicine During COVID‐19 for Outpatient Sports and Musculoskeletal Medicine Physicians

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“…Telemedicine may include a variety of technologies to securely deliver remote health care including: live (synchronous) videoconferencing, typically a two-way audiovisual link between a patient and an HCP in different locations; audio-only visits via patient portals and messaging technologies; remote patientmonitoring tools; and store-and-forward technologies that collect images and data to be transmitted at a later time (e.g., educational materials) 5 . These technologies offer several possible advantages including: the ability to quickly ask and receive answers to questions; more timely diagnosis and institution of treatment for some conditions such as stroke; patients have access to medical specialists as well as a general HCP; the possibility of enhanced patient privacy; reduced costs and increased convenience; and reduced need for physical contact limiting potential infectious exposures.…”

“…the need for technical training on the part of the HCP and to some degree, the patient; the necessary equipment to conduct the tele-visit; the possibility of a reduction in continuity of care like the retail healthcare movement; and last but certainly, not the least of the disadvantages is the inability to conduct a physical examination 5 .…”

“…Patient acceptance of, and satisfaction with, telemedicine has generally been favorable 5 . In one study examining the management of osteoporosis 11 , participants expressed comfort with the use of technology and believed that the quality of care was comparable to in-person visits.…”

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