Facilitators and Barriers for Telemedicine Systems in India from Multiple Stakeholder Perspectives and Settings

Abstract

Telemedicine is viewed as a crucial tool for addressing the challenges of limited medical resources at healthcare facilities. However, its adoption in healthcare is not entirely realised due to perceived barriers. This systematic review outlines the critical facilitators and barriers that influence the implementation of telemedicine in the Indian healthcare system, observed at the infrastructural, socio-cultural, regulatory and financial levels, from the perspectives of healthcare providers, patients, patient caregivers, society, health organisations and the government. This review complies with the current PRISMA-P protocol. 1200 peer-reviewed studies published from December 2016 to December 2021 in the PubMed, Cochrane, Scopus, Web of Science, CINAHL, MEDLINE and PsycInfo databases were considered for the title and abstract screening, after which 157 articles were chosen for the full-text review. In the end, 26 studies were selected for data synthesis. Data privacy and security concerns, doctor and patient resistance to information and communications technology (ICT), poor infrastructure, and lack of ICT training were considered significant barriers to implementing telemedicine. However, reduced healthcare delivery costs, improved patient access to healthcare in remote areas, and reduced patient waiting times all helped promote telemedicine implementation. The review outcomes also revealed that the barriers and facilitators at the regulatory and financial level largely influenced the adoption of telemedicine systems in India, with 59% (n=20) articles citing a reduction in healthcare delivery costs as the critical facilitator and 59% citing fear of violation of patient privacy and security as the significant barrier.

Mapping the Regulatory Framework for Telemedicine in Zambia: A Content Analysis

“…Furthermore, cost-effective solutions, like reusable ICT resources, reduce the financial burden, making telemedicine more feasible and accessible, especially in resource-limited areas. These elements collectively enhance the quality, reach, and sustainability of telemedicine, significantly contributing to the transformation of healthcare delivery (16,21,25,26). This approach aligns with global trends in digital health and is crucial for creating a comprehensive and inclusive telemedicine environment in Zambia.…”

“…It emphasizes the importance of standardized ICT systems, interoperability, secure data sharing, and cost-effective solutions (9). These elements are essential for the effective operation of telemedicine services (19)(20)(21) facilitating a unified and efficient telemedicine network that is accessible to all citizens. For instance, solid and reliable ICT systems are the backbone of telemedicine, supporting complex needs such as real-time communication and data management, and ensuring compatibility across various platforms (22).…”

Reviewing the evolution of U. S. telemedicine post-pandemic by analyzing its growth, acceptability, and challenges in remote healthcare delivery during Global Health Crises

“…The study also points out the advantages of telemedicine, such as cost savings and improved care coordination, while stressing the importance of compliance with data protection laws to ensure patient safety and quality of care. Venkataraman et al (2023) conducted a systematic review to identify the critical facilitators and barriers influencing the implementation of telemedicine in the Indian healthcare system. The study observed these factors from multiple stakeholder perspectives, including healthcare providers, patients, patient caregivers, society, health organizations, and the government.…”