Factors Affecting Adoption of a Telemedicine Device by Primary Care Health Workers in the Philippines

Abstract

Background and Introduction. The RxBox is a telemedicine device that measures and transmits vital signs to remote experts. It has been deployed to primary care health centers (PCHC) in the Philippines serving disadvantaged populations, to decrease morbidity and mortality due to common diseases and poor access to care. Factors affecting its adoption by healthcare workers is unknown. Materials and Methods.The study determined social and behavioral factors that affect adoption of a telemedicine device into the clinical workflow using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. This is a mixed methods research using review of records, survey and focused group discussions.Results and Discussion. RxBox telemedicine devices were installed in 79 primary care health centers (PCHC) and were used a total of 15,705 times within the study period. An ordinary least squares regression analysis using the combined site and individual-level data showed that among the UTAUT parameters, only compatibility, facilitating conditions, and social factors have significant relationships with intent-to-use of the RxBox. The innovation assisted primary care health workers in their clinical responsibilities, improved the stature of their PCHC in the community, and helped in the care for patients. Training and technology support after deployment as well as encouragement by peer and champions (the PCHC physician, local government leaders) reinforced continuous use after training. Users described the experienced improvements in quality of services provided by the PCHC and the consequent benefits to their patients.Conclusions. These factors should be accounted for in designing strategies to reinforce health workers' attitudes and enhance support towards acceptance and use of novel telemedicine devices into clinical routine in local health centers. Lessons are immediately useful for local leaders in low-and lower middle-income countries that suffer disproportionately from unnecessary maternal deaths and mortality due to non-communicable diseases. This contributes to the body of knowledge and should bolster national-level advocacy to institute an enabling policy on telehealth Information Communication Technology (ICT) and use of Filipino innovations towards health

Design of a Blended Learning Course for Training Community Healthcare Providers on eHealth-enabled Newborn Hearing Screening

“…The training component of the HeLe project centered on conceptual and practical discussions on using newborn hearing screening devices and how eHealth can strengthen the newborn hearing screening service in local health settings. Hence, in designing the course, we built on the training programs (Table 1) offered by the NHSRC 33 and the National Telehealth Center (NTHC) 34 , both of which are under the National Institutes of Health, the University of the Philippines Manila (UP Manila). As mentioned, the NHSRC was established through the Philippine Republic Act 9709 and is the lead agency in training healthcare providers on newborn hearing screening 34 .…”

The Role of Initial Trust in the Behavioral Intention to Use Telemedicine Among Filipino Older Adults

“…To overcome the challenges faced by older adults in adopting telemedicine, innovative strategies have been implemented such as proactively engaging older adults via telehealth assessing their technological capabilities and preferences, involvement of caregivers in supporting and guiding older adults through technology, and providing telemedicine literacy through technological support, practice visits, and coaching ( Lam et al, 2020 ). Aside from strategies that involve engagement, caregiver support, technological capability assessment and development, providing high-tech and reliable telemedicine services can also provide a positive experience and increase trust such as the experience on the introduction of RxBox telemedicine device in the country ( Marcelo et al, 2021 ).…”