Rural Family Physicians Are Twice as Likely to Use Telehealth as Urban Family Physicians

Jetty, Anuradha; Moore, Miranda; Coffman, Megan; Petterson, Stephen; Bazemore, Andrew

doi:10.1089/tmj.2017.0161

Cited by 54 publications

(42 citation statements)

References 33 publications

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“…Geographically, 24% (12/50) of the studies were based in the United States [ 35 - 46 ], 10% (5/50) of the studies were based in the United Kingdom [ 47 - 51 ], and the rest were spread across many countries: Australia [ 52 , 53 ], Australia and the United Kingdom [ 15 ], Austria [ 54 ], Canada [ 55 - 57 ], Germany [ 58 - 60 ], Iran [ 61 ], Iraq [ 62 ], Japan [ 63 ], the Netherlands [ 64 ], the Netherlands, Spain, and the United Kingdom [ 65 ], Nigeria [ 66 ], Norway [ 67 , 68 ], South Korea [ 69 , 70 ], Spain [ 71 - 74 ], Spain Colombia and Bologna [ 75 ], Sri Lanka [ 76 ], Sweden [ 77 , 78 ], Switzerland [ 79 ], Taiwan [ 80 , 81 ], and Turkey [ 82 ].…”

Section: Resultsmentioning

confidence: 99%

“…The studies also cover diverse disease areas and medical specialties, including ambulatory care [ 58 ], cognitive behavioral therapy [ 40 ], cardiovascular disease [ 56 , 83 ], dermatology [ 73 ], diabetes [ 50 , 63 , 65 ], general practice [ 35 , 52 , 59 ], intensive care [ 36 ], neurology [ 48 ], pediatric [ 45 ], primary and acute care [ 46 , 49 , 55 , 71 , 74 ], psychiatry and mental health [ 41 , 53 , 68 ], residential aged care [ 57 ], reproductive health [ 37 ], and substance use recovery [ 39 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…TAM extensions were used in 34% (17/50) of the studies and varied from additions stemming from the literature and the research-specific context [ 35 , 36 , 38 , 57 , 60 , 61 , 68 , 70 , 71 , 73 , 74 ] to extensions using other frameworks such as Chau and Hu’s model of telemedicine acceptance and theory of interpersonal behavior (TIB) [ 83 ], the organizational readiness for change model [ 45 ], theory of reasoned action (TRA), and theory of planned behavior [ 74 ], and in combination with the UTAUT [ 58 , 69 ].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Understanding Clinicians’ Adoption of Mobile Health Tools: A Qualitative Review of the Most Used Frameworks

Jacob¹,

Sánchez-Vázquez²,

Ivory³

2020

JMIR Mhealth Uhealth

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Background Although there is a push toward encouraging mobile health (mHealth) adoption to harness its potential, there are many challenges that sometimes go beyond the technology to involve other elements such as social, cultural, and organizational factors. Objective This review aimed to explore which frameworks are used the most, to understand clinicians’ adoption of mHealth as well as to identify potential shortcomings in these frameworks. Highlighting these gaps and the main factors that were not specifically covered in the most frequently used frameworks will assist future researchers to include all relevant key factors. Methods This review was an in-depth subanalysis of a larger systematic review that included research papers published between 2008 and 2018 and focused on the social, organizational, and technical factors impacting clinicians’ adoption of mHealth. The initial systematic review included 171 studies, of which 50 studies used a theoretical framework. These 50 studies are the subject of this qualitative review, reflecting further on the frameworks used and how these can help future researchers design studies that investigate the topic of mHealth adoption more robustly. Results The most commonly used frameworks were different forms of extensions of the Technology Acceptance Model (TAM; 17/50, 34%), the diffusion of innovation theory (DOI; 8/50, 16%), and different forms of extensions of the unified theory of acceptance and use of technology (6/50, 12%). Some studies used a combination of the TAM and DOI frameworks (3/50, 6%), whereas others used the consolidated framework for implementation research (3/50, 6%) and sociotechnical systems (STS) theory (2/50, 4%). The factors cited by more than 20% of the studies were usefulness, output quality, ease of use, technical support, data privacy, self-efficacy, attitude, organizational inner setting, training, leadership engagement, workload, and workflow fit. Most factors could be linked to one framework or another, but there was no single framework that could adequately cover all relevant and specific factors without some expansion. Conclusions Health care technologies are generally more complex than tools that address individual user needs as they usually support patients with comorbidities who are typically treated by multidisciplinary teams who might even work in different health care organizations. This special nature of how the health care sector operates and its highly regulated nature, the usual budget deficits, and the interdependence between health care organizations necessitate some crucial expansions to existing theoretical frameworks usually used when studying adoption. We propose a shift toward theoretical frameworks that take into account implementation challenges that factor in the complexity of the sociotechnical structure of health care organizations and the interplay between the technical, social, and organizational aspects. Our consolidated framework offers recommendations on which factors to include when investigating clinicians’ adoption of mHealth, taking into account all three aspects.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Understanding Clinicians’ Adoption of Mobile Health Tools: A Qualitative Review of the Most Used Frameworks

Jacob¹,

Sánchez-Vázquez²,

Ivory³

2020

JMIR Mhealth Uhealth

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“…Существуют и гендерные различия: хотя использование цифровых технологий обычно в большей степени распространено среди мужчин, чем среди женщин, именно женщины в большей степени использовали возможности получения онлайн-консультаций в рамках американской системы eVisit, причем это не было связано с традиционной ролью женщины в семье -заботой о других членах семьи [Jung, Padman, 2014]. Есть и существенные территориальные различия: семейные врачи, обслуживающие население сельской местности, в два раза чаще назначали телеконсультации с узкопрофильными специалистами [Jetty et al, 2017].…”

Section: перспективы и барьеры внедрения онлайн-консультаций в мировуunclassified

A Study of the Population’s Attitude to Telemedicine Technologies on the Example of Online Medical Consultations

Matyushina¹,

Калабихина²

2018

POPECON

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The new law “on telemedicine” requires the population’s participation in its implementation. The expansion of new methods of medical consulting should take place in a science-based context. The goal of this research is to educe the attitude of the population to online consultation. 50 semistructured interviews were conducted, analysis was used in analyzing the scripts. Main results are the picture of population’s attitude to online medical consultation, and the structure of the barriers to development of ones. The population understands the imminence of such a format, but relegates it to “not really medical” services and has a narrow interpretation of the scope of online consultation application – in terms of expanding access to services, but not in terms of improving the quality of diagnosis, for instance, in attaining a “second opinion”. Survey participants saw the advantage of this format in reducing the time spent and in leveling the territorial inequality in access to medical aid. Medical online consultations often cause distrust and anxiety (anxiety of inaccurate diagnosis, cost-saving at the expense of quality and fear of fraud). We have indicated three groups of barriers: patient and doctor availability, technical and regulatory availability of the healthcare system, and digital inequality in terms of age and geography. The respondents give the principal role in overcoming the barriers to the state, which reﬂects the general paternalistic attitude of the population in matters of health.

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“…In many countries worldwide, the number of general practitioners (GPs) will decline in the coming years leading to a widening deficit in medical care, especially in rural areas. 1 This trend is in serious contradiction to the rising demand for their services. By 2030, the number of older people will increase rapidly due to a demographic change.…”

Section: Introductionmentioning

confidence: 99%

<p>Employment of Telemedicine in Nursing Homes: Clinical Requirement Analysis, System Development and First Test Results</p>

Ohligs¹,

Stocklassa²,

Rossaint³

et al. 2020

CIA

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Purpose: Demographic change and lack of specialized workforces are challenging. Likewise, home visits by general practitioners (GPs) become rarer. If a nursing home resident develops acute symptoms, nurses are often inclined to call the rescue service. Besides patient-related consequences, this might lead to unnecessary hospitalization and farreaching health economic costs. Due to legal restrictions of remote treatment in Germany, which were recently loosened, telemedicine is still in the early stages. The aim of this study was to employ a holistic telemedical system for nursing homes which facilitates the connection to a GP and thus avoids unnecessary hospitalizations in the case of ambulatorysensitive illnesses. Materials and Methods: After an inter-professional requirement analysis, the iterative development was started. In addition to an audio-video connection, several point of care measurements were integrated. Finally, first field tests were performed in a nursing home in a rural area in Germany. Results: One nursing home was equipped with telemedical system based on the results of the requirement analysis and tele-medically connected to a GP. Over a period of seven months, 56 routine and emergency teleconsultations took place. Only one of those required a hospital admission. In addition to video telephony, electrocardiography and assessment of vitals such as pulse, blood pressure, oxygen saturation and auscultation of heart and lungs were applied frequently. Conclusion: A telemedical system including integrated medical devices was successfully developed and has turned out to be helpful and even necessary for careful and reliable decision-making by the GP. First test results show high acceptance for elderly care. Involved patients, nurses, and the GP itemize various specific benefits, including economic, personal, and altruistic issues. Another issue that the current COVID-19 crisis brought to light is lowering the risk of contagion; GPs can replace their home visits by using telepresence combined with point of care measures.

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Rural Family Physicians Are Twice as Likely to Use Telehealth as Urban Family Physicians

Cited by 54 publications

References 33 publications

Understanding Clinicians’ Adoption of Mobile Health Tools: A Qualitative Review of the Most Used Frameworks

Understanding Clinicians’ Adoption of Mobile Health Tools: A Qualitative Review of the Most Used Frameworks

A Study of the Population’s Attitude to Telemedicine Technologies on the Example of Online Medical Consultations

<p>Employment of Telemedicine in Nursing Homes: Clinical Requirement Analysis, System Development and First Test Results</p>

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