The individual and contextual determinants of the use of telemedicine: A descriptive study of the perceptions of Senegal's physicians and telemedicine projects managers

Abstract

Telemedicine is considered to be an effective strategy to aid in the recruitment and retention of physicians in underserved areas and, in doing so, improve access to healthcare. Telemedicine’s use, however, depends on individual and contextual factors. Using a mixed methods design, we studied these factors in Senegal based on a micro, meso and macro framework. A quantitative questionnaire administered to 165 physicians working in public hospitals and 151 physicians working in district health centres was used to identify individual (micro) factors. This was augmented with qualitative descriptive data involving individual interviews with 30 physicians working in public hospitals, 36 physicians working in district health centres and 10 telemedicine project managers to identify contextual (meso and macro) factors. Physicians were selected using purposeful random sampling; managers through snowball sampling. Quantitative data were analyzed descriptively using SPSS 23 and qualitative data thematically using NVivo 10. At the micro level, we found that 72.1% of the physicians working in public hospitals and 82.1% of the physicians working in district health centres were likely to use telemedicine in their professional activities. At the meso level, we identified several technical, organizational and ethical factors, while at the macro level the study revealed a number of financial, political, legal, socioeconomic and cultural factors. We conclude that better awareness of the interplay between factors can assist health authorities to develop telemedicine in ways that will attract use by physicians, thus improving physicians’ recruitment and retention in underserved areas.

The Effect of the COVID-19 Pandemic on Physicians’ Use and Perception of Telehealth: The Case of Lebanon

“…The sudden requirement for telemedicine put the physicians in an unregulated situation; some regulation could have helped them with this transition. Ensuring the continuity of telemedicine activities after the COVID-19 crisis requires adequate regulations, especially considering that the absence of medicolegal frameworks protecting physicians is a major barrier for the adoption for telemedicine [ 25 , 26 ].…”

“…Finally, our study was conducted during the COVID-19 crisis and did not examine whether the change in use and perception of telehealth would outlast the pandemic. Since providing telehealth services was essential to their mission as physicians during the pandemic, the physicians’ willingness to engage in telehealth increased [ 25 ]. Once the crisis is over, a reduction in telehealth is expected.…”

Clinicians perceptions of a telemedicine system: a mixed method study of Makassar City, Indonesia

“…To overcome this problem, Indonesia began to develop telemedicine, since it enables health professionals to communicate over long distances using the internet for the exchange of health information [3,4]. It is believed that telemedicine has the potential to overcome healthcare disparities and improve equitable access to healthcare by receipt of specialist's second opinions from a distance, and could also reduce workload and professional isolation of remote healthcare workers [4,5].…”

Physicians’ perceptions on the impact of telemedicine on recruitment and retention in underserved areas: a descriptive study in Senegal

“…As part of a larger mixed methods study [ 10 , 11 ], this research involved an exploratory qualitative approach entailing short individual interviews undertaken between January and June 2014. Participants comprised physicians who worked in Senegal’s public sector (public hospitals and district health centres).…”

“…Although atypical in qualitative studies, we used random sampling to select 30 physicians working in each of the settings to reflect the multi-method nature of the larger study [ 10 , 11 ]. These physicians were contacted to establish their willingness to participate in the study, which included both a quantitative survey and a qualitative interview component reported on here.…”