User Acceptance of Telemedicine by Health Care Workers A Case of the Eastern Cape Province, South Africa

Abstract

The Eastern Cape province of South Africa is one of the poorest provinces in the country with vast rural areas. A telemedicine system was implemented in the province in order to improve health care services. Despite large investments from the National Department of Health, only a third of telemedicine sites in the province are operational. Technology problems, such as unreliable electricity supply and low bandwidth, was identified as barriers to the successful implementation of telemedicine in South Africa, but these issues have since been addressed. Nevertheless, the uptake of telemedicine remains poor. One of the documented barriers to the successful implementation of telemedicine is user acceptance by health care workers. This study made use of the Technology Acceptance Model (TAM) to identify the factors that influence the user acceptance of telemedicine among health care workers in a developing country such as South Africa. The study used a quantitative survey approach. A questionnaire was distributed to all the hospitals and clinics around the province where telemedicine had been implemented. The results were analyzed using SPSS 20 and the conclusions drawn from the results were presented to five experts in the field of telemedicine and Information Systems. In general, the attitude of the health care workers was positive towards telemedicine, although the present usage of the system was low. Health care workers, especially those in the rural areas, perceived the telemedicine system to be useful to improve the quality of health care services they provide. The perceived ease of use of the telemedicine system was influenced by both the educational qualification and area in which the health care workers worked. Those that did not complete high school and worked in rural areas were apprehensive about using the telemedicine system. However, the majority of the health care workers indicated that they did plan to make use of the telemedicine system in the future. Interventions focused on education should be specific for rural or urban areas. In rural areas education should focus on computer literacy skills and how to use the telemedicine system, while in urban areas the awareness of the telemedicine should be increased.

Use of unified theory of acceptance and use of technology model for telemedicine services: an exploratory study

“…6 Patients in rural areas do not have to travel long distances to urban hospitals in order to access specialist care, while waiting times and transportation costs are reduced (Wooton, Patil, Scott, & Ho, 2009) it is myth that to establish a telemedicine platform is an expensive. 7 The basic system needs hardware, software and telecommunication link. Need for the study Quality health care is considered a fundamental human right for all citizen in India Judicially recognized under article 21 of Constitution.…”

Reimplementing Telemedicine in the Eastern Cape

“…Telemedicine was identified by the WHO as a possible tool to improve access to health care services in the rural areas of developing countries. Telemedicine, meaning 'medicine at a distance', could be used to extend the accessibility of health care in the most under-serviced areas of the Eastern Cape (Cilliers & Flowerday, 2014). Therefore, telemedicine became an integral part of the national Department of Health's e-Health strategy in South Africa, with millions of rands being invested in various telemedicine projects since 1999 (Motsoaledi, 2010).…”

“…Typical primary healthcare services included preventative and curative services such as mother and child health, immunisations, preventative screening, family planning, and treatment of acute and chronic conditions in the community. Patients that could not be treated at the CHCs were referred to the second tier, that is the district hospitals, for more comprehensive care or the third tier, the tertiary hospitals, for specialist care (O'Mahony, Wright, Yogeswaran, & Govere, 2014;Cilliers & Flowerday, 2014). The province had 762 primary health care clinics, 60 community health care centres, 63 district hospitals, 11 regional hospitals, 12 specialised hospitals and one tertiary teaching hospital.…”

“…As a large part of the community lived in rural communities, health care services needed to be moved into these communities. Typical healthcare problems reported in the rural communities included chronic lifestylerelated diseases such as diabetes, hypertension and HIV/AIDS, high rate of maternal deaths and preventable deaths such as mental illness/neuropsychiatric disorders, violence and motor vehicle accidents (Yerramilli, 2015;Cilliers & Flowerday, 2014). For these reasons, the Eastern Cape Province was chosen as one of the sites where telemedicine was rolled out to increase the access to health care among the population.…”

The experiences of teleradiology end users regarding role extension in a rural district of the North West province: A qualitative analysis

“…5 Teleradiology in South Africa was first implemented in 1999, across three provinces, namely, Free State, Mpumalanga and the North West. 6,7,8 Many developments have since occurred, with the addition of more teleradiology sites. In KwaZulu-Natal, South Africa, teleradiology successfully facilitates appropriate patient management at the district hospital level, reducing unnecessary transfers to urban tertiary institutes.…”