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The purpose of this paper is to observe and analyse the effects of the use of telemedicine in care homes on the use of acute hospital resources.

The study was an uncontrolled retrospective observational review of data on emergency hospital admissions and Emergency Department (ED) visits for care home residents in Airedale, Wharfedale and Craven. Acute hospital activity for residents was observed before and after the installation of telemedicine in 27 care homes. Data from a further 21 care homes that did not use telemedicine were used as a control group, using the median date of telemedicine installation for the “before and after” period. Patient outcomes were not considered.

Care homes with telemedicine showed a 39 per cent reduction in the costs of emergency admissions and a 45 per cent reduction in ED attendances after telemedicine installation. In the control group reductions were 31 and 31 per cent, respectively. The incremental difference in costs between the two groups of care homes was almost £1.2 million. The cost of telemedicine to care commissioners was £177,000, giving a return on investment over a 20-month period of £6.74 per £1 spent.

The results should be interpreted carefully. There is inherent bias as telemedicine was deployed in care homes with the highest use of acute hospital resources and there were some methodological limitations due to poor data. Nevertheless, controlling the data as much as possible and adopting a cautious approach to interpretation, it can be concluded that the use of telemedicine in these care homes was cost-effective.

There are very few telemedicine studies focused on care homes.

The purpose of this conceptual paper is to present the scope of telemedicine, current state of telemedicine in India, challenges in its diffusion and suggest the way forward for implementation of such initiatives.

This is a viewpoint paper that is prepared based on authors’ exposure and knowledge about research topic and the context. A number of appropriate and current citations have been utilised to illustrate current state on the topic as well as to support authors arguments presented in this paper.

The discussion presented in this paper suggests that optimal utilisation of technology in healthcare delivery system requires overcoming barriers at multiple levels including policy, resources and socio-cultural levels. Successful implementation of telemedicine entails involvement of all the stakeholders, namely, the specialists, general duty doctors, paramedical personnel, technical staff, coordination staff, policymakers and, most importantly, the target community, from the design stage itself.

The primary value of this paper lies in providing an overview of current state of telemedicine development in India. It is believed that this article will act as a precursor to future articles on this topic.

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in visiting brick-and-mortar clinics or hospitals during the pandemic, Telemedicine had emerged as a potent alternative for seeking redressal to health issues. Based on theory and focus interviews with the telemedicine users, the researchers proposed a model to understand the intent and actual usage of telemedicine in India.

The cross-sectional study undertaken used a questionnaire designed on a seven-point Likert scale and administered to respondents with the objective of identifying the determinants of intent and actual usage of telemedicine services. Simple random sampling was used to collect primary data. The data was cleaned and finally a sample of 405 responses complete in all respects was considered for analysis. The questionnaire comprised of 34 items and following the recommendation of Hair et al. (2016), which says the minimum sample size in structural equation modeling should be ten times the number of indicator variables, a sample size of 405 was deemed adequate.

The research paper finds that performance expectancy, attitude, credibility and self-efficacy positively impact the intention of consumers to use telemedicine services. As the effort expectancy or risk perception toward telemedicine increases the intent and actual usage of telemedicine decreases. The intention to use telemedicine emerged as a strong predictor of the actual usage of telemedicine. Intent to use telemedicine was explained 81.4% by its predictors of performance expectancy, effort expectancy, attitude, risk, credibility and self-efficacy, and actual usage was explained 79.9% by its predictors. This study also reports that telemedicine was found to be popular among chronic as well as episodic patients though the preference was skewed in favor of the episodic patients. One of the advantages of telemedicine is its availability round the clock, and the study found that 8 a. m. to 12 noon time slot as the most preferred slot for seeking telemedicine services.

Chang (2004) opined that telemedicine can fulfill the needs of all stakeholders: citizens, health-care consumers, medical doctors and health-care professionals, policymakers, and so on. Considering the promise telemedicine holds, this realm must be studied and leveraged to the full potential. The study found that patients were using telemedicine even for their day-to-day aliments. This indicates a growing popularity of telemedicine and as such an opportunity for telemedicine companies to leverage it. In India, pharmaceutical companies cannot give commercial advertisements for medicines, and the same can only be sold through a registered medical practitioner’s prescription. As such there is total dependency on the medical practitioner for the sale of medicines. Telemedicine companies offer services of home delivering medicines clubbed with medical consultation thus giving them forward integration in their business models. Using telemedicine the patients had control over the timings of the services offered, and as such the waiting time to get a consultation and subsequent treatment was reduced considerably. Best medical advice from across the globe is available to the patient at less cost. Medical practitioners also stand to benefit as they can treat a variety of cases, collaborate among the medical fraternity and give consultation safely in case of fatal contagious diseases.

This study points to a definite growing popularity of telemedicine services not only in episodic patients but also chronic patients. Telemedicine with its unique advantages holds the promise to grow exponentially in the future and is a compelling health-care segment to focus on for delivering health-care solution to the geographically distant consumers.

Purpose – Use of telemedicine is increasingly prevalent in order to provide better access to expert care, and we examine telemedicine use internationally.

Design/methodology – Using Donabedian's structure, process outcome framework, we conduct an analysis of published studies in the United States, Europe, and Asia to examine the uses, conditions treated, barriers, and future of telemedicine.

Findings – We identify several similarities and challenges to telemedicine use in each region. We find use of videoconferencing between providers or providers and patients for the treatment of acute and chronic conditions. Studies in the United States are more likely to identify applications for the use of chronic conditions, whereas studies in Europe or Asia are more likely to use them for acute access to expertise. Each region reported comparable challenges in reimbursement, liability, technology, and provider licensing.

Research limitations – We compare available research articles from three diverse regions, and many of the articles were merely descriptive in nature. Furthermore, the number of articles per region varied.

Practical implications – Barriers to telemedicine use include a lack of reimbursement, language commonality, technological availability, physician licensure or credentialing, trained support staff and patient privacy, and security assurances. Practitioners and policy makers should work to address these barriers.

Originality/value – Through this work, a summary of the research to date describes telemedicine use in the United States, Asia, and Europe. Identification of use and barriers may provide impetus for improving access to care by finding ways to increase telemedicine use through standardization.

This chapter discusses about the advancement in the field of telemedicine and how often the general public are using the services that are provide by the telehealth and telemedicine market. This chapter starts with the introduction of the medicine in the world, which were the earliest medical practice and how all that thing leads to the today’s telehealth market. This chapter also describes the models that are being used in today’s world, and how these models as implemented and how telemedicine services are implemented more efficiently. Telemedicine and telehealth market is growing day by day and a lot people are getting to know about it, but there is still some section of the society, specially the lower middle class and the people in the rural areas that do not have any access or knowledge about the concept of telehealth services.

This study aimed to determine the impact of telemedicine with WhatsApp on adherence to treatment plans amongst patients who have experienced oral and maxillofacial surgeries like implants, wisdom tooth removal, facial trauma and facial reconstruction.

The researchers used a descriptive survey research design and sampled a total of 294 patients in Nigeria who experienced oral and maxillofacial surgeries 6 months before the study and provided responses that were used for analysis. The questionnaire was used as the instrument for data collection.

The researchers found that telemedicine for counselling after oral and maxillofacial surgeries have a significant relationship with adherence to the treatment plan. The analysis revealed a significant interactive effect of telemedicine competence F(3,290) 11.423, p = 001 ? p2 = 0.038. The more skilful patients are at telemedicine, the more likely they are to engage in it and vice versa. The participants also preferred a combination of live and recorded interaction forms. It was also found that a combination of different message forms, like audio, text and video, predicts satisfaction with telemedicine.

This study has shown that social media are now playing important roles in health care delivery to patients, and this may continue to expand as societies evolve.

The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.

This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.

Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.

This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.

Telemedicine, similarly to social media, accelerates information exchange, enriches information, provides better access to information and, furthermore, has an impact on mobilizing resources in business-to-business relationships. This paper aims to contribute to the understanding of the changes brought about by telemedicine, as a new technology, in patient routes.

This case study method was applied to examine five health-care protocols through their patient routes (series of activities) with and without telemedicine technology. The ARA model was applied to examine the changes telemedicine engendered in relation to activities, resources and actors. The strategy of visual mapping was applied for the comparative analysis.

The analyzed cases show that the new resources applied through telemedicine technology modified the number and substance of relevant activities and the set and role of actors who were involved. The quantity or the availability of output information increased in patient routes when new resources were added by telemedicine technology. When technology change occurred, any change in data or information systems – the two building blocks of information – could result in new or modified activities. If data that is used or produced while undertaking an activity change simultaneously along with the information system used for encrypting this data, then this “joint change” will certainly entail some kind of change in the set of activities, resources or actors that are involved. If not, then the activities continued the same as with the face-to-face protocol (without the new technology).

The novelty of the paper is that the results highlight the role of information in the extent of change in interactions induced by new technology. Findings about such changes show how information influenced by activities, resources and actors can help decision-makers in relation to the use of telemedicine.

This study aims to analyze the way Indonesian and the US laws regulate the reality and implications of legal issues regarding telemedicine, including the protection of citizens in using telemedicine.

This normative legal study used secondary data comprising primary and secondary legal materials based on the law as a norm. The normative legal method was used because the data were based on laws and regulations, reports, journals and research governing telemedicine in Indonesia and the USA.

The results showed similarities between Indonesia and the USA regarding health services as part of protecting human rights. The differences in implementing telemedicine are from a legal aspect. The legal comparison of telemedicine implementation between the two countries resulted in differences in regulation, informed consent, medical records, practice licenses and medical prescriptions.

This study discussed telemedicine’s legal aspects in Indonesia and the USA.

This study aimed to determine the implementation and guidelines used by the USA to be considered for adoption by Indonesia for legal certainty.

The results showed that legal threats could be a weakness of law in Indonesia. Therefore, the government should develop guidelines about telemedicine to accommodate citizens’ legal protection and certainty.

This study is original and could be used as a reference for policymakers in Indonesia and the USA in protecting citizens using telemedicine services. The findings provide a perspective based on Health Law in Indonesia.

The purpose of this paper is to understand the customer sentiment towards telemedicine apps and also to apply machine learning algorithms to analyse the sentiments in the adoption during the COVID-19 pandemic.

Text mining that uses natural language processing to extract insights from unstructured text is used to find out the customer sentiment towards the telemedicine apps during the COVID-19 pandemic. Machine learning algorithms like support vector machine (SVM) and Naïve Bayes classifier are used for classification, and their sensitivity and specificity are found using a confusion matrix.

The paper explores the customer sentiment towards telemedicine apps and their adoption during the COVID-19 pandemic. Text mining that uses natural language processing to extract insights from unstructured text is used to find out the customer sentiment towards the telemedicine apps during the COVID-19 pandemic. Machine learning algorithms like SVM and Naïve Bayes classifier are used for classification, and their sensitivity and specificity are found using a confusion matrix. The customers who used telemedicine apps have positive sentiment as well as negative sentiment towards the telemedicine apps. Some of the customers have concerns about the medicines delivered, their delivery time, the quality of service and other technical difficulties. Even a small percentage of doctors feel uncomfortable in online consultation through the application.

The primary value of this paper lies in providing an overview of the customers’ approach towards the telemedicine apps, especially during the COVID-19 pandemic.