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Article
Publication date: 6 July 2015

Nick Hex, Justin Tuggey, Dianne Wright and Rebecca Malin

– 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.

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Originality/value

There are very few telemedicine studies focused on care homes.

Details

Clinical Governance: An International Journal, vol. 20 no. 3
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 19 October 2015

Rajesh K. Chandwani and Yogesh K. Dwivedi

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Transforming Government: People, Process and Policy, vol. 9 no. 4
Type: Research Article
ISSN: 1750-6166

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Article
Publication date: 1 June 2021

Som Sekhar Bhattacharyya and Prasad Vidyasagar Mandke

The purpose of this paper is to study the phenomenon of abrupt shift by both doctors and patients to telemedicine during the coronavirus (COVID-19) pandemic and associated…

Abstract

Purpose

The purpose of this paper is to study the phenomenon of abrupt shift by both doctors and patients to telemedicine during the coronavirus (COVID-19) pandemic and associated economic lockdown in India. The study explored various drivers of telemedicine technology awareness, adoption and usage. These drives were studied from both the doctors and the patients’ perspectives using the Push–Pull–Mooring (PPM) theoretical model.

Design/methodology/approach

An exploratory qualitative research was carried out with 24 doctors and 32 patients. This research was conducted in major urban cities of India. It was carried out during the economic lockdown due to the COVID-19 pandemic. The data was collected based upon a semi-structured open-ended questionnaire using telephonic interviews. Once thematic saturation was achieved, thematic content analysis was conducted. Finally, the themes were classified and analyzed using the PPM theoretical model

Findings

The data analysis indicated that there was the presence of all three factors, namely, push, pull and mooring. For the doctors, pull and push factors were more substantive than mooring factors. Although for the patients push and mooring factors were more important and pressing than pull factors.

Research limitations/implications

This study was conducted during the COVID-19 pandemic and associated economic lockdown in India. The interview respondents were located only in urban India. Future studies could be conducted to explore similarities and differences in telemedicine adoption patterns during non-crisis times vis-a-vis crisis times in urban and rural settings.

Practical implications

The insights from this study could be used by medical service providers to leverage telemedicine technology to improve the business model, service delivery, pricing strategy, value proposition and behavioral characteristics. Patients on the other hand could gather perspectives regarding how best to use telemedicine technological services.

Originality/value

The authors provided an integrated perspective regarding telemedicine technology awareness, adoption and usage in an emerging economy of India during the critical times of the COVID-19 pandemic crisis and the associated prolonged economic lockdown. This was one of the first studies that applied PPM theory for telemedicine adoption

Details

Journal of Science and Technology Policy Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2053-4620

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Article
Publication date: 18 January 2021

Yusi Cheng, Wei Wei, Yunying Zhong and Lu Zhang

This paper aims to explore how hospitable telemedicine services empowered patients during the COVID-19. Expanding from the technology aspect, this research integrated the…

Abstract

Purpose

This paper aims to explore how hospitable telemedicine services empowered patients during the COVID-19. Expanding from the technology aspect, this research integrated the philosophy of hospitality organizational culture by including factors related to human-human interaction as significant predictors for patients’ sense of empowerment (perceived competence and control) in coping with their emotional stress (anxiety and isolation).

Design/methodology/approach

Survey data were obtained from 409 general consumers who have used video-based virtual consultation since February 2020. Stepwise multiple regression and simple linear regression analyses were used for hypotheses testing.

Findings

The results reveal that the doctors’ reliability, responsiveness and empathy significantly predict patients’ perceived competence and control. Perceived usefulness and convenience of telemedicine technology enhance patients’ perceived competence and control. Patients’ sense of empowerment significantly reduces their anxiety and sense of isolation.

Research limitations/implications

To fully understand the role of hospitality in people’s telemedicine experiences, future studies are encouraged to not only examine the patients-clinicians interactions but also explore the patients-support staff interactions.

Practical implications

Health care providers’ “bed-side” manners empower patients in managing their emotional stress. Health care providers should be trained for their empathetic ability and communication skills. Strategies such as collaborating with hospitality schools and business schools can be implemented to help build medical student’s patient-centric attitudes and skills.

Originality/value

This paper provided empirical evidence for the value of hospitality in health care and offered useful suggestions for health care providers, especially by empowering vulnerable people during catastrophic events such as COVID-19.

Details

International Journal of Contemporary Hospitality Management, vol. 33 no. 3
Type: Research Article
ISSN: 0959-6119

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Book part
Publication date: 25 June 2012

Abby Swanson Kazley, Amy C. McLeod and Karen A. Wager

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

Abstract

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.

Details

Health Information Technology in the International Context
Type: Book
ISBN: 978-1-78052-859-5

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Book part
Publication date: 30 September 2020

Madhulika Bhatia, Shubham Chaudhary, Madhurima Hooda and Bhuvanesh Unhelkar

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…

Abstract

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.

Details

Big Data Analytics and Intelligence: A Perspective for Health Care
Type: Book
ISBN: 978-1-83909-099-8

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Article
Publication date: 24 December 2020

Karina M. Serrano, Glauco H.S. Mendes, Fabiane L. Lizarelli and Gilberto M.D. Ganga

This study aimed to find factors influencing the acceptance of telemedicine for adults in Brazil. Moreover, it investigates the moderating role of disease complexity and…

Abstract

Purpose

This study aimed to find factors influencing the acceptance of telemedicine for adults in Brazil. Moreover, it investigates the moderating role of disease complexity and the generational digital divide phenomenon on the intention to use the telemedicine service.

Design/methodology/approach

A quasi-experiment was employed. Primary data were collected using a survey research method considering two different scenarios based on disease complexity and symptom severity. A total of 248 responses were collected using a structured questionnaire. The authors also tested these two scenarios in three generations (X, Y and Z) of adults. Partial least squares structural equation modeling (PLS-SEM) was used to analyze the collected data and test the research hypotheses.

Findings

The results indicated that performance expectancy and perceived security and reliability are two predictors of the behavioral intention to use telemedicine, whereas effort expectancy and social influence showed no statistical significance. Furthermore, the results demonstrated that adults tend to adopt telemedicine regardless of the level of disease complexity. Finally, this study does not support the existence of a digital divide in the three generations.

Originality/value

The study applies the UTAUT model to assess the telemedicine acceptance for younger generations. It examines patient risk perception (security and reliability) as one antecedent of telemedicine acceptance.

Details

International Journal of Health Care Quality Assurance, vol. 34 no. 1
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 3 August 2012

Duncan E. Jackson and Sally I. McClean

This innovative analysis aims to quantify the use of evaluation criteria in telemedicine and to identify current trends in metric adoption. The focus is to determine the…

Abstract

Purpose

This innovative analysis aims to quantify the use of evaluation criteria in telemedicine and to identify current trends in metric adoption. The focus is to determine the frequency of actual performance metric reporting in telemedicine evaluation, in contrast to systematic reviews where assessment of study quality is the goal.

Design/methodology/approach

Automated literature search identified telemedicine studies reporting quantitative performance metrics. Studies were classified by telemedicine class; store‐and‐forward (SAF), real‐time consultation (RTC) and telecare (TC), and study stage. Studies were scanned for evaluation metric reporting, i.e. clinical outcomes, satisfaction, patient quality and cost measures.

Findings

Evaluation metric use was compared among telemedicine classes, and between pilot and routine use stages. Diagnostic accuracy was reported significantly more frequently in pilots for RTC and TC. Cost measures were more frequently reported in routine use for TC. Clinical effectiveness and hospital attendance were better reported in routine use for SAF. Comparison also revealed different evaluation strategies. In pilots, SAF favoured diagnostic accuracy, compared to RTC and TC. TC preferred clinical effectiveness evaluations and TC more frequently assessed patient satisfaction. Cost was only reported in less than 20 per cent of studies, but most frequently in RTC. Routine use led to increased reporting of all metrics, except diagnostic accuracy. Clinical effectiveness reporting increased significantly with routine use for RTC and SAF, but declined for TC.

Originality/value

Clinical outcomes and patient satisfaction were reported frequently in telemedicine studies, but reporting of other performance metrics was rare. Understanding current trends in metric reporting will facilitate better design of future telemedicine evaluations.

Details

Journal of Health Organization and Management, vol. 26 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 10 August 2012

Kituyi G. Mayoka, Agnes S. Rwashana, Victor W. Mbarika and Stephen Isabalija

The purpose of this paper is to develop a framework for designing sustainable telemedicine information systems in developing countries.

Abstract

Purpose

The purpose of this paper is to develop a framework for designing sustainable telemedicine information systems in developing countries.

Design/methodology/approach

Both quantitative and qualitative research methods were used. Primary data were collected from two hospitals in Uganda using a self‐administered questionnaire and an interview guide. Descriptive statistics were used to analyze survey data, while content analysis method was used to analyze interview responses. The framework was developed based on Hevner et al.'s design science framework.

Findings

The key requirements for designing sustainable telemedicine information systems in developing countries were identified as the need for speed, ease of use and affordability.

Research limitations/implications

This study was theoretical in nature. Although primary data were used, the researchers were unable to carry out a series of practical tests of this framework with prototype systems on a cross‐section of users.

Practical implications

Design and sustainability of telemedicine information systems is still a big challenge to most developing countries, despite its wide usage in the developed countries. While various telemedicine frameworks exist, not much has been done to adequately address the issue of design for sustainability. This paper proposes an appropriate framework that will guide telemedicine information systems designers on designing telemedicine systems that are sustainable in local conditions of developing countries.

Originality/value

The main contribution of this paper is in the area of information systems design for sustainability, from a developing country perspective. The paper also extends on the constructs of design science research theory and shows how they can be applied in information systems design and evaluation.

Details

Journal of Systems and Information Technology, vol. 14 no. 3
Type: Research Article
ISSN: 1328-7265

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Article
Publication date: 1 November 2001

Siriginidi Subba Rao

Briefly discusses the impact of information technology on medicine and health care. Introduces the concept of an integrated health information system, and details its…

Abstract

Briefly discusses the impact of information technology on medicine and health care. Introduces the concept of an integrated health information system, and details its functions and its benefits, especially for developing countries. Defines telemedicine and describes its origin, scope and functioning. Details its advantages, namely the expansion and export of skills, and explains its use in fetal telemedicine, teleendoscopy, telemedical education and telepathology.

Details

Work Study, vol. 50 no. 6
Type: Research Article
ISSN: 0043-8022

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