Attitudes, Barriers, and Concerns Regarding Telemedicine Among Swedish Primary Care Physicians: A Qualitative Study

Abstract

Purpose: The primary care physician's traditional patient contacts are challenged by the rapidly accelerating digital transformation. In a quantitative survey analysis based on the theory of planned behavior, we found high behavioral intention to use telemedicine among Swedish primary care physicians, but low reported use. The aim of this study was to further examine the physicians' experiences regarding telemedicine, with a focus on possible explanations for the gap between intention and use, through analysis of the free-text comments supplied in the survey. Material and Methods: The material was collected through a web-based survey which was sent out to physicians at 160 primary health care centers in southern Sweden from May to August 2019. The survey covered four areas: general experiences of telemedicine, digital contacts, chronic disease monitoring with digital tools, and artificial intelligence. A total of 100 physicians submitted one or more free-text comments. These were analyzed using qualitative content analysis with an inductive approach. Results: The primary care physicians expressed attitudes towards telemedicine that focused on clinical usefulness. Barriers to use were the loss of personal contact with patients and a deficient technological infrastructure. The major concerns were that these factors would result in patient harm and an increased workload. The connection between intention and use postulated by the theory of planned behavior was not applicable in this context, as external factors in the form of availability and clinical usefulness of the specific technology were major impediments to use despite a generally positive attitude. Conclusion: All telemedicine tools must be evaluated regarding clinical usefulness, patient safety, and effects on staff workload, and end users should be included in this process. Utmost consideration is needed regarding how to retain the benefits of personal contact between patient and provider when digital solutions are introduced.

Implementation of Telemonitoring in Health Care: Facilitators and Barriers for Using eHealth for Older Adults with Chronic Conditions

“…The interviews with the care team highlighted several important aspects related to the usefulness and relevance and reasons for using telemonitoring in their daily work. Clinical usefulness has previously been reported; the intended telemonitoring must be evaluated regarding clinical usefulness, patient safety, and effects on staff workload, 33 aspects confirmed by our study results. They all agreed that technology will certainly change the future way of work with respect to caring for older adults regarding the importance of planning ahead, changing routines, and involving all team members.…”

Towards Mapping of Information Technology-Induced Alterations in Online Physicians’ Professional Identities: A Conceptual Framework and Empirical Illustrations from Sweden

“…Illustratively, Vignette 5 highlights a role of digital divide between online physicians and proponents of medicine practiced in the "traditional way". Evidence suggest that many concerns from the provider perspective persist even in highlydigitalized countries such as Sweden [52], where the present pilot DPCT initiative was carried out. The physicians' concerns include doubts about DPCT safety for patients and claims about "increased risk of misunderstandings" [52].…”

“…Evidence suggest that many concerns from the provider perspective persist even in highlydigitalized countries such as Sweden [52], where the present pilot DPCT initiative was carried out. The physicians' concerns include doubts about DPCT safety for patients and claims about "increased risk of misunderstandings" [52]. In addition, DPCT may be seen as "stressful time-thief[s]" and representing threats to the medical profession and physicians' own integrity [52].…”

“…The physicians' concerns include doubts about DPCT safety for patients and claims about "increased risk of misunderstandings" [52]. In addition, DPCT may be seen as "stressful time-thief[s]" and representing threats to the medical profession and physicians' own integrity [52].…”

Experiences of the Telemedicine and eHealth Conferences in Poland—A Cross-National Overview of Progress in Telemedicine

“…The constant development of modern technologies is quickly reflected in telemedicine in the form of many new tools and solutions such as artificial intelligence [107][108][109][110], wearable medical devices and sensors [111][112][113][114][115][116], health-related Internet of Things (IoT) [117][118][119], implantable medical devices operated by telemedicine, augmented reality [120][121][122][123][124][125], virtual reality [124,[126][127][128][129] and support medical decision making [108,[130][131][132]. Changes in physicians' attitudes toward the use of telemedicine solutions devices lead to changes in medical practice [133,134]. Altered medical practice leads to medical economy savings by delegating specific medical procedures to the point of care instead of the hospital.…”