The Essence of Telehealth Readiness in Rural Communities: An Organizational Perspective

Abstract

This paper examines telehealth readiness from an organizational perspective and explores the essence of telehealth readiness among four domains, namely, patients, practitioners, the public, and organizations in rural Canadian communities. Because readiness is a necessary requirement for the successful implementation of an innovation, it is important to identify and ensure core factors of readiness before costly investments are made. The findings presented here derive from a qualitative phenomenological research approach involving semistructured telephone interviews with four key informants (respondents). The data identified four categories of readiness in an organizational setting: core readiness, engagement, structural readiness, and nonreadiness. Understanding organizational readiness within rural and remote communities is an important step for the successful implementation of telehealth services into existing systems of health care.

Factors Associated with the Use of a Teleconsultation System in Brazilian Primary Care

“…Another group was selected by its clinical importance: ''period of time working in primary care,'' ''usefulness of the system,'' ''connection to Internet,'' and ''negative interference in the professional role toward patients.'' 14,16,[19][20][21]23,24,26 The criterion adopted to stop the decision tree was a p value of < 0.05 (chi-squared analysis), and the predictive accuracy was evaluated by 23 Do you believe that asking for a second opinion through the teleconsultation system could negatively interfere in your professional role towards patients? 24 Do you believe that asking for a second opinion through the teleconsultation system could negatively interfere in your professional role towards the community?…”

“…Factors related to use of the teleconsultation system: Although these factors can be related to the telehealth center, to the operational system, or to the remote sites, in this study the questionnaire was applied only to professionals in remote sites, even though it included questions about their evaluation of factors related to the center and system. The questionnaire consisted of 27 questions about factors grouped into seven categories: institutional, 14 organizational, [15][16][17] infrastructure, 6,14,18 technical, 6,19,20 socioeconomic, [19][20][21][22] human, 17,23,24 and educational. 25 Answers were given in a 4-or 5-point scale.…”

“…Several published studies have described the barriers and factors associated with e-health acceptance and adoption. The main factors can be summarized as follows: (1) lack of evidence of the impact of e-health in health indicators, 15,19,29 (2) need for changes in health management and work process, [15][16][17]26,30,31 (3) users' perception of usefulness, benefits, and limitations, [19][20][21]26 (4) lack of evidence of cost-effectiveness and sustainability, 14,15,22,29,32 (5) low acceptance of technology, 19-21,26,31,33,34 (6) deficiency in local infrastructure, 6,14,18 (7) ethical and legal aspects, 3,19,26,28,35 (8) human factors, related to users' perceptions about e-health, 17,23,24,26 (9) lack of adequate specialist clinical staff, 4,6,36 and (10) lack of large-scale studies to evaluate the adoption of e-health. 4,17,35 Some models, theories, and concepts from different areas have been used to study the adoption of telemedicine by users, such as the Technology Acceptance Model, 19,21 Theory of Planned Behavior, 21,24 Theory of Interpersonal Behavior, 24 Unified Theory of Acceptance and Use of Technology, 18,…”

“…These features and the result of the comparative analysis between the 21 municipalities with no use of the system and the 193 municipalities with some utilization, which showed in the descriptive analysis more experienced professionals as nonusers and the variable ''work experience at primary care'' as significant ( p = 0.010), suggest that use of the teleconsultation system is associated with a health professional's necessity. 16,19,20,26,[40][41][42] These studies suggest that the social factor ''utility of the system'' will have a strong association with the use of telehealth systems. This correlation between use and utility is supported by the fact that the majority of users are located in remote regions with low HDI, where the public health system is deficient owing to the difficulties in retaining experienced specialists.…”

Leveraging E‐Health for Future‐Oriented Healthcare Systems in Developing Countries

“…The poor contextualization has been the cause for the lack of an appropriate framework or model to be used for e-health readiness assessment in developing countries. Several studies such as (Jennett et al, 2005;Khoja, 2007;Ojo et al, 2008;Li & Seale, 2012;Rezai-Rad, 2012) recommended the importance of considering the context, while developing a model for e-health assessment in developing countries. From the reviewed literature, brain storming sessions and workshops, this study identified five categories of factors that are needed to assess e-health readiness in developing countries.…”