Facilitators of Physician Adoption of Telemedicine Programs — Part 1 of 3
Proper design and implementation of a telemedicine program is essential, but many programs focus on process design and the purchase of technology
Physicians should be a involved in the development of telemedicine programs
This article will focus on two factors influencing physician engagement and adoption of telemedicine: Usefulness and Ease-of-Use
November 16, 2019 — The proper design and implementation of a telemedicine program is crucial to its success. There is no argument about this. However, many programs focus on process design and the purchase of technology. There is more to health IT “success” than designing or purchasing a reasonably functional technology(1).
The success of telemedicine (TM) programs depends on the end-users, that is the physicians and patients actually using it, and this largely depends on how it is implemented. Physicians must be involved and their needs taken into account in order to implement the program. It is important to understand the relationship between physicians and technology and how they evaluate the introduction of new technologies in their daily practice(2). Telemedicine is valuable to health care only when physicians use it proactively(3).
Read: Facilitators of Physician Adoption of Telemedicine Programs — Part 2 of 3
Read: Facilitators of Physician Adoption of Telemedicine Programs — Part 3 of 3
A thorough Physician Adoption Strategy (PAS) is essential to designing and implementing a TM program. Program managers must remember that physicians are principal users of TM services, and their acceptance of it has a profound influence on its success(3). Limited physicians’ acceptance of TM presents a serious threat to its successful implementation(4). Literature has attributed the failure of many early TM endeavors to lack of user acceptance. In a TM program, physicians are arguably the most important users and their acceptance of the technology often has a crucial impact on the program's success(5).
There are 5 factors that influence the physician’s adoption of TM programs: 1) Usefulness of the program, 2) Ease of use of the program, 3) IT support (Facilitation), 4) Social Influence (from patients, peers and management), and 5) Financial Incentives/Reinforcement factor. There are additional factors which influence the perception of usefulness such as physician’s attitude towards technology (good vs bad, harmful vs beneficial, pleasant vs unpleasant) and self-efficacy (the physician perception of their skill level and ability to use the TM technology).
This article will be focusing on two (2) factors: Usefulness and Ease of Use.
Perceived Usefulness (PU)
In general something useful is something that can be used for a practical purpose. Simply put: Do physicians think that TM is useful? Actually, many physicians consider TM to be useful, especially those with previous experience with the technology(2). But, how about those physicians who’ve never used TM, or are “old school” and have a negative attitude towards technology?
The PU of TM directly impacts the intention to use it — which now commonly refers to adoption(3). PU is the perception that using TM leads to enhanced personal performance and the perception that it will help the physician attain gains in job performance(1). Here are some metrics to use when designing a “useful” TM program(4):
TM will allow physicians to have quick and convenient access to patients
TM will facilitate communication between various care providers
TM will improve quality of care
TM will will reduce the risk of error and waste
It is the responsibility of the TM implementation team to design a program that is useful. The following are components of a useful program and these should be incorporated in the PAS(1):
Useful for the job
Increases productivity
Enhances the effectiveness of the job
Allows tasks to be completed more quickly
Improves job performance
Makes it easier to do the job
Increases quality of care
Increases the quality of work
Improves work efficiency
Allows tasks to be done more accurately
Allows greater control of work
Improves patient care and management
Perceived Ease of Use (PEoU)
Aside from being useful, a TM program should be perceived as easy to use by physicians. In fact, PEoU has an influential effect on PU as well. PEoU is the perception of the degree of ease associated with using TM(1). However, the perception of ease of use can be negatively influenced by the physician’s attitude towards technology or the physician’s lack of self-efficacy in using information technology.
Metrics to use when designing an “easy to use” TM program(4):
Physician thinks TM will be easy to use
Physician thinks TM will be simple to use in consultations with patients
The following are components of an easy to use program and these should be incorporated in the PAS(1):
Easy to use
Clear and understandable
Easy to become skillful with the system
Easy to learn to operate
Flexible to use/interact with it
Low mental effort
Easy to do what the physician wants
Does not demand much care or attention
Navigation is easy.
In summary, when designing and implementing a TM program, an appropriate PAS must be in place to assure the success of the program. In this article I discussed two (2) factors associated with the intention of physicians to engage and adopt TM: Perceived Usefulness (PU) and Perceived Ease of Use (PEoU).
In the next article, I will discuss 2 (two) other factors that influence the intention of physicians to adopt telemedicine: Social Influence and IT Support (Facilitation).
If you have any question about this article, feel free to contact me.
References
Holden RJ, Karsh BT. The technology acceptance model: its past and its future in health care. Journal of biomedical informatics. 2010;43(1):159-172.
Ruiz Morilla MD, Sans M, Casasa A, Gimenez N. Implementing technology in healthcare: insights from physicians. BMC medical informatics and decision making. 2017;17(1):92.
Rho MJ, Choi IY, Lee J. Predictive factors of telemedicine service acceptance and behavioral intention of physicians. International journal of medical informatics. 2014;83(8):559-571.
Gagnon MP, Ghandour el K, Talla PK, et al. Electronic health record acceptance by physicians: testing an integrated theoretical model. Journal of biomedical informatics. 2014;48:17-27.
Hu PJ, Chau PY. Physician acceptance of telemedicine technology: an empirical investigation. Topics in health information management. 1999;19(4):20-35.
