Facilitators of Physician Adoption of Telemedicine Programs — Part 3 of 3
This article focus on an important factor influencing physician engagement and adoption of telemedicine: Financial Incentives/Reinforcement Factor
December 3, 2019 — This is the third and last article of the series where I’m discussing factors that facilitate the adoption of telemedicine by physicians. In the first article I discussed the concepts of usefulness and ease of use. In the second article, I discussed the concepts of social influence and facilitating conditions.
As mentioned previously, physician’s adoption and participation in a telemedicine program is crucial for its success. This can be achieved by having in place a thorough Physician Adoption Strategy (PAS) as part of the design and implementation plan of the program.
Read: Facilitators of Physician Adoption of Telemedicine Programs — Part 1 of 3
Read: Facilitators of Physician Adoption of Telemedicine Programs — Part 2 of 3
The 5 factors that influence the physician’s adoption of telemedicine programs are:
Usefulness of the program
Ease of use of the program
Facilitation and IT support
Social Influence (from patients, peers and management)
Financial Incentives/Reinforcement factor
In this article I will focus on the Financial Incentives/Reinforcement factor. In this instance I’m referring to positive reinforcement — the introduction of something desirable (money, free time, prize, reward, promotion, recognition, etc…) to influence or strengthen a desired behavior.
Financial Incentives/Reinforcement Factor
Reinforcement factor (RF) is defined as the extent to which physicians believe they should be rewarded for participating in a telemedicine program(1). RF has a significant influence on clinicians’ intention to participate in telemedicine. Appropriate incentives for physician participation in telemedicine services must be included in the implementation of a new telemedicine program(1). These incentives must be budgeted into the program(2).
Adding a telemedicine modality to the workflow of a physician is considered added work, and physicians would expect to be paid or rewarded for using telemedicine on top of their busy work schedule(1).
Physicians would be less inclined to participate in a telemedicine program without suitable incentives. The lack of incentives was suggested to be a major impediment to physician’s telemedicine use and may become a future obstacle for a telemedicine program(2). Managers and implementer of telemedicine programs should offer incentives for physician participation to ensure the success of the program(3).
This explains why lack lack of insurance reimbursement is a major barrier to telemedicine implementation.
Next Steps
Design a physician adoption strategy
A physician adoption strategy is a crucial component of any telemedicine program. Without physician involvement, the future of the program is in jeopardy. Now, without going into much detail, here are a few thoughts to consider when designing the strategy:
Who are your physician champions that can lead the strategy? Do you have any? Consider partnering or hiring a physician who can be your champion if needed.
When searching for physician champions, stay away from your senior medical leadership. Senior faculty are more preoccupied with traditional issues and usually want to avoid change and keep the status quo.
Involve your physicians in the development of the program from the very early stages.
Recognize your telemedicine physician leaders and make them the face of your program. Many program developers make telemedicine a technology issue, however, this is wrong. Technology is there to support the initiatives of the clinicians to improve patient care.
Showcase your telemedicine program as a healthcare intervention, not as the latest technology development. Remember, by highlighting the program as a clinical and healthcare intervention other physicians will be influenced to participate in your program.
Keep the intervention as simple as possible. The telemedicine intervention should be easily incorporated into the physician’s workflow.
Clearly define what is the clinical purpose of the telemedicine program. Is it to improve the current diabetic management program? Is it to increase access to specialty care to remote areas? Lead with vision.
Make sure to provide your physicians with specific outcome metrics from the start. This helps guide the efforts with purpose (vs just doing telemedicine because I was told to…)
Use surveys to identify appropriate incentives or reinforcements. Yes, money is nice. However, it’s not always about the money. Flexibility, better time allocation, recognition, or improved patient satisfaction can be effective reinforcement factors. Ask around. Do not assume.
Have a strong IT team and be ready to support your physicians. Training and education should be provided. Do not assume a physician will excel at telemedicine just because he/she knows how to use a computer.
If you have any question about this article, feel free to contact me.
References
Adenuga KI, Iahad NA, Miskon S. Towards reinforcing telemedicine adoption amongst clinicians in Nigeria. International journal of medical informatics. 2017;104:84-96.
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.
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.
