The slow pace of interactive video telemedicine adoption: The perspective of telemedicine program administrators on physician participation
The slow pace of interactive video telemedicine adoption: The perspective of telemedicine program administrators on physician participation
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DOI：
10.1089/tmj.2007.0090
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发表时间：
2007-12-01
期刊：
影响因子：
--
通讯作者：
Grigsby, Jim
中科院分区：
文献类型：
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作者：
Grigsby, Bill;Brega, Angela G.;Grigsby, Jim
我们对远程医疗项目管理人员进行了半结构化访谈，作为对医生和管理人员对远程医疗的态度和知识进行的全国调查的一部分。远程医疗管理人员接受了有关影响医生采用交互式视频 (IAV) 远程医疗的因素的采访。这些管理人员所属的七个网络代表“传统”远程医疗计划，主要通过 IAV 提供专业远程会诊。这些计划位于不同的地理区域，包括咨询和推荐网站。我们仅包含多个管理员做出响应的完善网络的数据。使用标准定性研究方法对数据进行分析。我们的结论是，报销问题是采用率的重要决定因素，但它们本身并不能完全解释 IAV 远程医疗传播缓慢的原因。同样，呼吁医生作为理性决策者是必要的，但不足以增加网络内远程医疗的数量。有效说服医生实施远程医疗或转诊患者的远程医疗网络和管理人员表明，他们重视积极招募积极参与其中一种或另一种角色的医生。然而，大多数鼓励医生采用远程医疗的努力都集中在专家的供应上，而不是刺激有患者转诊的初级保健提供者的需求。习惯被认为是解释医生采用远程医疗的一个重要因素，尽管被忽视了。
We conducted semistructured interviews with telemedicine program administrators as part of a national survey of physicians and managers regarding attitudes toward, and knowledge of, telemedicine. Telemedicine administrators were interviewed regarding factors affecting physician adoption of interactive video (IAV) telemedicine. The seven networks with which these managers were affiliated represented "traditional" telemedicine programs, primarily providing specialty teleconsultation via IAV. These programs were located in different geographic regions, and included both consulting and referring sites. We include data only for well-established networks for which multiple administrators responded. Data were analyzed using standard qualitative research methods. We conclude that reimbursement issues are important determinants of the rate of adoption, but that by themselves they do not fully account for the slow diffusion of IAV telemedicine. Likewise, appeals to physicians as rational decision-makers are necessary but insufficient means of increasing the volume of telemedicine within a network. Telemedicine networks and administrators that have been effective in persuading physicians to practice telemedicine or to refer patients demonstrate an emphasis on aggressive recruitment of physicians who will be involved actively in one or the other role. Most efforts to encourage physicians to adopt telemedicine, however, have focused on the supply of specialists, rather than stimulating demand among primary care providers who have patients to refer. Habit was identified as an important, albeit overlooked, factor explaining physician adoption of telemedicine.