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      The Effect of the COVID-19 Pandemic on Physicians’ Use and Perception of Telehealth: The Case of Lebanon

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          Abstract

          The COVID-19 pandemic forced physicians to quickly adapt and find ways to provide their usual offline services by using online tools. We aimed to understand how physicians adapted to the sudden need for telehealth and if their perception of telehealth changed due to their experience during the COVID-19 pandemic. We conducted an exploratory sequential mixed-methods study. We interviewed five Lebanese physicians and thematically analyzed the interviews. We developed a questionnaire based on the analysis results and administered it online to physicians in Lebanon. In total, 140 responses were collected. We found that, during the COVID-19 pandemic, physicians engaged in more telehealth activities in the realms of telemedicine, public awareness, continuing medical education, research, administration, and teaching. They also expanded their repertoire of information-technology tools. Our results also show that there was a significant shift in the physicians’ perceptions, indicating greater openness and willingness to adopt telehealth services. However, a significant amount of skepticism and uncertainty regarding telemedicine remains, especially concerning its efficiency, safety, and the adequacy of existing regulations. Based on our findings, we offer recommendations for health IT policy makers, developers, and researchers, to sustain the continuity of telehealth activities beyond the COVID-19 pandemic.

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          Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)

          The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare.
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            Determinants of successful telemedicine implementations: a literature study.

            Telemedicine implementations often remain in the pilot phase and do not succeed in scaling-up to robust products that are used in daily practice. We conducted a qualitative literature review of 45 conference papers describing telemedicine interventions in order to identify determinants that had influenced their implementation. The identified determinants, which would influence the future implementation of telemedicine interventions, can be classified into five major categories: (1) Technology, (2) Acceptance, (3) Financing, (4) Organization and (5) Policy and Legislation. Each category contains determinants that are relevant to different stakeholders in different domains. We propose a layered implementation model in which the primary focus on individual determinants changes throughout the development life cycle of the telemedicine implementation. For success, a visionary approach is required from the multidisciplinary stakeholders, which goes beyond tackling specific issues in a particular development phase. Thus the right philosophy is: 'start small, think big'.
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              A Review of Telehealth Service Implementation Frameworks

              Despite the potential of telehealth services to increase the quality and accessibility of healthcare, the success rate of such services has been disappointing. The purpose of this paper is to find and compare existing frameworks for the implementation of telehealth services that can contribute to the success rate of future endeavors. After a thorough discussion of these frameworks, this paper outlines the development methodologies in terms of theoretical background, methodology and validation. Finally, the common themes and formats are identified for consideration in future implementation. It was confirmed that a holistic implementation approach is needed, which includes technology, organizational structures, change management, economic feasibility, societal impacts, perceptions, user-friendliness, evaluation and evidence, legislation, policy and governance. Furthermore, there is some scope for scientifically rigorous framework development and validation approaches.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                06 July 2020
                July 2020
                : 17
                : 13
                : 4866
                Affiliations
                [1 ]Global Center for Medical Engineering and Informatics, Osaka University, Osaka 565-0871, Japan
                [2 ]Faculty of Medicine, Saint Joseph University, Beirut 1107 2180, Lebanon; ehelou@ 123456gmail.com (E.E.H.); wakim1@ 123456hotmail.com (J.W.); jeanine.helouelsaliba@ 123456usj.edu.lb (J.E.H.); daheralain@ 123456hotmail.com (A.D.); charlineeh@ 123456gmail.com (C.E.H.)
                [3 ]Academic Center for Computing and Media Studies, Kyoto University, Kyoto 606-8315, Japan; v.aboukhalil@ 123456gmail.com
                Author notes
                Author information
                https://orcid.org/0000-0001-5233-7025
                Article
                ijerph-17-04866
                10.3390/ijerph17134866
                7370008
                32640652
                0cd9a87e-643b-460e-a52a-7780edbe7b7d
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 01 June 2020
                : 04 July 2020
                Categories
                Article

                Public health
                telehealth,telemedicine,perceptions,use,physicians,lebanon,covid-19,pandemic,change
                Public health
                telehealth, telemedicine, perceptions, use, physicians, lebanon, covid-19, pandemic, change

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