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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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          Most cited references 28

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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

             Liezl van Dyk (2014)
            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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              e-Health readiness assessment tools for healthcare institutions in developing countries.

              e-Health Readiness refers to the preparedness of healthcare institutions or communities for the anticipated change brought by programs related to Information and Communications Technology (ICT). This paper presents e-Health Readiness assessment tools developed for healthcare institutions in developing countries. The objectives of the overall study were to develop e-health readiness assessment tools for public and private healthcare institutions in developing countries, and to test these tools in Pakistan. Tools were developed using participatory action research to capture partners' opinions, reviewing existing tools, and developing a conceptual framework based on available literature on the determinants of access to e-health. Separate tools were developed for managers and for healthcare providers to assess e-health readiness within their institutions. The tools for managers and healthcare providers contained 54 and 50 items, respectively. Each tool contained four categories of readiness. The items in each category were distributed into sections, which either represented a determinant of access to e-health, or an important aspect of planning. The conceptual framework, and the validity and reliability testing of these tools are presented in separate papers. e-Health readiness assessment tools for healthcare providers and managers have been developed for healthcare institutions in developing countries.
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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
                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
                Article
                ijerph-17-04866
                10.3390/ijerph17134866
                7370008
                32640652
                © 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/).

                Categories
                Article

                Public health

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

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