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      Validation of a Short Questionnaire to Assess Healthcare Professionals’ Perceptions of Asynchronous Telemedicine Services: The Catalan Version of the Health Optimum Telemedicine Acceptance Questionnaire

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          Telemedicine is both effective and able to provide efficient care at a lower cost. It also enjoys a high degree of acceptance among users. The Technology Acceptance Model proposed is based on the two main concepts of ease of use and perceived usefulness and is comprised of three dimensions: the individual context, the technological context and the implementation or organizational context. At present, no short, validated questionnaire exists in Catalonia to evaluate the acceptance of telemedicine services amongst healthcare professionals using a technology acceptance model. This article aims to statistically validate the Catalan version of the EU project Health Optimum telemedicine acceptance questionnaire. The study included the following phases: adaptation and translation of the questionnaire into Catalan and psychometric validation with construct (exploratory factor analysis), consistency (Cronbach’s alpha) and stability (test–retest) analysis. After deleting incomplete responses, calculations were made using 33 participants. The internal consistency measured with the Cronbach’s alpha coefficient was good with an alpha coefficient of 0.84 (95%, CI: 0.79–0.84). The intraclass correlation coefficient was 0.93 (95% CI: 0.852–0.964). The Kaiser–Meyer–Olkin test of sampling showed to be adequate (KMO = 0.818) and the Bartlett test of sphericity was significant (Chi-square 424.188; gl = 28; p < 0.001). The questionnaire had two dimensions which accounted for 61.2% of the total variance: quality and technical difficulties relating to telemedicine. The findings of this study suggest that the validated questionnaire has robust statistical features that make it a good predictive model of healthcare professional’s satisfaction with telemedicine programs.

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          Most cited references 15

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          Methods for testing data quality, scaling assumptions, and reliability: the IQOLA Project approach. International Quality of Life Assessment.

          Following the translation development stage, the second research stage of the IQOLA Project tests the assumptions underlying item scoring and scale construction. This article provides detailed information on the research methods used by the IQOLA Project to evaluate data quality, scaling and scoring assumptions, and the reliability of the SF-36 scales. Tests include evaluation of item and scale-level descriptive statistics; examination of the equality of item-scale correlations, item internal consistency and item discriminant validity; and estimation of scale score reliability using internal consistency and test-retest methods. Results from these tests are used to determine if standard algorithms for the construction and scoring of the eight SF-36 scales can be used in each country and to provide information that can be used in translation improvement.
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            Teledermatology applied following patient selection by general practitioners in daily practice improves efficiency and quality of care at lower cost.

            Teledermatology, the application of telemedicine in the field of dermatology, has similar accuracy and reliability as physical dermatology. Teledermatology has been widely used in daily practice in the Netherlands since 2005 and is fully reimbursed. This study prospectively investigated the effect of teledermatology on efficiency, quality and costs of care when integrated in daily practice and applied following patient selection by the general practitioner (GP). Teledermatology consultations between GP and regional dermatologist were performed in daily GP practice in the Netherlands. Efficiency of care was measured by the decrease in the number of physical referrals to the dermatologist. Quality of care was measured by the percentage of teleconsultations for second opinion, physical referrals resulting from these teleconsultations, the response time of the dermatologists and educational effect experienced by the GP. Costs of conventional healthcare without teledermatology were compared with costs with teledermatology. One thousand, eight hundred and twenty GPs and 166 dermatologists performed teledermatology, and 37,207 teleconsultations performed from March 2007 to September 2010 were included. In the group of patients where the GP used teleconsultation to prevent a referral (n =26,596), 74% of physical referrals were prevented. In the group of patients where the GP used teleconsultation for a second opinion (n =10,611), 16% were physically referred after teleconsultation. The prevented referral rate in the total population was 68%. The mean response time of dermatologists was 4·6 h (median 2·0). GPs indicated that there was a beneficial educational effect in 85% of the teleconsultations. The estimated cost reduction was 18%. Teledermatology can lead to efficient care probably at lower cost. We are therefore of the opinion that teledermatology following GP selection should be considered as a possible pathway of referral to secondary care. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.
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              Evaluation of teledermatology adoption by health-care professionals using a modified Technology Acceptance Model.

              We examined the main factors affecting the intention of physicians to use teledermatology using a modified Technology Acceptance Model (TAM). The investigation was carried out during a teledermatology pilot study conducted in Spain. A total of 276 questionnaires were sent to physicians by email and 171 responded (62%). Cronbach's alpha was acceptably high for all constructs. Theoretical variables were well correlated with each other and with the dependent variable (Intention to Use). Logistic regression indicated that the original TAM model was good at predicting physicians' intention to use teledermatology and that the variables Perceived Usefulness and Perceived Ease of Use were both significant (odds ratios of 8.4 and 7.4, respectively). When other theoretical variables were added, the model was still significant and it also became more powerful. However, the only significant predictor in the modified model was Facilitators with an odds ratio of 9.9. Thus the TAM was good at predicting physicians' intention to use teledermatology. However, the most important variable was the perception of Facilitators to using the technology (e.g. infrastructure, training and support).

                Author and article information

                Int J Environ Res Public Health
                Int J Environ Res Public Health
                International Journal of Environmental Research and Public Health
                25 March 2020
                April 2020
                : 17
                : 7
                [1 ]Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Sant Fruitós de Bages, Spain; (X.M.G.); (G.S.V.); (A.R.-C.)
                [2 ]Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08272 Sant Fruitós de Bages, Spain
                [3 ]Department of Economics and Business, Universitat de Vic-Universitat Central de Catalunya, 08500 Vic, Spain; jlgarcia@
                [4 ]Unitat d’anàlisi i Qualitat, Xarxa Sanitària i Social de Santa Tecla, 43003 Tarragona, Spain
                [5 ]Centre d’Atenció Primària Sant Joan de Vilatorrada, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08250 Sant Joan de Vilatorrada, Spain
                [6 ]TIC Salut Social–Generalitat de Catalunya, 08005 Barcelona, Spain; flopez@
                [7 ]CRES&CEXS–Universitat Pompeu Fabra, 08002 Barcelona, Spain
                [8 ]Hospital Sant Joan de Déu, Digital Care Research Group, Universitat de Vic-Universitat Central de Catalunya, 08500 Vic, Spain; francesc.garcia@
                Author notes
                [* ]Correspondence: (J.V.-A.); gfloresm@ (G.F.M.); Tel./Fax: +34-936-93-00-40 (J.V.-A.)
                © 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 (


                Public health

                questionnaires and surveys, telemedicine, validation studies, health personnel


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