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      Clinicians’ Perspectives About the Feasibility and Effectiveness of Using Telemedicine in First Aid: A Qualitative Study

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          Abstract

          Objective

          This study investigated clinicians’ perspectives on the feasibility and effectiveness of using telemedicine in the context of providing first aid. It is crucial to identify and explore clinicians’ attitudes and awareness of tele-first-aid in China to keep pace with ongoing global trends.

          Design

          This was a qualitative study. Data gathered from in-depth interviews with 22 clinicians were coded into themes and analyzed.

          Participants

          Participants included hospital-based clinicians: four clinical specialists, eight emergency nurses, four emergency doctors, three general practitioners, and three clinical administrators.

          Setting

          The study was conducted in university-affiliated hospitals.

          Results

          All clinicians who were invited to participate believed that the use of telemedicine in first aid was promising and effective. Participants stated that relevant technology should be designed to synergize the chain of existing platforms in the industry and that it should be determined who has the authority to utilize such technology and how it should be used to achieve the sought-after benefits. The use of such technology refreshes the role of clinicians and their relationship with patients. Additionally, participants believed that the government could play an important role especially in the reform of medical systems.

          Conclusion

          Telemedicine can facilitate the provision of conventional first aid and systematically exploit existing resources due to its feasibility and effectiveness. The social benefits of using tele-first-aid in clinical and community applications, especially when used in coordination with existing resources, make its adoption an inevitable trend in the field.

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          Most cited references43

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          Telemedicine Practice: Review of the Current Ethical and Legal Challenges

          Background: Telemedicine involves medical practice and information and communications technology. It has been proven to be very effective for remote health care, especially in areas with poor provision of health facilities. However, implementation of these technologies is often hampered by various issues. Among these, ethical and legal concerns are some of the more complex and diverse ones. In this study, an analysis of scientific literature was carried out to identify the ethical and legal challenges of telemedicine. Materials and Methods: English literature, published between 2010 and 2019, was searched on PubMed, Scopus, and Web of Science by using keywords, including “Telemedicine,” “Ethics,” “Malpractice,” “Telemedicine and Ethics,” “Telemedicine and Informed consent,” and “telemedicine and malpractice.” Different types of articles were analyzed, including research articles, review articles, and qualitative studies. The abstracts were evaluated according to the selection criteria, using the Newcastle–Ottawa Scale criteria, and the final analysis led to the inclusion of 22 articles. Discussion: From the aforementioned sample, we analyzed elements that may be indicative of the efficacy of telemedicine in an adequate time frame. Ethical aspects such as informed consent, protection data, confidentiality, physician's malpractice, and liability and telemedicine regulations were considered. Conclusions: Our objective was to highlight the current status and identify what still needs to be implemented in telemedicine with respect to ethical and legal standards. Gaps emerged between current legislation, legislators, service providers, different medical services, and most importantly patient interaction with his/her data and the use of that data.
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            Introduction to the Practice of Telemedicine

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              Barriers to telemedicine: survey of current users in acute care units.

              The present study of current telemedicine users is a unique attempt to understand the barriers and motivational factors related to the utilization of telemedicine. A survey of emergency and critical care remote presence telemedicine users was conducted to determine the factors that motivate and the barriers that impede the acceptance and maintenance of a robotic telemedicine (RTM) program. The majority of the survey users were in the Emergency Department or in the Intensive Care Unit. E-mail invitations were sent to 483 individuals representing 63 healthcare institutions and groups in North America and Europe. Respondents were directed to a Web-based survey. The survey consisted of 96 separate questions, addressing user familiarity and 5-point Likert scales, addressing issues spanning the conceptual and practical issues surrounding adoption of telemedicine. A total of 106 surveys were completed, representing an individual response rate of 21.9% but an institutional response rate of 60.3%. More than two-thirds of the respondents were physicians who participated in active RTM programs. Across seven different topics related to barriers to implementing RTM, the majority of all respondents indicated that cultural issues did not constitute meaningful hurdles, technological matters were generally favorable, and that most personnel were agreeable to both achieving the buy-in to start an RTM program and to maintaining RTM once started. However, respondents proclaimed that RTM's success was still hampered by licensing, credentialing, and malpractice protection, as well as costs, billing, and reimbursement issues. Achieving immediate patient access, overcoming service gaps, improving quality, providing clinical support, maintaining patient satisfaction, and adhering to practice guidelines were viewed as significant motives for RTM implementation. The leading applications of RTM included emergency response and consultation. The patients, physicians, nurses, nor hospital executives served as barriers to implementation. However, licensing, costs for technology, and reimbursement for RTM continue to impede progress.
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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                ijgm
                ijgm
                International Journal of General Medicine
                Dove
                1178-7074
                12 July 2021
                2021
                : 14
                : 3343-3353
                Affiliations
                [1 ]Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University , Nanchang, 330006, People’s Republic of China
                [2 ]School of Nursing, Nanchang University , Nanchang, 330006, People’s Republic of China
                Author notes
                Correspondence: Shulei Jia School of Nursing, Nanchang University , No. 461 of Ba Yi Road, Donghu District, Nanchang, 330006, People’s Republic of ChinaTel +86 1579 786 1504Fax +86 791 86360530 Email jiashulei2021@163.com
                Article
                314901
                10.2147/IJGM.S314901
                8285227
                5103ac29-9735-4ff9-aff7-615cfef57b03
                © 2021 Fang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 08 April 2021
                : 31 May 2021
                Page count
                Figures: 1, Tables: 3, References: 43, Pages: 11
                Funding
                Funded by: Natural Science Foundation of Jiangxi Province, open-funder-registry 10.13039/501100004479;
                Funded by: Science and technology project of Jiangxi Health Commission;
                Funded by: Natural Science Foundation of Jiangxi Province, open-funder-registry 10.13039/501100004479;
                Funded by: Educational Reform Project of Jiangxi Province;
                Natural Science Foundation of Jiangxi Province(20192BBG70015), Science and technology project of Jiangxi Health Commission(202130353), Natural Science Foundation of Jiangxi Province(20171BAB215027), Educational Reform Project of Jiangxi Province(JXJG-18-1-31).
                Categories
                Original Research

                Medicine
                telemedicine,first aid,qualitative study,clinicians
                Medicine
                telemedicine, first aid, qualitative study, clinicians

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