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      Knowledge and Attitude of Health Professionals toward Telemedicine in Resource-Limited Settings: A Cross-Sectional Study in North West Ethiopia

      research-article
      1 , , 2
      Journal of Healthcare Engineering
      Hindawi

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          Abstract

          Background

          In resource-limited environments, such as those categorized as underdeveloped countries, telemedicine becomes viewed as effective channel for utilizing the scarce medical resources and infrastructures. The aim of this study was to assess knowledge and attitude toward telemedicine among cross section of health professionals' working in three hospitals in North West Ethiopia.

          Methods

          An institution-based cross-sectional study was conducted among 312 health professionals working in three different hospitals of North Gondar Administrative Zone during November 13 to December 10, 2017. Data were collected using structured self-administered questionnaires. Data entry and analysis were done using SPSS version 20. The mean, percentage, and standard deviation were calculated to describe the characteristics of respondents. The chi-square test was used as appropriate, to evaluate the statistical significance of the differences between the responses of the participants. A P value of < 0.05 was considered significant.

          Result

          A total of 312 study subjects were approached and included in the study from November 13 to December 10, and the response rate was 95.5%. The majority of respondents (195 (65.4%)) were male, and the majority of the respondents (66.1%) were in the age group of 21–29 years. A large number of respondents (224 (75%)) were bachelor's degree holders. Only 37.6% of the respondents had demonstrated good knowledge of telemedicine, of which 74.1% were male, 65.2% of them were in the age group of 20–29 years, and 63.4% of them had >5 years of work experience. 191 (64.0%) respondents had good attitude toward telemedicine.

          Conclusion

          The findings of the study suggest that although the respondents' knowledge of telemedicine is limited, most of them have good attitude toward telemedicine. This study underlined the need of giving training on telemedicine in order to fill the knowledge gap.

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          Most cited references27

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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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            Is Open Access

            Telemedicine: Opportunities and Developments in Member States: Report on the Second Global Survey on eHealth 2009 (Global Observatory for eHealth Series, Volume 2)

            Seewon Ryu (2012)
            Information systems and communication technologies (ICTs) gave us new and innovative wave of communication life such as living in cyber space, instant messaging, and communications with whom anyone in anywhere. These are changing not only life-style, but also mode of business in every industry. Health care service industry is resource-intensive, process-oriented, and doing business traditionally by method of confrontation between medical professionals and patients. ICTs have great potential to address some of the challenges faced by both developed and developing countries in providing accessible, cost-effective, high-quality health care services. Telemedicine uses ICTs to overcome geographical barriers, and increase access to health care services. These are particularly beneficial for rural and underserved communities in developing countries - groups that traditionally suffered from lack of access to health care. In light of this potential, the World Health Organization (WHO) established the Global Observatory for eHealth (GOe) to review the benefits that ICTs can bring to health care and patients' wellbeing. The Observatory is charged with determining the status of eHealth solutions, including telemedicine, at the national, regional, and global levels, and providing WHO's Member States with reliable information and guidance on best practices, policies, and standards in eHealth. In 2005, following the formation of WHO's eHealth strategy, the Observatory conducted a global eHealth survey to obtain general information about the state of eHealth among Member States. Based on the data from that survey, the GOe carried out a second global survey in 2009; it was designed to explore eight thematic areas in detail, the results of each being reported and analysed in individual publications - the Global Observatory for eHealth series. The telemedicine module of the 2009 survey examined the current level of development of four fields of telemedicine: teleradiology, teledermatogy, telepathology, and telepsychology, as well as four mechanisms that facilitate the promotion and development of telemedicine solutions in the short- and long-term: the use of a national agency, national policy or strategy, scientific development, and evaluation. Telemedicine - opportunities and developments in Member States discusses the results of the telemedicine module, which was completed by 114 countries (59% of Member States). There are comprehensive reviews about telemedicine in the world; Overview of telemedicine: definition, history, applications, and potential barriers to telemedicine diffusion Telemedicine in developing countries such as Mongolia, Mexico Barriers, Legal and ethical considerations, to realizing the promise of telemedicine in developing Implications for telemedicine development, implementation, evaluation, and sustainability GOe Second Global Survey on eHealth: Methods and process Telemedicine services in the world by groups Telemedicine initiatives occurring around the world Norway's teleECG initiative Factors facilitating telemedicine development: Governance, policy and strategy, scientific development, evaluation processes The Swinfen Charitable Trust Telemedicine Network Discussions and recommendations about factors facilitating and barriers to telemedicine development Following the analysis of the survey results, WHO recommends steps Member States can take to capitalize on the potential of ICTs. One such step is creation of national agencies to coordinate telemedicine and eHealth initiatives, ensuring they are appropriate to local contexts, cost-effective, consistently evaluated, and adequately funded as part of integrated health service delivery. Ultimately telemedicine initiatives should strengthen - rather than compete with - other health services. Korea has been implementing trial projects of telemedicine in limited service area and populations for more than twenty years from the late 1980s. The Korean Government continued trial projects to develop safe and efficient telemedicine model, and intended to economic buildup. However, medical professional groups think that telemedicine would not be safe, and they are worried about whether it would be beneficial to themselves and patients. Scientists and medical doctors in cooperation with ICTs companies and local governments have been tried various models of telemedicine for more than 20 years in Korea. Recently, effectiveness of telemedicine in public health care has been revealed: compliance and effectiveness of telemedicine of hypertensive patients in the underserved communities [1,2], and effectiveness of eHealth services of public area [3], factors to adoption of telehealth services [4], and the effect of eHealth services of managing metabolic syndrome in rural area [5]. There are also accumulated and structured experiences and technological and managerial systems in participants of telemedicine projects. In Korea, a bill about telemedicine to the limited underserved populations and communities was made and submitted to the national assembly in May, 2010. The Ministry of Health and Welfare should have more interest and be active to realize the needed and safe telemedicine services. We recommend this report to those persons or groups interested about telemedicine in Korea and other countries that do not think about telemedicine, and are hesitating to adopt actively. Especially, we should understand what were successful service models and technological systems of eHealth in view of their culture and healthcare policy, and consider those factors facilitating and barriers of telemedicine recommended in the last of report. We expect that the report would be contributed that telemedicine be an alternative and useful solution to the communities underserved, and the general public, in case of limited and indispensible case.
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              The attitudes of health care staff to information technology: a comprehensive review of the research literature.

              What does the publicly available literature tell us about the attitudes of health care staff to the development of information technology in practice, including the factors which influence them and the factors which may be used to change these attitudes? Twelve databases were searched for literature published between 2000 and 2005 that identified research related to information technology (IT), health professionals and attitude. English language studies were included which described primary research relating to the attitudes of one or more health care staff groups towards IT. Letters, personal viewpoints, reflections and opinion pieces were not included. Complex factors contribute to the formation of attitudes towards IT. Many of the issues identified were around the flexibility of the systems and whether they were 'fit for purpose', along with the confidence and experience of the IT users. The literature suggests that attitudes of practitioners are a significant factor in the acceptance and efficiency of use of IT in practice. The literature also suggested that education and training was a factor for encouraging the use of IT systems. A range of key issues, such as the need for flexibility and usability, appropriate education and training and the need for the software to be 'fit for purpose', showed that organizations need to plan carefully when proposing the introduction of IT-based systems into work practices. The studies reviewed did suggest that attitudes of health care professionals can be a significant factor in the acceptance and efficiency of use of IT in practice. Further qualitative and quantitative research is needed into the approaches that have most effect on the attitudes of health care staff towards IT.
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                Author and article information

                Contributors
                Journal
                J Healthc Eng
                J Healthc Eng
                JHE
                Journal of Healthcare Engineering
                Hindawi
                2040-2295
                2040-2309
                2018
                18 November 2018
                : 2018
                : 2389268
                Affiliations
                1Debre Markos University, College of Medicine and Health Science, Department of Health Informatics, Debre Marqos, Ethiopia
                2University of Gondar, College of Medicine and Health Science, Department of Clinical Pharmacy, Gondar, Ethiopia
                Author notes

                Academic Editor: Stefano Capolongo

                Author information
                http://orcid.org/0000-0002-7411-1411
                http://orcid.org/0000-0002-5779-5671
                Article
                10.1155/2018/2389268
                6276438
                30581547
                a3448136-5d2f-4cd6-a183-c94956503ab5
                Copyright © 2018 Kirubel Biruk and Eden Abetu.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 June 2018
                : 3 August 2018
                : 30 August 2018
                Categories
                Research Article

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