Assessing core, e-learning, clinical and technology readiness to integrate telemedicine at public health facilities in Uganda: a health facility - based survey.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Computer-Assisted Instruction* ; Health Facilities* ; Health Surveys* ; Public Health*; Delivery of Health Care/*organization & administration ; Delivery of Health Care, Integrated/*organization & administration ; Telemedicine/*organization & administration; Cross-Sectional Studies ; Health Facility Administration ; Humans ; Male ; Telemedicine/statistics & numerical data ; Uganda

Background: In developing countries like Uganda, there are shortages of health workers especially medical specialists. The referral process is frustrating to both patients and health workers (HWs). This is due to delays in accessing laboratory results/tests, costs of travel with resultant delay in consulting specialists. Telemedicine can help reduce these problems. To facilitate successful and sustainable telemedicine implementation the eHealth readiness of different stakeholders should be undertaken. This study was conducted at public health facilities (HFs) in Uganda to assess eHealth readiness across four domains; core, e-learning, clinical and technology, that might hamper adoption and integration of telemedicine.
Methods: A cross-sectional study using mixed methods for data collection was conducted at health center IVs, regional and national referral hospitals. The study was conducted in three parts. Quantitative data on core, e-learning and clinical readiness domains were collected from doctors and other healthcare providers (nurses/midwives, public health officers and allied healthcare workers). Respondents were categorised into 'aware and used telemedicine', 'aware and not used', 'unaware of telemedicine'. Focus Group Discussions were conducted with patients to further assess core readiness. Technology readiness was assessed using a questionnaire with purposively selected respondents; directors, heads of medical sections, and hospital managers/superintendents. Descriptive statistics and correlations were performed using Spearman's rank order test for relationship between technology readiness variables at the HFs.
Results: 70% of health professionals surveyed across three levels of HF were aware of telemedicine and 41% had used telemedicine. However, over 40% of HWs at HC-IV and RRH were unaware of telemedicine. All doctors who had used telemedicine were impressed with it. Telemedicine users and non-users who were aware of telemedicine showed core, clinical, and learning readiness. Patients were aware of telemedicine but identified barriers to its use. A weak but positive correlation existed between the different variables in technology readiness.
Conclusion: Respondents who were aware of and used telemedicine across all HF levels indicated core, learning and clinical readiness for adoption and integration of telemedicine at the public HFs in Uganda, although patients noted potential barriers that might need attention. In terms of technology readiness, gaps still exit at the various HF levels.

Telemed J E Health. 2007 Aug;13(4):425-31. (PMID: 17848110)
World Hosp Health Serv. 2008;44(1):36-8. (PMID: 18549033)
J Biomed Inform. 2010 Feb;43(1):159-72. (PMID: 19615467)
Worldviews Evid Based Nurs. 2012 Apr;9(2):78-87. (PMID: 22409341)
Iran J Public Health. 2012;41(10):43-51. (PMID: 23304661)
BMC Health Serv Res. 2014 Apr 23;14:184. (PMID: 24754917)
Telemed J E Health. 2014 May;20(5):496-504. (PMID: 24801522)
BMC Med Inform Decis Mak. 2014 May 13;14:40. (PMID: 24886567)
Front Public Health. 2014 Nov 03;2:173. (PMID: 25405146)
BMC Health Serv Res. 2015 Sep 28;15:427. (PMID: 26416464)
Hum Resour Health. 2015 Dec 02;13:91. (PMID: 26626015)
BMC Health Serv Res. 2016 Nov 10;16(1):644. (PMID: 27832788)
J Telemed Telecare. 2018 Feb;24(2):110-117. (PMID: 28008790)
Hum Resour Health. 2017 Feb 3;15(1):11. (PMID: 28159017)
Asian J Psychiatr. 2017 Jun;27:1-4. (PMID: 28558877)
Afr J Prim Health Care Fam Med. 2017 May 29;9(1):e1-e10. (PMID: 28582996)
Int J Med Inform. 2017 Nov;107:56-64. (PMID: 29029692)

D43 TW007004 United States TW FIC NIH HHS; D43TW007004 Fogarty International Center of the National Institutes of Health

Keywords: E-readiness; Health facilities; Telemedicine; Uganda

Date Created: 20190501 Date Completed: 20190722 Latest Revision: 20200225

20240628

PMC6489273

10.1186/s12913-019-4057-6

31035976