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Adoption of telemedicine: from pilot stage to routine delivery

Open access
Zanaboni, Paolo, Wootton, Richard·2012·BMC Medical Informatics and Decision Making

Abstract

BACKGROUND: Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. DISCUSSION: We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1) the process of adoption of telemedicine in comparison with other technologies; and 2) the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. SUMMARY: The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify suitable financial and professional incentives for potential telemedicine users and understand their importance for widespread adoption.

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  1. World Health Organization: The World Health Report 2008: Primary Health Care: Now More Than Even. Geneva. 2008
  2. Doarn CR, Merrell RC: A roadmap for telemedicine: barriers yet to overcome. Telemed J E Health. 2008, 14 (9): 861-2. 10.1089/tmj.2008.8479. · DOI
  3. Wootton R: Realtime telemedicine. J Telemed Telecare. 2006, 12 (7): 328-36. 10.1258/135763306778682387. · DOI
  4. Grigsby B, Brega AG, Bennett RE, Devore PA, Paulich MJ, Talkington SG, Floersch NR, Barton PL, Neal S, Araya TM, Loker JL, Krohn N, Grigsby J: The slow pace of interactive video telemedicine adoption: the perspective of telemedicine program administrators on physician participation. Telemed J E Health. 2007, 13 (6): 645-56.
  5. Wade V, Eliott J, Karnon J, Elshaug AG: A qualitative study of sustainability and vulnerability in Australian telehealth services. Stud Health Technol Inform. 2010, 161: 190-201.
  6. Brebner EM, Brebner JA: Implementation and evaluation of telemedicine for remote health-care--the European Northern Periphery Programme Project. J Telemed Telecare. 2001, 7 (Suppl 1): 68-9.
  7. MacFarlane A, Murphy AW, Clerkin P: Telemedicine services in the Republic of Ireland: an evolving policy context. Health Policy. 2006, 76 (3): 245-58. 10.1016/j.healthpol.2005.06.006. · DOI
  8. Helitzer D, Heath D, Maltrud K, Sullivan E, Alverson D: Assessing or predicting adoption of telehealth using the diffusion of innovations theory: a practical example from a rural program in New Mexico. Telemed J E Health. 2003, 9 (2): 179-87. 10.1089/153056203766437516. · DOI
  9. Gagnon MP, Duplantie J, Fortin JP, Landry R: Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?. Implement Sci. 2006, 1: 18-10.1186/1748-5908-1-18. · DOI · Paper page
  10. Obstfelder A, Engeseth KH, Wynn R: Characteristics of successfully implemented telemedical applications. Implement Sci. 2007, 27;2: 25- · DOI
  11. Gagnon MP, Légaré F, Fortin JP, Lamothe L, Labrecque M, Duplantie J: An integrated strategy of knowledge application for optimal e-health implementation: a multi-method study protocol. BMC Med Inform Decis Mak. 2008, 24;8: 17- · DOI
  12. Wootton R, Hebert MA: What constitutes success in telehealth?. J Telemed Telecare. 2001, 7 (Suppl 2): 3-7. · DOI · Paper page
  13. Norum J, Pedersenwz S, Størmer J, Rumpsfeld M, Stormoww A, Jamissenzz N, Sundeyy H, Ingebrigtsen T, Larsen ML: Prioritisation of telemedicine services for large scale implementation in Norway. J Telemed Telecare. 2007, 13: 185-192. 10.1258/135763307780908076. · DOI
  14. Steinbrook R: The age of teleradiology. N Engl J Med. 2007, 357 (1): 5-7. 10.1056/NEJMp078059. · DOI
  15. Ebbert TL, Meghea C, Iturbe S, Forman HP, Bhargavan M, Sunshine JH: The state of teleradiology in 2003 and changes since 1999. AJR Am J Roentgenol. 2007, 188 (2): W103-12. 10.2214/AJR.06.1310. · DOI
  16. Bergmo TS: An economic analysis of teleradiology versus a visiting radiologist service. J Telemed Telecare. 1996, 2 (3): 136-42. 10.1258/1357633961929952. · DOI
  17. Fitzgerald R: Medical regulation in the telemedicine era. Lancet. 2008, 372 (9652): 1795-6. 10.1016/S0140-6736(08)61743-2. · DOI
  18. Benjamin M, Aradi Y, Shreiber R: From shared data to sharing workflow: merging PACS and teleradiology. Eur J Radiol. 2010, 73 (1): 3-9. 10.1016/j.ejrad.2009.10.014. · doi:10.1016/j.ejrad.2009.10.014
  19. Rogers EM: Diffusion of Innovations. 1983, New York, The Free Press
  20. Russell LB: The diffusion of hospital technologies: some econometric evidence. J Hum Resour. 1977, 12 (4): 482-502. 10.2307/145371. · DOI
  21. Hillman AL, Schwartz JS: The adoption and diffusion of CT and MRI in the United States. A comparative analysis. Med Care. 1985, 23 (11): 1283-94. 10.1097/00005650-198511000-00007. · DOI
  22. Haddock CC, Begun JW: The diffusion of two diagnostic technologies among hospitals in New York state. Int J Technol Assess Health Care. 1988, 4 (4): 593-600. 10.1017/S0266462300007649. · doi:10.1017/s0266462300007649
  23. Grigsby J, Rigby M, Hiemstra A, House M, Olsson S, Whitten P: Telemedicine/telehealth: an international perspective. The diffusion of telemedicine. Telemed J E Health. 2002, 8 (1): 79-94. 10.1089/15305620252933428. · DOI
  24. Wootton R, Youngberry K, Swinfen R, Swinfen P: Referral patterns in a global store-and-forward telemedicine system. J Telemed Telecare. 2005, 11 (Suppl 2): S100-3. · DOI
  25. Tuerk PW, Fortney J, Bosworth HB, Wakefield B, Ruggiero KJ, Acierno R, Frueh BC: Toward the development of national telehealth services: the role of Veterans Health Administration and future directions for research. Telemed J E Health. 2010, 16 (1): 115-7. 10.1089/tmj.2009.0144. · DOI
  26. Hill RD, Luptak MK, Rupper RW, Bair B, Peterson C, Dailey N, Hicken BL: Review of Veterans Health Administration telemedicine interventions. Am J Manag Care. 2010, 16 (12 Suppl HIT): e302-10.
  27. Larsen D, Stamm BH, Davis K, Magaletta PR: Prison Telemedicine and Telehealth Utilization in the United States: State and Federal Perceptions of Benefits and Barriers. Telemed J E Health. 2004, 10 (Suppl 2): 81-90. · doi:10.1089/1530562042632056
  28. Mahnke CB, Jordan CP, Bergvall E, Person DA, Pinsker JE: The Pacific Asynchronous TeleHealth (PATH) system: review of 1,000 pediatric teleconsultations. Telemed J E Health. 2011, 17 (1): 35-9. 10.1089/tmj.2010.0089. · DOI
  29. Masella C, Zanaboni P, Borghi G, Castelli A, Marzegalli M, Tridico C: Introduction of a telemonitoring service for patients affected by Chronic Heart Failure. Proceedings of the 11th IEEE International Conference on e-Health Networking, Application and Services. HealthCom2009: 16-18 December 2009; Sydney, Australia. Edited by: IEEE Press Piscataway, NJ, USA. 2009, 138-145. · DOI
  30. Walker J, Whetton S: The diffusion of innovation: factors influencing the uptake of telehealth. J Telemed Telecare. 2002, 8 (Suppl 3): 73-5. · DOI
  31. Gagnon MP, Ouimet M, Godin G, Rousseau M, Labrecque M, Leduc Y, Ben Abdeljelil A: Multi-level analysis of electronic health record adoption by health care professionals: a study protocol. Implement Sci. 2010, 5: 30-10.1186/1748-5908-5-30. · DOI
  32. Whitten P, Sypher BD: Evolution of telemedicine from an applied communication perspective in the United States. Telemed J E Health. 2006, 12 (5): 590-600. 10.1089/tmj.2006.12.590. · DOI
  33. Whitten PS, Mackert MS: Addressing telehealth's foremost barrier: provider as initial gatekeeper. Int J Technol Assess Health Care. 2005, 21 (4): 517-21. · DOI
  34. Ackerman MJ, Filart R, Burgess LP, Lee I, Poropatich RK: Developing next-generation telehealth tools and technologies: patients, systems, and data perspectives. Telemed J E Health. 2010, 16 (1): 93-5. 10.1089/tmj.2009.0153. · DOI
  35. Hailey D: The need for cost-effectiveness studies in telemedicine. J Telemed Telecare. 2005, 11 (8): 379-83. 10.1258/135763305775013563. · DOI
  36. Hersh WR, Hickam DH, Severance SM, Dana TL, Pyle Krages K, Helfand M: Diagnosis, access and outcomes: Update of a systematic review of telemedicine services. J Telemed Telecare. 2006, 12 (Suppl 2): S3-31. · DOI · Paper page
  37. Bergmo TS: Economic evaluation in telemedicine - still room for improvement. J Telemed Telecare. 2010, 16 (5): 229-31. 10.1258/jtt.2010.009008. · DOI
  38. Bergmo TS: Can economic evaluation in telemedicine be trusted? A systematic review of the literature. Cost Eff Resour Alloc. 2009, 7: 18-10.1186/1478-7547-7-18. · DOI
  39. Whited JD: Economic analysis of telemedicine and the teledermatology paradigm. Telemed J E Health. 2010, 16 (2): 223-8. 10.1089/tmj.2009.0100. · DOI
  40. Mars M, Scott RE: Global e-health policy: a work in progress. Health Aff. 2010, 29 (2): 237-43. 10.1377/hlthaff.2009.0945. · DOI
  41. Wootton R, Tahir MSM: Challenges in launching a Malaysian teleconsulting network. Understanding Health Communications Technologies. Edited by: Whitten P, Cook D. 2004, San Francisco, CA: Jossey-Bass, 11-18.
  42. Spaulding RJ, Russo T, Cook DJ, Doolittle GC: Diffusion theory and telemedicine adoption by Kansas health-care providers: critical factors in telemedicine adoption for improved patient access. J Telemed Telecare. 2005, 11 (Suppl 1): 107-9. · DOI
  43. Vuononvirta T, Timonen M, Keinänen-Kiukaanniemi S, Timonen O, Ylitalo K, Kanste O, Taanila A: The attitudes of multiprofessional teams to telehealth adoption in northern Finland health centres. J Telemed Telecare. 2009, 15 (6): 290-6. 10.1258/jtt.2009.090108. · DOI
  44. Llewellyn S, Eden R, Lay C: Financial and professional incentives in health care. International Journal of Public Sector Management. 1999, 12 (1): 6-16. 10.1108/09513559910262643. · doi:10.1108/09513559910262643
  45. Gosden T, Forland F, Kristiansen IS, Sutton M, Leese B, Giuffrida A, Sergison M, Pedersen L: Impact of payment method on behaviour of primary care physicians: a systematic review. J Health Serv Res Policy. 2001, 6 (1): 44-55. 10.1258/1355819011927198. · DOI · Paper page
  46. Croxson B, Propper C, Perkins A: Do doctors respond to financial incentives? UK family doctors and the GP fundholder scheme. Journal of Public Economics. 2001, 79 (2): 375-98. 10.1016/S0047-2727(00)00074-8. · DOI
  47. Benson T: Why general practitioners use computers and hospital doctors do not-- Part 1: incentives. BMJ. 2002, 325 (7372): 1086-9. 10.1136/bmj.325.7372.1086. · DOI · Paper page
  48. Petersen LA, Woodard LD, Urech T, Daw C, Sookanan S: Does pay-for-performance improve the quality of health care?. Ann Intern Med. 2006, 145 (4): 265-72. · DOI · Paper page
  49. Serumaga B, Ross-Degnan D, Avery AJ, Elliott RA, Majumdar SR, Zhang F, Soumerai SB: Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series study. BMJ. 2011, 342: d108-10.1136/bmj.d108. · DOI · Paper page
  50. Robinson DF, Savage GT, Campbell KS: Organizational learning, diffusion of innovation, and international collaboration in telemedicine. Health Care Manage Rev. 2003, 28 (1): 68-78. · DOI
  51. Cook DJ, Doolittle GC, Ferguson D, Hanks N, Hood J, Howard M, Troha J, Mehling D, Zurbuchen N: Explaining the adoption of telemedicine services: an analysis of a paediatric telemedicine service. J Telemed Telecare. 2002, 8 (Suppl 2): 106-7. · DOI
  52. Shea S: Health delivery system changes required when integrating telemedicine into existing treatment flows of information and patients. J Telemed Telecare. 2006, 12 (Suppl 2): S85-90. · doi:10.1258/135763306778393126
  53. Casalino L, Gillies RR, Shortell SM, Schmittdiel JA, Bodenheimer T, Robinson JC, Rundall T, Oswald N, Schauffler H, Wang MC: External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases. JAMA. 2003, 289 (4): 434-41. 10.1001/jama.289.4.434. · DOI · Paper page
  54. Simon JS, Rundall TJ, Shortell SM: Adoption of Order Entry with Decision Support for Chronic Care by Physician Organizations. J Am Med Inform Assoc. 2007, 14 (4): 432-9. 10.1197/jamia.M2271. · DOI
  55. Miller RH, Sim I: Physicians' use of electronic medical records: barriers and solutions. Health Aff. 2004, 23 (2): 116-26. 10.1377/hlthaff.23.2.116. · DOI · Paper page
  56. Légaré F, Ratté S, Stacey D, Kryworuchko J, Gravel K, Graham ID, Turcotte S: Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database Syst Rev. 2010, CD006732-5 · DOI · Paper page
  57. Sjögren LH, Törnqvist H, Schwieler A, Karlsson L: The potential of telemedicine: barriers, incentives and possibilities in the implementation phase. J Telemed Telecare. 2001, 7 (Suppl 1): 12-3. · DOI
  58. Scales DC, Dainty K, Hales B, Pinto R, Fowler RA, Adhikari NK, Zwarenstein M: An innovative telemedicine knowledge translation program to improve quality of care in intensive care units: protocol for a cluster randomized pragmatic trial. Implement Sci. 2009, 4: 5-10.1186/1748-5908-4-5. · DOI

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Metadata

Authors
Zanaboni, P., & Wootton, R.
Venue
BMC Medical Informatics and Decision Making
Published
2012-01-04
Volume
12
Issue
1
Pages
1-1
ISSN
1472-6947 (ISSN-L)
OpenAlex
W2136894535
Cited by
317
References
15
FWCI
17.07
Type
journal article
Language
en
Open access
gold
Licence
creativecommons.org/licenses/by/2.0 (tdm)

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