There is evidence that telemedicine can be used safely, easily, and cost-effectively in primary health care services. This study aims to determine family physicians' opinions regarding the potential advantages, disadvantages, and usage areas of telemedicine in primary health care services.
Methods:
This study was designed with a qualitative case study. The Standards for Reporting Qualitative Research (SRQR) checklist was followed throughout the research process. Interviews were conducted with family physicians working in a provincial center using snowball sampling in the study. MaxQDA 20 software was used for analysis process, and themes and subthemes were identified through a deductive-reflective thematic analysis method. The family physicians who participated in the study are between 29 and 56. In addition, family medicine specialists, general practitioners, and academic department heads were included in the study. Family physicians are evenly distributed in terms of gender and professional experience.
Results:
All interviewed family physicians stated that they had not received professional or technical training in delivering telemedicine. It was observed that family physicians had different perspectives on telemedicine in primary care. The data obtained in the study were analyzed under the main themes of the advantages, disadvantages, and services that can be provided in primary telemedicine. Physicians have different views on telemedicine, including negative, undecided, and positive opinions.
Conclusion:
It is understood that many services could be delivered remotely if the scope, procedures, and processes of the services to be provided are determined with guidelines. It is recommended that family physicians receive professional and technical training in telemedicine.
Get full access to this article
View all access options for this article.
References
1.
DogramaciYG.Telemedicine, Health Tourism and Remote Health Services: Distance Contracts. İstanbul Hukuk Mecmuası, 2020; 78(2):657–710; doi: 10.26650/mecmua.2020.78.2.0014
2.
Nicol Turner LeeJK, RobertsJ.Removing Regulatory Barriers to Telehealth Before and After COVID-19. Brookings Institution: USA; 2020.
3.
Pan American Health Organization. Framework for the Implementation of a Telemedicine Service. Pan American Health Organization: Washington, DC; 2016.
4.
American Medical Association (AMA). Telehealth Implementation Playbook. AMA Press Center: Chicago, IL; 2022.
5.
BashshurRL, HowellJD, KrupinskiEA, et al.The empirical foundations of telemedicine interventions in primary care. Telemed J E Health, 2016; 22(5):342–375; doi: 10.1089/tmj.2016.0045
6.
DrerupB, EspenschiedJ, WiedemerJ, et al.Reduced no-show rates and sustained patient satisfaction of telehealth during the COVID-19 pandemic. Telemed J E Health, 2021; 27(12):1409–1415; doi: 10.1089/tmj.2021.0002
7.
KaplanB.Access, equity, and neutral space: Telehealth beyond the pandemic. Ann Fam Med, 2021; 19(1):75–78; doi: 10.1370/afm.2633
8.
MooreMA, CoffmanM, JettyA, et al.Family physicians report considerable interest in, but limited use of, telehealth services. J Am Board Fam Med, 2017; 30(3):320–330; doi: 10.3122/jabfm.2017.03.160201
9.
PogorzelskaK, ChlabiczS. Patient satisfaction with telemedicine during the COVID-19 pandemic—A systematic review. Int J Environ Res Public Health, 2022; 19(10):6113; doi: 10.3390/ijerph19106113
10.
BodenheimerT, GrumbachK. Electronic technology: A spark to revitalize primary care?. JAMA, 2003; 290(2):259–264; doi: 10.1001/jama.290.2.259
11.
HillJV, AllmanLR, DitzlerTF. Utility of real-time video teleconferencing in conducting family mental health sessions: Two case reports. Telemed J E Health, 2001; 7(1):55–59; doi: 10.1089/153056201300093930
12.
CunninghamN, MarshallC, GlazerE. Telemedicine in pediatric primary care: Favorable experience in nurse-staffed inner-city clinic. JAMA, 1978; 240(25):2749–2751; doi: 10.1001/jama.1978.03290250053029
13.
DunnEV, ConrathDW, BloorWG, et al.An evaluation of four telemedicine systems for primary care. Health Serv Res, 1977; 12(1):19–29.
14.
AdepojuOE, TranL, AgwunchaR, et al.Associations between patient-and provider level factors, and telemedicine use in family medicine clinics. J Am Board Fam Med, 2022; 35(3):457–464; doi: 10.3122/jabfm.2022.03.210416
15.
DavisMM, FreemanM, KayeJ, et al.A systematic review of clinician and staff views on the acceptability of incorporating remote monitoring technology into primary care. Telemed J E Health, 2014; 20(5):428–438; doi: 10.1089/tmj.2013.0166
16.
EtzRS, SolidCA, GonzalezMM, et al.Telemedicine in primary care: Lessons learned about implementing health care innovations during the COVID-19 pandemic. Ann Fam Med, 2023; 21(4):297–304; doi: 10.1370/afm.2979
17.
ImlachF, McKinlayE, MiddletonL, et al.Telehealth consultations in general practice during a pandemic lockdown: Survey and interviews on patient experiences and preferences. BMC Fam Pract, 2020; 21(1):269; doi: 10.1186/s12875-020-01336-1
18.
Ministry of Health. Regulation on the Provision of Remote Health Services. Official Gazette: Ankara; 2022.
19.
EkinciB.Remote Health Service Delivery (Telemedicine) Project. Turk Health Literacy J, 2022; 3(2):122–124; doi: 10.54247/SOYD.2022.53
20.
ÖzH.Remote Health Service Provision-Samsun Sample. Turk Health Literacy J, 2022; 3(2):115–118; doi: 10.54247/SOYD.2022.51
21.
CreswellJW.Araştırma Deseni (Nitel, Nicel ve Karma Yöntem Yaklaşımları) [Research Design (Qualitative, Quantitative and Mixed Methods Approaches)]. Eğiten Kitap: Ankara; 2017.
22.
O'BrienBC, HarrisIB, BeckmanTJ, et al.Standards for Reporting Qualitative Research: A synthesis of recommendations. Acad Med, 2014; 89(9):1245–1251; doi: 10.1097/ACM.0000000000000388
23.
FuschPI, NessLR. Are we there yet? Data saturation in qualitative research. Qual Rep, 2015; 20(9):1408–1416; doi: 10.46743/2160-3715/2015.2281
24.
ConnellyLM.Trustworthiness in qualitative research. Medsurg Nurs, 2016; 25(6):435.
25.
BraunV, ClarkeV. One size fits all? What counts as quality practice in (reflexive) thematic analysis?. Qual Res Psychol, 2021; 18(3):328–352; doi: 10.1080/14780887.2020.1769238
26.
HaE, ZwickyK, YuG, et al.Developing a telemedicine curriculum for a family medicine residency. PRiMER, 2020; 4:21; doi: 10.22454/PRiMER.2020.126466
27.
DorseyER, TopolEJ. State of telehealth. N Engl J Med, 2016; 375(2):154–161; doi: 10.1056/NEJMra1601705
28.
FreemanKA, DukeDC, HarrisMA. Behavioral health care for adolescents with poorly controlled diabetes via Skype: Does working alliance remain intact?. J Diabetes Sci Technol, 2013; 7(3):727–735; doi: 10.1177/193229681300700318
29.
VendittiSA, SazegarP, FuchsLC, et al.Family medicine resident and faculty perceptions about the strengths and limitations of telemedicine training. PRiMER, 2022; 6:9; doi: 10.22454/PRiMER.2022.665996
30.
KahnNB.Redesigning family medicine training to meet the emerging health care needs of patients and communities: Be the change we wish to see. Fam Med, 2021; 53(7):499–505; doi: 10.22454/FamMed.2021.897904
31.
KosakZ.Incorporating telehealth into family medicine training: An emerging need. Fam Med, 2022; 54(4):316–317; doi: 10.22454/FamMed.2022.201063
32.
BajraR, LinS, TheobaldM, et al.Telemedicine competencies in family medicine clerkships: A CERA study. Fam Med, 2023; 55(6):405–410; doi: 10.22454/FamMed.2023.242006
33.
TheobaldM, BrazeltonT. STFM forms task force to develop a national telemedicine curriculum, from STFM. Ann Fam Med, 2020; 18(3):285–286; doi: 10.1370/afm.2549
34.
ZwickyK, HaE. Telemedicine 101: Best Practices for Residents. 2020. Available from: https://resourcelibrary.stfm.org/viewdocument/telemedicine-101-best-practices-fo?CommunityKey=2751b51d-483f-45e2-81de-4faced0a290a [Last accessed: August18, 2023].
35.
KrupinskiEA, BernardJ. Standards and guidelines in telemedicine and telehealth. Healthcare (Basel), 2014; 2(1):74–93; doi: 10.3390/healthcare2010074
36.
World Health Organization. Consolidated Telemedicine Implementation Guide. World Health Organization: Geneva; 2022.
37.
The American Telemedicine Association (ATA) A. Practice Guidelines Archive. 2023. Available from: https://www.americantelemed.org/resource_categories/practice-guidelines [Last accessed: August18, 2023].
38.
Indian Medical Council. Telemedicine Practice Guidelines Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine. Ministry of Health and Family Welfare India. Online Guidelines: India; 2020.
39.
Academy of Medicine Singapore. National Telemedicine Guidelines. Ministry of Health Singapore. Online Guidelines: Singapore; 2015.
40.
VinkerS.Innovations in family medicine and the implication to rural and remote primary care. Adv Clin Exp Med, 2023; 32(2):147–150; doi: 10.17219/acem/158171
41.
VosburgRW, RobinsonKA. Telemedicine in primary care during the COVID-19 pandemic: Provider and patient satisfaction examined. Telemed J E Health, 2022; 28(2):167–175; doi: 10.1089/tmj.2021.0174
42.
PeterseimC, WatsonKH. Family medicine telehealth clinic with medical students. PRiMER, 2020; 4:35; doi: 10.22454/PRiMER.2020.861306
