Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 25, 2019
Date Accepted: Dec 15, 2019
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Barriers and facilitators that influence telemedicine real-time online consultation at patients’ home: A Systematic Literature Review.
ABSTRACT
Background:
HealthCare providers are adopting information communication technologies (ICT) to enhance their services. Telemedicine is one of the services that rely heavily on ICT technologies to enable remote patients to communicate with their health professional. The patient communicates with the health professional for a follow-up or for a consultation about his/her health condition. This communication process is referred to as an electronic consultation (e-consultation). However, the usage of e-consultation can be influenced positively or negatively by external or internal factors. External factors refer to the environment surrounding the system and the system itself, while internal factors refer to user behaviour and motivation.
Objective:
This review aims to (1) investigate the barriers and the facilitators that influence the use of home consultation systems in the healthcare context. Further, it aims to (2) identify the effectiveness of Home Online Health Consultation (HOHC) systems in improving patients’ health and (3) patients’ satisfaction with it.
Methods:
The researchers conducted a systematic literature review to search for articles (empirical studies) about online health consultation in three digitals libraries: Scopus, Association for Computing Machinery (ACM) and Web of Science. The search on the databases yielded 1016 articles and after following the Inclusion and Exclusion criteria, the number of included articles for the final review was 44. A qualitative content analysis was performed to identify barriers and facilitators to HOHC, its effectiveness and patients’ satisfaction with it.
Results:
The systematic literature review identified several external and internal facilitators and barriers to HOHC systems that were used in the creation of a HOHC framework. The framework consists of four requirements, 17 facilitators and eight barriers, categorized as internal and external influences on HOHC.
Conclusions:
Patients from different age groups and different health conditions benefited from remote health services. OHC via video conferencing was effective in delivering online treatment and was well accepted by patients as it simulated in-person face-to-face consultation. Acceptance by patients was assisted by online consultation facilitators that promoted effective and convenient remote treatment. However, some patients preferred face-to-face consultation showing resistance to the online consultation. Resistance to online consultations was influenced by a few of the identified barriers. Overall, the framework identified the facilitators and barriers that positively and negatively influence the uptake of HOHC.
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