JMIR Publications

ABSTRACT

Background:

Diabetes mellitus (DM) is one of the most challenging diseases in the 21st century and the sixth leading cause of death. Telemedicine has increasingly been implemented in the care of DM patients. Although teleconsultations at home have shown to be more effective for inducing HbA1c reduction than other telemedicine options, prior to the COVID-19 crisis, their use had been lagging behind. Studies about physicians’ or patients’ perceptions about telemedicine have been performed independently of each other and very few concerned teleconsultations. In a time of great pressure for health systems and when an important portion of health care has to be assured at a distance, obtaining insights about home from the stakeholders directedly involved in the health care interaction is particularly important.

Objective:

The perceptions of patients and physicians about their intentions to use home synchronous teleconsultations for DM care were examined in order to identify drivers and barriers inherent to programs that involve home teleconsultations.

Methods:

Two identical questionnaires integrating the Technology Acceptance Model (TAM) and the Unified Theory of Technology Acceptance and Use (UTAU) and also assessing the confidence in ICT use of patients and physicians were developed. Responses by patients (n=75) and physicians (n=68) were analysed using a Canonical Correlation Analysis.

Results:

Associations between predictor constructs (performance, effort, social influence, facilitating conditions and attitude) and intention of use yielded significant functions with canonical R2 of 0.95 (physicians) and 0.98 (patients). The main identified barriers to patient intention of use were the expected effort to explain the medical problem, and privacy and confidentiality issues. Major drivers were the facilitation of contact with the physician, which is beneficial to patient disease management and treatment, time savings, and reciprocity concerning physicians’ willingness to do teleconsultations. Responses from physicians revealed association between intention of use and the expected performance of home teleconsultations. The major barrier to intention of use expressed in physician’s answers were doubts concerning the quality of patient examination. The major drivers were time savings, productivity increases, improvements in patient’s health and patient management, NHS costs reduction and reciprocity relatively to patient’s willingness to engage in teleconsultations.

Conclusions:

In order to promote the use of home teleconsultations for DM, decision makers should: a) improve patients’ health literacy so that the physician-patient communication is more effective; b) explore ICT developments to reduce current virtual examination limitations; c) ensure patient privacy and data confidentiality; and d) demonstrate the capabilities of home teleconsultations to physicians.