Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 22, 2023
Date Accepted: Feb 26, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Telehealth care through the internet hospital model in China: Physicians’ views on access, expectations, and communication
ABSTRACT
Background:
The internet hospital in China is an emerging medical service model similar to other telehealth models used worldwide. Internet hospitals are currently in a stage of rapid development, giving rise to a series of new opportunities and challenges for patient care. Little research has examined the views of chronic disease physicians regarding internet hospitals in China.
Objective:
We aimed to explore the experience and views of chronic disease physicians at three tertiary hospitals in Changsha, China, regarding opportunities and challenges in internet hospital care.
Methods:
We conducted semi-structured qualitative interviews with physicians (n=26) who had experience working in the internet hospitals affiliated with chronic disease departments in three tertiary hospitals in Changsha, Hunan province, south-central China. Interviews were transcribed verbatim and analyzed by content analysis using NVivo software (Version 11).
Results:
A consensus emerged among interviewed doctors that internet hospitals initiated by business enterprises are generally further developed than those initiated by physical hospitals. Physicians emphasized that internet hospitals expand opportunities to conduct follow-up care and health education for patients with chronic illness. However, physicians described disparities in access for particular groups of patients, such as older adult patients, patients with lower education levels, patients with limited internet or technology access, and rural patients. Physicians also perceived a gap between patients’ expectations and the reality of limitations regarding both physicians' availability and the scope of services offered by internet hospitals, which raised challenges for doctor-patient boundaries and trust. Physicians noted challenges in doctor-patient communication related to comprehension and informed consent in internet hospital care.
Conclusions:
The development of internet hospitals involves multiple industries, including medical institutions, national policymaking departments, and technology providers. Findings from this study highlight the need for physician training in telehealth communication skills, legislation regulating informed consent in telehealth care, public education clarifying the scope of internet hospital services, and design of internet hospitals that is informed by the needs of patient groups with barriers to access such as older adults.
Citation
