JMIR Publications

ABSTRACT

Background:

Non-communicable diseases (NCDs) account for 71% of global deaths, with hypertension and diabetes as major contributors. The COVID-19 pandemic disrupted traditional healthcare services for NCDs, highlighting telehealth as a crucial alternative. Telehealth – defined as the use of electronic communication technologies to deliver healthcare remotely – can overcome geographic barriers and enhance patient engagement. However, telehealth usability among healthcare professionals (HCPs) remains understudied across low-, middle-, and high-income countries.

Objective:

This study examined which usage characteristics were most strongly associated with usability among HCPs, and compared telehealth usage patterns across Brazil (HMIC), Ghana (LMIC), Honduras (HMIC), and the United Kingdom (HIC).

Methods:

An international cross-sectional survey was conducted with 290 HCPs across four countries. Participants completed the System Usability Scale (SUS) and provided data on telehealth system use, training, and demographics. Descriptive statistics summarised participant characteristics, telehealth use, and usability scores. Multiple linear regression identified factors associated with telehealth usability. Given the non-probability design, no formal inferential comparisons were made between countries. Instead, observed patterns were reported descriptively.

Results:

Higher telehealth usability scores were associated with greater connection stability (95% CI = [3.28, 6.76]), higher satisfaction with support information (95% CI = [3.07, 7.05]), physicians by profession (95% CI = [0.23, 7.40]), more frequent use of telehealth (95% CI = [1.36, 4.73]), and longer duration of telehealth use (95% CI = [0.50, 2.69]). Average usability scores were highest among users in Ghana (M = 79.75) and the UK (M = 79.00), followed by Brazil (M = 72.01) and Honduras (M = 63.09). According to SUS guidelines, scores corresponded to ‘good’ usability for users in Ghana, the UK, and Brazil, and below the ‘good’ threshold for users in Honduras. Most telehealth users in Ghana (87.4%), Honduras (81.6%), and Brazil (71.3%) reported using only one telehealth system, compared 33.3% in the UK. Ghanaian HCPs were also more likely to have used telehealth before the pandemic (75.5%) than those in the UK (51.7%), Brazil (49.4%), or Honduras (18.4%). Other telehealth usage patterns across countries are reported.

Conclusions:

The study revealed differences in telehealth infrastructure and training between users from HICs, HMICs, and LMICs. Findings emphasize the need for targeted improvements in telehealth training and internet infrastructure to enhance usability. Comprehensive support and consistent telehealth use can further optimize usability. Tailored strategies addressing each country’s specific challenges are essential for effective telehealth integration and improved healthcare outcomes for NCD patients globally.