Development and validation of a new tool to identify factors that influence users' motivation toward the use of teleconsultation systems: A modified Delphi study

Empirical Evidence of Internal and External Factors Influencing Users' Motivation Toward Teleconsultation Use

Introduction: The use of teleconsultation systems has increased in recent years, which has improved patients' access to health care providers and enabled seamless interaction between them. The literature points out several factors that either facilitate or impede the use of teleconsultation. However, there is a lack of studies that provide empirical evidence of factors that influence consumers' motivation toward the use of teleconsultation systems. Aim and Objective: This study aimed to provide empirical evidence of the internal and external factors that influence consumers' motivation toward the use of teleconsultation systems. Methods: A cross-sectional survey was used to collect data from consumers who used a real-time teleconsultation system called the Sehha application in Saudi Arabia between March 13 and June 14, 2021. SPSS 27.0.1 was used for descriptive analysis. Results: Four hundred eighty-five participants completed the survey, 471 of whom were included in the analysis. The findings confirmed that internal and external factors exert an influence on consumers' motivation toward the use of teleconsultation systems. The findings indicated that the presence of factors such as saving time, saving cost, accessibility to health care, ease-of-use, reliable internet access, availability of devices, and appropriate places during the online connection would increase consumers' motivation toward teleconsultation systems use. Also, the findings indicated that users' familiarity with systems similar to teleconsultation systems, users' perception of teleconsultation convenience, the influence of others on users' decision to use teleconsultation, and user's skills and confidence in using teleconsultation easily, and their trust in the teleconsultation system would also increase their motivation to use it. Furthermore, the findings showed that demographic factors, including age, gender, level of education, and employment status, did not influence users' motivation toward the use of teleconsultation Conclusions: This study provided empirical evidence of a variety of internal and external factors that exert an influence on consumers' motivation toward the use of teleconsultation systems.

Selection of criteria for a telemedicine framework for designing, implementing, monitoring and evaluating telemedicine interventions: Validation using a modified Delphi process

Objectives

The call to scale up telemedicine services globally as part of the digital health transformation lacks an agreed-upon set of constructs to guide the implementation process. A lack of guidance hinders the development, consolidation, sustainability and optimisation of telemedicine services. The study aims to reach consensus among telemedicine experts on a set of implementation constructs to be developed into an evidence-based support tool.

Methods

A modified Delphi study was conducted to evaluate a set of evidence-informed telemedicine implementation constructs comprising cores, domains and items. The study evaluated the constructs consisting of five cores: Assessment of the Current Situation, Development of a Telemedicine Strategy, Development of Organisational Changes, Development of a Telemedicine Service, and Monitoring, Evaluation and Optimisation of Telemedicine Implementation; seven domains: Individual Readiness, Organisational Readiness, Clinical, Economic, Technological and Infrastructure, Regulation, and Monitoring, Evaluation and Optimisation; divided into 53 items. Global telemedicine specialists (n = 247) were invited to participate and evaluate 58 questions. Consensus was set at ≥70%.

Results

Forty-five experts completed the survey. Consensus was reached on 78% of the constructs evaluated. Regarding the core constructs, Monitoring, Evaluation and Optimisation of Telemedicine Implementation was determined to be the most important one, and Development of a Telemedicine Strategy the least. As for the domains, the Clinical one had the highest level of consensus, and the Economic one had the lowest.

Conclusions

This research advances the field of telemedicine, providing expert consensus on a set of implementation constructs. The findings also highlight considerable divergence in expert opinion on the constructs of reimbursement and incentive mechanisms, resistance to change, and telemedicine champions. The lack of agreement on these constructs warrants attention and may partly explain the barriers that telemedicine services continue to face in the implementation process.

An empirical study on factors influencing consumers' motivation towards teleconsultation system use. A preliminary report about the Sehha application from Saudi Arabia

BACKGROUND

The use of the teleconsultation system has increased in recent years, which enabled healthcare providers and patients to share, communicate and transfer information in real-time via different types of telemedicine services and applications. However, there is a lack of studies that underpin factors that motivate patients to use teleconsultation systems.

AIM AND OBJECTIVE

This study aimed to identify factors that influence consumers' motivation to use teleconsultation systems by developing a theoretical framework and empirically testing the developed framework with a real-world teleconsultation system.

METHODS

A cross-sectional study was used for this research to empirically validate the proposed model. The online survey consisted of 51 items, which were developed by the researchers. Partial least squares structural equation modelling (PLS-SEM) was used to analyze the measurement model and structural model.

RESULTS

485 participants completed the online survey, 471 of which were included in the model analysis. The measurement analysis indicated that convergent validity was achieved as all items' outer lording were well above the threshold of 0.70, all indicators reliability and AVEs were well above the threshold of 0.50. Also, the measurement analysis indicated that discriminate validity was achieved as the Heterotrait-Monotrait ratio of correlations for all constructs were below the threshold of 0.90. In the structural model analysis, the inner constructs of the model, autonomy, competence and relatedness explained 60.1% of the variance in users' motivation toward the use of the teleconsultation system. The outer constructs of the model, subjective norm, external and internal facilitating conditions, explained 67.3% of the variance in users' autonomy, whereas attitude, performance expectancy, external and internal facilitating conditions explained 51.9% of the variance in the users' competence, and subjective norm explained 25.6% of the variance in the users' relatedness.

CONCLUSIONS

The developed framework can explain why consumers are motivated to use teleconsultation systems for online medical consultations. The model indicated that a variety of internal and external factors can positively or negatively influence consumers' perceived autonomy, competence and relatedness, which can impact their motivation toward the use of teleconsultation systems.