Utilization of Telemedicine by the Lebanese Physicians During Time of Pandemic

Teleconsultation Platforms Versus WhatsApp Consultations: Evaluating Patients and Physicians' Attitudes

Background: Since the 1990s, society has witnessed a surge in information and communication technologies that extended to the health care system. Teleconsultation platforms have become widely established tools that provide an opportunity for emerging countries such as Lebanon to expand and advance health care services. However, their use in Lebanon remains limited considering many people's preference to resort to nonmedical platforms such as WhatsApp for consultations. Methods: The purpose of this mixed-method study is to evaluate patients' and physicians' attitudes toward teleconsultation platforms versus WhatsApp consultations in Lebanon. In the quantitative component, 1,467 patients were administered a self-developed questionnaire, while in the qualitative component, a semistructured interview was conducted with 14 physicians practicing in Lebanon. Results: Results revealed that teleconsultation platforms and WhatsApp are not interchangeable. Patients' and physicians' experiences, perceptions, and satisfaction with teleconsultation platforms and WhatsApp are discussed. Conclusions: Individual and governmental recommendations for safer, more controlled, and more ethical online consultation practices are provided for both physicians and patients, through both modalities.

Utilization of telehealth services in low- and middle-income countries amid the COVID-19 pandemic: a narrative summary

BACKGROUND

During the current period of the pandemic, telehealth has been a boon to the healthcare system by providing quality healthcare services at a safe social distance. However, there has been slow progress in telehealth services in low- and middle-income countries with little to no evidence of the cost and effectiveness of such programmes.

OBJECTIVE

To provide an overview of the expansion of telehealth in low- and middle-income countries amid the COVID-19 pandemic and identify the challenges, benefits, and costs associated with implementing telehealth services in these countries.

METHODS

We performed a literature review using the search term: '*country name* AND ((telemedicine[Title][Abstract]) OR (telehealth[Title][Abstract] OR eHealth[Title][Abstract] OR mHealth[Title][Abstract]))'. Initially, we started with 467 articles, which were reduced to 140 after filtering out duplicates and including only primary research studies. Next, these articles were screened based on established inclusion criteria and 44 articles were finalised to be used in the review.

RESULTS

We found telehealth-specific software being used as the most common tool to provide such services. Nine articles reported patient satisfaction of greater than 90% with telehealth services. Moreover, the articles identified the ability to make a correct diagnosis to resolve the condition, efficient mobilisation of healthcare resources, increased accessibility for patients, increased service utilisation, and increased satisfaction as benefits of telehealth services, whereas inaccessibility, low technological literacy, and lack of support, poor security standards and technological concerns, loss of interest by the patients, and income impacts on physicians as challenges. The review could not find articles that explored the financial information on telehealth programme implementation.

CONCLUSION

Although telehealth services are growing in popularity, the research gap on the efficacy of telehealth is high in low- and middle-income countries. To better guide the future development of telehealth services, rigorous economic evaluation of telehealth is needed.

Perception and Attitude of Lebanese IBD Patients During the COVID-19 Pandemic

Objective

The emergence of the COVID pandemic affected daily living and healthcare access of IBD patients, due to delays of elective procedures and in-hospital treatments. Our aim is to determine the repercussions of the pandemic on the daily habits of IBD patients and on their compliance to follow-up and treatment.

Methods

This was a cross-sectional observational study. A questionnaire was administered in between 2020 and 2022 to IBD patients in a tertiary center in Lebanon. The outcomes measured were patient perceptions regarding COVID and how it affected their treatment.

Results

A total of 201 answers were included in the analysis with male predominance. Two-thirds had Crohn's disease. Near 80% were afraid of being infected by COVID-19 and 87.6% were afraid of physical contact. 91.5% reduced their daily habits and 96.0% have used personal protective equipment. 47.3% of the patients report that there are factors that reduced their worries, the most common factor being contacting their physician (61.0%). The main source of information was the treating physician (37.8%). A quarter of patients think that their condition predisposed to COVID-19 infection and about two-thirds believe that immunosuppressive therapy did so. The same amount reported concern regarding visiting the hospital. 27.4% preferred telemedicine and 44.8% preferred over-The-phone consultation to an in-person visit. Three-quarters were in favor of vaccination. 59.6% delayed their in-center treatment, which was associated with a reduction in daily life activities. 13.9% wanted to discontinue their treatment, which was associated with smoking, cardiovascular, and rheumatological comorbidities, but only 4% did so.

Conclusion

The pandemic had significant repercussions on the everyday life of IBD patients, with some preferring to consult via telemedicine and others considering stopping their treatment.

How Physicians in a Moroccan Tertiary Care Center Perceive Teleconsultation During COVID-19 Pandemic?

Background: Recent technological advances have paved the way for a new modality of medical practice known as teleconsultation. Positive perceptions about the benefits of teleconsultation and its acceptance by clinicians are key predictors of its uptake. The aim of this study was to assess knowledge, perceptions, and acceptability of teleconsultation among Moroccan physicians. Methods: This is a descriptive cross-sectional study conducted at the Cheikh Khalifa International University Hospital (HCK) of Casablanca, Morocco. Study participants answered an anonymous self-administered questionnaire designed based on similar studies. The questionnaire contained four sections related to demographic characteristics, knowledge about telemedicine and teleconsultation, perceptions about teleconsultation, and its acceptability by the study participants. Results: Of 486 eligible participants, a total of 212 completed the questionnaire. Approximately 96.7% had prior knowledge of teleconsultation. Most participants identified internet access (95.3%), data security (93.4%), and confidentiality (92.9%) as the main facilitators to the use of teleconsultation. The main barriers to the use of teleconsultation were internet access issues (98.6%), poor audio quality (96.2%), poor video quality (94.3%), and difficulty encountered by patients in expressing themselves and communicating with their physician (79.7%). The majority of participants (91.5%) believed that teleconsultation will be an integral part of future medical practice and about 70.8% thought that they would be able to allot time to teleconsultation in their current schedules. Conclusions: The findings of this study should be used by policy makers to remove barriers and promote enablers of teleconsultation use by physicians to bring health care closer to the Moroccan population.

Teleconsultations Quality During the COVID-19 Pandemic in Poland in the Opinions of Generation Z Adults

Introduction: The aim of the study was to collect and evaluate the opinions of representatives of Generation Z on their satisfaction with medical teleconsultation services during the COVID-19 pandemic in Poland. Methods: An online survey was conducted from April to June 2021. We received replies from 424 students. The research tools used comprised a validated Doctor-Patient Communication (DPC) questionnaire, the Telehealth Satisfaction Scale (TeSS), and a self-authored questionnaire. Results: About 60% of the respondents rated communication with a doctor during the remote visit as medium, with a DPC score value in the intermediate range (36-50). Only 7.5% of students rated DPC as high (DPC score over 50). Also, satisfaction with telemedicine measured by the modified Telehealth Satisfaction Scale was assessed as intermediate by 61.3% of respondents. DPC and satisfaction with telemedicine services are better assessed by students living in large cities and those who used paid telemedicine services. Conclusions: The need to improve the quality of DPC has been observed. Also, the functioning of telemedicine platforms, with the possibility of using images in teleconsultations would be welcome, with the concomitant leveling out of the disproportions in the quality of telemedicine services and DPC between urban and rural areas, as well as between commercial and noncommercial services. This could improve the service delivery process and, consequently, be beneficial for the competitiveness of telemedicine, which will be based on medical rather than organizational aspects.

Telemedicine use during COVID-19 pandemics and associated factors among health professionals working in health facilities at resource-limited setting 2021

Background

Digitizing healthcare has been a potential solution for transforming healthcare service delivery in the era of COVID-19 pandemics. To limit and minimize the virus spread, telemedicine helps control and prevent the pandemic by delivering healthcare services over long distances using Information communication technology. The objective of the study was to determine the level of telemedicine utilization among health professionals in the era of the COVID-19 Pandemic and the factors associated with it.

Methods

An institutional-based cross-sectional study design was used to collect data from 845 healthcare professionals. A pilot study was conducted on 5% of the study participants before the actual data collection process. After completion, changes were made based on the pilot study results, and a Cronbach alpha value of 0.76 was obtained. Descriptive and binary logistic regression models were used. Variables with a P-Value of less than or equal to 0.2 from the bivariable analysis were entered into the multivariable analysis. The odds ratio, 95% confidence interval, and p-value less than 0.05 were used to interpret a significant association, Hosmer-Lemeshow goodness-of-fit test, and the multicollinearity test were used to assess the assumptions.

Result

64.2% of the respondents had good use of telemedicine during COVID-19 with a response rate of 87.2%. 507 (62.8%) were male, and 525(71.2%) reported by nearly threefold (AOR = 2.96, % CI: [1.54-5.76]), IT support staff in the health facility (AOR = 8.32, 95 %CI: [4.77-14.52]), ICT training (AOR = 4.15, % CI: [2.13-8.02]), the frequency of searching health information (AOR = 6.19, % CI: [2.12-18.07]), and social media used (AOR = 3.46, % CI: [1.43-8.32]) were found significantly associated with health professionals' use of telemedicine.

Conclusion

The majority of healthcare providers practice telemedicine to control and prevent the spread of the COVID-19 virus. However, the availability of the internet, the presence of IT support staff, ICT training, the frequency of searching for health information, and the use of social media were significantly associated with the level of telemedicine utilization. Initiatives for full implementation of telemedicine in the health facility and motivating the health professionals are needed to carry out their medical practice by providing training and improving internet access in health facilities.