Moderating effect of gender on adoption of digital health consultation: a patient perspective study

Facilitators and Barriers for Telemedicine Systems in India from Multiple Stakeholder Perspectives and Settings: A Systematic Review

Background: Telemedicine is viewed as a crucial tool for addressing the challenges of limited medical resources at health care facilities. However, its adoption in health care is not entirely realized due to perceived barriers. This systematic review outlines the critical facilitators and barriers that influence the implementation of telemedicine in the Indian health care system, observed at the infrastructural, sociocultural, regulatory, and financial levels, from the perspectives of health care providers, patients, patient caregivers, society, health organizations, and the government. Methods: This review complies with the current Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015. A total of 2,706 peer-reviewed studies published from December 2016 to September 2023 in the PubMed, Cochrane, Scopus, Web of Science, CINAHL, MEDLINE, and PsycInfo databases were considered for the title and abstract screening, after which 334 articles were chosen for the full-text review. In the end, 46 studies were selected for data synthesis. Results: Analysis of the literature revealed key barriers such as data privacy and security concerns, doctor and patient resistance to information and communications technology (ICT), infrastructure issues, and ICT training gaps. Facilitators included reduced health care delivery costs, enhanced patient access to health care in remote areas, and shorter patient wait times. The real-world experiences of Indian telemedicine practitioners and pioneers are also explored to complement literature-based perspectives on telemedicine implementation. Both stress the need for reliable internet connectivity, technological adoption, comprehensive ICT training, positive sociocultural attitudes, stringent data privacy measures, and viable business models as crucial for effective telemedicine adoption, with experts emphasizing practical adaptability alongside the literature-recognized facilitators.

Digital health care services in post COVID-19 scenario: modeling the enabling factors

Purpose

The recent pandemic of COVID-19 has posed challenges for delivering essential and desirable health-care services for the masses. Digital health-care services initiated by several hospitals and health practitioners promise efficient and safe health care in the new normal post-COVID era but need a supportive enabling ecosystem. Therefore, this study aims toward identifying and modeling the key enabling factors for digital health-care services.

Design/methodology/approach

A total of nine factors were identified from the literature review and verified by the domain experts which can enable the wider acceptance of digital health-care services. The identified factors were then modeled with the help of the total interpretive structural modeling (TISM) approach and fuzzy Matrices d’Impacts Croises Multiplication Appliquée à un Classement (MICMAC) and a meaningful contextual relationship were developed for the factors.

Findings

This study reflects that the trust of patients is required for the acceptance of digital health care. Quality of patient care and affordability cum accessibility of online services will define mass engagement. Hospital staff resilience, hospital care service capacity, strategic partnerships and collaborations supported by technology and regulatory structure are the major factors defining the enabling ecosystem.

Originality/value

This study has its uniqueness in the way the TISM approach and fuzzy MICMAC are used for modeling the enabling factors toward growth and acceptance of digital health-care services in the days to come in developing nations. The focus of this study can be considered as relevant for the study interested in investigating the role of cognitive dimensions in influencing actors’ behaviors and decisions.