PERCEIVED EFFECT OF TELEMEDICINE ON MEDICAL SERVICE DELIVERY BY FEDERAL MEDICAL CENTERS IN NORTH CENTRAL ZONE OF NIGERIA

The study investigated the perceived effect of telemedicine on medical service delivery by the Federal Medical Centers in North Central Nigeria. Six objectives guided the study. The study answered six research questions and tested two null hypotheses at 0.05 level of significance. The study adopted survey research design. The research was conducted in the North Central Zone of Nigeria. The population of the study was one thousand four hundred and seven (1407) medical staff (Doctors, Nurses, Laboratory Technologists and Pharmacists). The sample size was three hundred and eleven (311) respondents comprising 97 doctors, 178 nurses, 19 laboratory technologists and 17 pharmacists; this was determined using Taro Yamane formula. The instrument used for data collection was a structured questionnaire titled: Perceived Effect of Telemedicine Questionnaire (PETQ) developed by the researcher from literature reviewed. Three experts validated the instrument while split-half method was used to determine the internal consistency of the items and a reliability co-efficient of 0.76 was obtained, indicating that the instrument is reliable for the study. The instrument was administered by the researcher and four research assistants. Descriptive statistics of mean and standard deviation were used to answer the research questions while inferential statistics of Chi-square was used to test the null hypotheses at 0.05 level of significance. The findings revealed that nine (9) Telemedicine services are available to a high extent in the Federal Medical Centers in North Central Nigeria. The findings also revealed that Telemedicine exerts twelve (12) effects on medical service delivery, fourteen (14) challenges were discovered to be associated with the use of telemedicine, while eight (8) strategies were identified to mitigate the challenges of the use of telemedicine. It was also found that availability of telemedicine significantly affects medical service delivery in Federal Medical Centers in North Central Nigeria. Further analysis of data revealed that the degree of application of telemedicine exert significant effect on medical service delivery in Federal Medical Centers in North Central Nigeria. It was recommended that Federal Medical Centers should embark on drastic development of telemedicine in line with global trend in order to promote effective utilization of telemedicine services, stake holders should establish a basic understanding of what this medical technology can lead to as it will help policy makers enlighten the telemedicine debate by turning unique insights into more adequate approaches that will enrich and humanize mediated channels of health communication, thereby offering remedies and clarifications for effective health care exchange and delivery

PERCEIVED EFFECT OF TELEMEDICINE ON MEDICAL SERVICE DELIVERY BY FEDERAL MEDICAL CENTERS IN NORTH CENTRAL ZONE OF NIGERIA

The study investigated the perceived effect of telemedicine on medical service delivery by the Federal Medical Centers in North Central Nigeria. Six objectives guided the study. The study answered six research questions and tested two null hypotheses at 0.05 level of significance. The study adopted survey research design. The research was conducted in the North Central Zone of Nigeria. The population of the study was one thousand four hundred and seven (1407) medical staff (Doctors, Nurses, Laboratory Technologists and Pharmacists). The sample size was three hundred and eleven (311) respondents comprising 97 doctors, 178 nurses, 19 laboratory technologists and 17 pharmacists; this was determined using Taro Yamane formula. The instrument used for data collection was a structured questionnaire titled: Perceived Effect of Telemedicine Questionnaire (PETQ) developed by the researcher from literature reviewed. Three experts validated the instrument while split-half method was used to determine the internal consistency of the items and a reliability co-efficient of 0.76 was obtained, indicating that the instrument is reliable for the study. The instrument was administered by the researcher and four research assistants. Descriptive statistics of mean and standard deviation were used to answer the research questions while inferential statistics of Chi-square was used to test the null hypotheses at 0.05 level of significance. The findings revealed that nine (9) Telemedicine services are available to a high extent in the Federal Medical Centers in North Central Nigeria. The findings also revealed that Telemedicine exerts twelve (12) effects on medical service delivery, fourteen (14) challenges were discovered to be associated with the use of telemedicine, while eight (8) strategies were identified to mitigate the challenges of the use of telemedicine. It was also found that availability of telemedicine significantly affects medical service delivery in Federal Medical Centers in North Central Nigeria. Further analysis of data revealed that the degree of application of telemedicine exert significant effect on medical service delivery in Federal Medical Centers in North Central Nigeria. It was recommended that Federal Medical Centers should embark on drastic development of telemedicine in line with global trend in order to promote effective utilization of telemedicine services, stake holders should establish a basic understanding of what this medical technology can lead to as it will help policy makers enlighten the telemedicine debate by turning unique insights into more adequate approaches that will enrich and humanize mediated channels of health communication, thereby offering remedies and clarifications for effective health care exchange and delivery

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

Improving care quality with prison telemedicine: The effects of context and multiplicity on successful implementation and use

Background: Prison telemedicine can improve the access, cost and quality of healthcare for prisoners, however adoption in prison systems worldwide has been variable despite these demonstrable benefits. This study examines anticipated and realised benefits, barriers and enablers for prison telemedicine, thereby providing evidence to improve the chances of successful implementation. / Methods: A systematic search was conducted using a combination of medical subject headings and text word searches for prisons and telemedicine. Databases searched included: PubMed, Embase, CINAHL Plus, PsycINFO, Web of Science, Scopus and International Bibliography of the Social Sciences. Articles were included if they reported information regarding the use of/advocacy for telemedicine, for people residing within a secure correctional facility. A scoping summary and subsequent thematic qualitative analysis was undertaken on articles selected for inclusion in the review, to identify issues associated with successful implementation and use. / Results: One thousand, eight hundred and eighty-two non-duplicate articles were returned, 225 were identified for full text review. A total of 163 articles were included in the final literature set. Important considerations for prison telemedicine implementation include: differences between anticipated and realised benefits and barriers, differing wants and needs of prison and community healthcare providers, the importance of top-down and bottom-up support and consideration of logistical and clinical compatibility. / Conclusions: When implemented well, patients, prison and hospital staff are generally satisfied with telemedicine. Successful implementation requires careful consideration at outset of the partners to be engaged, the local context for implementation and the potential benefits that should be communicated to encourage participation

Economic issues associated with the operation and evaluation of telemedicine

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Telemedicine offers an alternative referral strategy for fetal cardiology but is currently only used for ‘high-risk’ pregnancies. A case-study of a cost-consequences analysis comparing telemedicine to direct referral to a perinatal cardiologist is initially presented, which highlights that for high risk women for whom telemedicine was considered no cardiac anomalies were missed using either referral method. In the light of a review of the literature on the economics of telemedicine, three of the key methodological issues (of selection bias, of patient costs and using quality-adjusted life years (QALYs)) are explored to demonstrate how the case study analysis could be improved. Pregnant women were selected for referral based on their characteristics and risk factors; thus the cost and effects for the two groups may have been biased. Various methods identified in the literature are applied to the case study to reduce selection bias, but the analysis presented is unable to determine which method is best, given a number of limitations including the small sample size. The analysis is extended to include estimated total patient costs. However, when patient costs are added to the total costs of pregnancy, they did not substantially increase the overall cost. The results presented provide a guideline for future researchers and pregnant women of the likely costs during pregnancy. Given that the majority of missed cardiac anomalies were amongst low risk women, a decision analytical model is developed looking at the lifetime costs and QALYs of introducing telemedicine screening for pregnant women whose unborn babies are at a low risk of congenital heart disease. The analysis shows that offering telemedicine to all low risk women is the dominant strategy. The thesis demonstrates, within the constraints of existing data, that it would be cost-effective to provide telemedicine as part of an antenatal screening programme for all low risk women, and this would help prevent future ‘missed anomalies’.Research and Development Division of the Department of Healt