Understanding Dynamic Collaboration in Teleconsultation

Information and communication technology (ICT) has been widely deployed in the provision of health care for decades. Teleconsultation, one of these new telemedicine solutions, has been prevalently implemented in numerous countries with its tremendous potential to improve healthcare. However, the clinical utility has remained at a disappointing level. Unlike prior research that focuses on the pre-adoption or implementation stages, our research explores not only the understanding the antecedences of actual usage in post-adoption of teleconsultation service, but also the reasons for low actual usage in clinical practice. We identify specific theoretical attributes that are relevant to our research question, and extend TOE into an integrative theoretical framework. Initial propositions are generated based on theoretical perspectives in each dimension of the framework. Finally, we design a comparative case study as our research methodology, and conduct deductive analysis to test our propositions using data from multiple sources. Theoretical and practical implications, as well as future research, are outlined

Creating a Better World with Information and Communication Technologies: Health Equity

When news broke on 23rd July 2014, that a case of the deadly virus Ebola had been confirmed in Lagos, home to about 21 million people and a major transportation hub, the World held its breath. If not contained, this virus could spread quickly killing a multitude of people around the World. By 15th October, cases of Ebola had been recorded around the World: Liberia reported 4249 cases with 2458 deaths, Sierra Leone reported 3252 cases with 1183 deaths, Guinea 1472 cases with 843 deaths, Nigeria reported 20 cases with 8 deaths, the USA reported 3 cases and 1 death, Spain and Senegal reported 1 case with no deaths (Qureshi et al, 2015)

Designing Cost-Effective Telemedicine Camps for Underprivileged Individuals in Less Developed Countries: A Decomposed Affordance-Effectivity Framework

Free telemedicine camps (telecamps) are emergent joint initiatives of healthcare organizations, national and local governments, and not-for-profit nongovernmental organizations (NGOs) with the goal of alleviating the health divide for underprivileged individuals in rural areas of less developed countries. Our study seeks to understand the effectiveness of physician-patient communication at telecamps with several salient characteristics: rural underprivileged patients, physicians in remote cities, and frugal telemedicine technology—specifically, videoconferencing—deployed in Hospitals on Wheels and appropriated by operators. We adopt a multiple-actor perspective, propose a decomposed affordance-effectivity framework, and combine variance and process perspectives to examine the phenomenon of interest. We collaborated with Apollo Hospitals, a leading hospital system in India, and collected multisource data from two major telecamps in rural South India. Based on an analysis of survey data from 216 telecamp participants through a variance perspective, we found support for the fit of patient-perceived media richness with two contingency factors—(1) disease diagnostic complexity and (2) patient healthcare needs fulfillment—in influencing patient satisfaction with teleconsultation. Based on an analysis of 46 sessions of teleconsultation video archives through a process perspective, we found that technology appropriation is realized through verbal and nonverbal communication events between patients and physicians, with on-site operators playing multiple roles that serve as “compensatory user effectivity.” Our findings yield theoretical and practical implications for how effective telemedicine encounters using frugal technologies can be designed in combination with other cost-effective support personnel resources to broaden healthcare access for underprivileged individuals in less developed countries and, more broadly, to actualize technology affordances in use situations involving multiple actors

Telemedicine: An Augmentation Strategy to Mitigate the Primary Care Shortage

According to the Association of American Medical Colleges, the primary care workforce shortage in 2025 will exceed 46,000 primary care physicians. Healthcare business leaders in Gwinnett County, Georgia have not evaluated the advantages and disadvantages of telemedicine (TM) to mitigate the workforce shortage. The purpose of this qualitative descriptive study was to determine factors primary care physician administrators consider when deciding to implement TM as a potential solution for the growing physician shortage. A purposive sample of 20 primary care physician administrators located in Gwinnett County, Georgia was drawn. The theory of disruptive technology was the conceptual framework. Data collected stemmed from semistructured interviews with each participant and review of organizational plans and workflow documents. Data were recorded, transcribed, and coded to develop themes. Three themes morphed from the study: TM awareness and education, TM cost and reimbursement, and TM implementation and utilization. Results indicated that awareness and education of leaders toward TM requires improvement, costs, and reimbursement were variables for deciding to implement or not implement TM, and TM implementation requires knowing the appropriate use of TM. The implications for positive social change include the potential for primary care physician administrators to positively influence the healthcare workforce shortage by adding flexibility to manage patient workflow with TM. Additionally, the potential for physician administrators to utilize TM for healthcare access, creating savings in transportation, energy consumption, and resource optimization, may provide better access to hard-to-reach populations