Telemedicine has many factors limiting its acceptance in developing countries like India

Telemedicine has been evolving over the last two decades; however, with the advent of the COVID 19 pandemic, its utility and acceptance have drastically increased. Most studies report increasing acceptability and satisfaction rates.

Sandeep Kumar et al conducted a study to assess patient preferences regarding telemedicine to in-person consultations and to attempt to assess the factors driving these preferences. The article has been published in Indian Journal of Orthopaedics.

A questionnaire-based cross-sectional study was conducted for patients who had both teleconsultation and in-person consultation in the orthopedic outpatient. The teleconsultations were done using a web RTC video conference using "Jitsi Meet". All consultations were conducted by six orthopedic faculty members and followed the national guidelines outlined by the appointed regulatory committee. After obtaining consent to participate in the study, the patients were divided into broad clinical categories and responses were recorded regarding the treatment of illness by the doctor and opinions regarding telemedicine.

The questionnaire was validated through the Delphi method. The questionnaire design was approved after mutual discussion and consensus among the orthopedic faculty and institutional review board members over a series of meetings. The mean agreement per question was 92.3%. Most questions were answered in Likert-based five-point objective responses (between 1: strong agreement and 5: strong disagreement) or a" yes/no" format. Prior to the implementation, the questionnaire was subjected to pilot testing on a group of 30 patients that met the inclusion crite ria. The internal consistency for closed ended questions was high, with a Cronbach's alpha of 0.82. Mean, median, percentage and proportions were used for statistical analysis of the data.

Key findings of the study were:

-The study group included 264 patients, with the majority with fractures and dislocations.-

The study group included 264 (54.7%) males and 218 (45.2%) females.

-The most common mode of transport was using a personal vehicle (60%, n= 290) or taxi (18.5%, n=89) to reach the hospital.

-The average time to reach the hospital was 1.84 h, and the median was 1 h.

-Most patients (55.7%) were comfortable using the software for teleconsultation, and half the respondents found telemedicine convenient.

-A large percentage of the study group preferred in-person consultation to teleconsultation (58.7%), and the primary reasons for discontinuing teleconsultation were dissatisfaction during the interaction with the doctor and poor connectivity to telecommunication networks.

The authors concluded that – "Telemedicine in an urban setting has high acceptance and satisfaction. Despite high satisfaction rates, there are multiple factors that are limiting its acceptance in developing countries including the availability and knowledge of the technology to be used. More studies identifying regional factors are required to address these drawbacks."

Further reading:

Patient Preferences Regarding Telemedicine to In person Consultation: A Questionnaire Based Survey

Sandeep Kumar, Arvind Kumar et al

Indian Journal of Orthopaedics (2022) 56:2202–2209

https://doi.org/10.1007/s43465-022-00750-0