Call Vaughn R A, Erickson Lance D, Dailey Nancy K, Hicken Bret L, Rupper Randall, Yorgason Jeremy B, Bair Byron
1 Department of Sociology, Brigham Young University , Provo, Utah.
2 Veterans Rural Health Resource Center-Western Region , VHA Office of Rural Health, Salt Lake City, Utah.
Telemed J E Health. 2015 Aug;21(8):644-51. doi: 10.1089/tmj.2014.0125. Epub 2015 Apr 3.
The rate of telemedicine adoption using interactive video between patient and provider has not met expectations. Technology, regulations, and physician buy-in are cited reasons, but patient acceptance has not received much consideration. We examine attitudes regarding telemedicine to better understand the subjective definitions of its acceptability and utility that shape patients' willingness to use telemedicine.
Using the Montana Health Matters study (a random, statewide survey [n=3,512]), we use latent class analysis to identify groups with similar patterns of attitudes toward telemedicine followed by multinomial logistic regression to estimate predictors of group membership.
Although only 5% are amenable to telemedicine regardless of circumstance, 23% would be comfortable if it could be convenient, whereas 29% would be situationally amenable but uncomfortable using telemedicine. Still, a substantial percentage (43%) is unequivocally averse to telemedicine despite the inconvenience of in-person visits. Educational attainment, prior Internet use, and rural residence are main predictors that increase the likelihood of being in an amenable group.
From the patient's perspective, the advantages of reduced travel and convenience are recognized, but questions remain about the equivalence to physician visits. Many people are averse to telemedicine, indicating a perceived incompatibility with patient needs. Only 1.7% of the respondents reported using telemedicine in the previous year; about half were veterans. Hence, few have used telemedicine, and key innovation adoption criteria-trialability and observability-are low. Increased attention to public awareness in the adoption process is needed to increase willingness to embrace telemedicine as a convenient way to obtain quality healthcare services.
患者与医疗服务提供者之间通过交互式视频采用远程医疗的比例未达预期。技术、法规和医生的接受度是被提及的原因，但患者的接受度却未得到太多关注。我们研究了对远程医疗的态度，以更好地理解其可接受性和实用性的主观定义，这些定义塑造了患者使用远程医疗的意愿。
利用蒙大拿州健康事务研究（一项全州范围的随机调查[n = 3512]），我们使用潜在类别分析来识别对远程医疗态度模式相似的群体，随后进行多项逻辑回归以估计群体成员的预测因素。
尽管只有5%的人无论在何种情况下都愿意接受远程医疗，但如果方便的话，23%的人会感到舒适，而29%的人在某些情况下会接受但使用远程医疗时会感到不舒服。尽管面对面就诊不便，但仍有相当比例（43%）的人明确反对远程医疗。教育程度、以前使用互联网的情况和农村居住是增加成为接受群体可能性的主要预测因素。
从患者的角度来看，减少出行和便利性的优势是被认可的，但远程医疗与看医生是否等同仍存在疑问。许多人反对远程医疗，表明他们认为远程医疗与患者需求不兼容。只有1.7%的受访者报告在前一年使用过远程医疗；其中约一半是退伍军人。因此，很少有人使用过远程医疗，关键的创新采用标准——可试用性和可观察性——较低。在采用过程中需要更多地关注公众意识，以提高人们接受远程医疗作为获得优质医疗服务便捷方式的意愿。
