Almathami Hassan Khader Y, Win Khin Than, Vlahu-Gjorgievska Elena
Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.
College of Computers and Information Systems, Umm Al-Qura University, Makkah, Saudi Arabia.
J Med Internet Res. 2020 Feb 20;22(2):e16407. doi: 10.2196/16407.
Health care providers are adopting information and communication technologies (ICTs) to enhance their services. Telemedicine is one of the services that rely heavily on ICTs to enable remote patients to communicate with health care professionals; in this case, the patient communicates with the health care professional for a follow-up or for a consultation about his or her health condition. This communication process is referred to as an e-consultation. In this paper, telemedicine services refer to health care services that use ICTs, which enable patients to share, transfer, and communicate data or information in real time (ie, synchronous) from their home with a care provider-normally a physician-at a clinical site. However, the use of e-consultation services can be positively or negatively influenced by external or internal factors. External factors refer to the environment surrounding the system as well as the system itself, while internal factors refer to user behavior and motivation.
This review aims to investigate the barriers and the facilitators that influence the use of home consultation systems in the health care context. This review also aims to identify the effectiveness of Home Online Health Consultation (HOHC) systems in improving patients' health as well as their satisfaction with the systems.
We conducted a systematic literature review to search for articles-empirical studies-about online health consultation in four digital libraries: Scopus, Association for Computing Machinery, PubMed, and Web of Science. The database search yielded 2518 articles; after applying the inclusion and exclusion criteria, the number of included articles for the final review was 45. A qualitative content analysis was performed to identify barriers and facilitators to HOHC systems, their effectiveness, and patients' satisfaction with them.
The systematic literature review identified several external and internal facilitators and barriers to HOHC systems that were used in the creation of a HOHC framework. The framework consists of four requirements; the framework also consists of 17 facilitators and eight barriers, which were further categorized as internal and external influencers on HOHC.
Patients from different age groups and with different health conditions benefited from remote health services. HOHC via video conferencing was effective in delivering online treatment and was well-accepted by patients, as it simulated in-person, face-to-face consultation. Acceptance by patients increased as a result of online consultation facilitators that promoted effective and convenient remote treatment. However, some patients preferred face-to-face consultation and showed resistance to online consultation. Resistance to online consultation was influenced by some of the identified barriers. Overall, the framework identified the facilitators and barriers that positively and negatively influenced the uptake of HOHC systems, respectively.
医疗服务提供者正在采用信息通信技术（ICTs）来提升其服务。远程医疗是严重依赖信息通信技术的服务之一，它能使远程患者与医疗专业人员进行沟通；在这种情况下，患者与医疗专业人员进行随访或就其健康状况进行咨询。这种沟通流程被称为电子咨询。在本文中，远程医疗服务指的是使用信息通信技术的医疗服务，这些技术使患者能够在家中与临床场所的医疗服务提供者（通常是医生）实时（即同步）共享、传输和交流数据或信息。然而，电子咨询服务的使用可能受到外部或内部因素的积极或消极影响。外部因素指的是系统所处的环境以及系统本身，而内部因素指的是用户行为和动机。
本综述旨在调查在医疗保健背景下影响家庭咨询系统使用的障碍和促进因素。本综述还旨在确定家庭在线健康咨询（HOHC）系统在改善患者健康状况以及患者对该系统满意度方面的有效性。
我们进行了一项系统的文献综述，以在四个数字图书馆（Scopus、美国计算机协会、PubMed和科学引文索引）中搜索关于在线健康咨询的实证研究文章。数据库搜索共得到2518篇文章；在应用纳入和排除标准后，最终纳入综述的文章数量为45篇。进行了定性内容分析，以确定HOHC系统的障碍和促进因素、其有效性以及患者对它们的满意度。
系统的文献综述确定了HOHC系统的几个外部和内部促进因素及障碍，这些因素被用于构建一个HOHC框架。该框架由四个要求组成；该框架还包括17个促进因素和8个障碍，它们被进一步归类为对HOHC的内部和外部影响因素。
不同年龄组和不同健康状况的患者都从远程健康服务中受益。通过视频会议进行的HOHC在提供在线治疗方面是有效的，并且受到患者的广泛接受，因为它模拟了面对面的现场咨询。由于促进有效和便捷远程治疗的在线咨询促进因素，患者的接受度有所提高。然而，一些患者更喜欢面对面咨询，并对在线咨询表现出抵触情绪。对在线咨询的抵触受到一些已确定障碍的影响。总体而言，该框架确定了分别对HOHC系统的采用产生积极和消极影响的促进因素和障碍。
