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调查患者继续使用远程会诊以预测危机后发展势头的意愿:调查研究

Investigating Patients' Intention to Continue Using Teleconsultation to Anticipate Postcrisis Momentum: Survey Study.

作者信息

Grenier Ouimet Antoine, Wagner Gerit, Raymond Louis, Pare Guy

机构信息

Research Chair in Digital Health, HEC Montreal, Montreal, QC, Canada.

Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.

出版信息

J Med Internet Res. 2020 Nov 26;22(11):e22081. doi: 10.2196/22081.

Abstract

BACKGROUND

The COVID-19 crisis has drastically changed care delivery with teleconsultation platforms experiencing substantial spikes in demand, helping patients and care providers avoid infections and maintain health care services. Beyond the current pandemic, teleconsultation is considered a significant opportunity to address persistent health system challenges, including accessibility, continuity, and cost of care, while ensuring quality.

OBJECTIVE

This study aims at identifying the determinants of patients' intention to continue using a teleconsultation platform. It extends prior research on information technology use continuance intention and teleconsultation services.

METHODS

Data was collected in November 2018 and May 2019 with Canadian patients who had access to a teleconsultation platform. Measures included patients' intention to continue their use; teleconsultation usefulness; teleconsultation quality; patients' trust toward the digital platform, its provider. and health care professionals; and confirmation of patients' expectations toward teleconsultation. We used structural equation modeling employing the partial least squares component-based technique to test our research model and hypotheses.

RESULTS

We analyzed a sample of 178 participants who had used teleconsultation services. Our findings revealed that confirmation of expectations had the greatest influence on continuance intention (total effects=0.722; P<.001), followed by usefulness (total effects=0.587; P<.001) and quality (total effects=0.511; P<.001). Usefulness (β=.60; P<.001) and quality (β=.34; P=.01) had direct effects on the dependent variable. The confirmation of expectations had direct effects both on usefulness (β=.56; P<.001) and quality (β=.75; P<.001) in addition to having an indirect effect on usefulness (indirect effects=0.282; P<.001). Last, quality directly influenced usefulness (β=.34; P=.002) and trust (β=.88; P<.001). Trust does not play a role in the context under study.

CONCLUSIONS

Teleconsultation is central to care going forward, and it represents a significant lever for an improved, digital delivery of health care in the future. We believe that our findings will help drive long-term teleconsultation adoption and use, including in the aftermath of the current COVID-19 crisis, so that general care improvement and greater preparedness for exceptional situations can be achieved.

摘要

背景

新冠疫情危机极大地改变了医疗服务的提供方式,远程会诊平台的需求大幅飙升,帮助患者和医护人员避免感染并维持医疗服务。除了当前的疫情,远程会诊被视为解决医疗系统长期挑战的重要契机,这些挑战包括医疗服务的可及性、连续性和成本,同时确保医疗质量。

目的

本研究旨在确定患者继续使用远程会诊平台意愿的决定因素。它扩展了先前关于信息技术使用持续意愿和远程会诊服务的研究。

方法

于2018年11月和2019年5月收集了可使用远程会诊平台的加拿大患者的数据。测量指标包括患者继续使用的意愿;远程会诊的有用性;远程会诊的质量;患者对数字平台、其提供商和医护人员的信任;以及患者对远程会诊期望的确认。我们使用基于偏最小二乘组件技术的结构方程模型来检验我们的研究模型和假设。

结果

我们分析了178名使用过远程会诊服务的参与者样本。我们的研究结果显示,期望确认对持续意愿的影响最大(总效应=0.722;P<0.001),其次是有用性(总效应=0.587;P<0.001)和质量(总效应=0.511;P<0.001)。有用性(β=0.60;P<0.001)和质量(β=0.34;P=0.01)对因变量有直接影响。期望确认除了对有用性有间接影响(间接效应=0.282;P<0.001)外,对有用性(β=0.56;P<0.001)和质量(β=0.75;P<0.001)也有直接影响。最后,质量直接影响有用性(β=0.34;P=0.002)和信任(β=0.88;P<0.001)。在本研究背景下,信任不起作用。

结论

远程会诊对未来的医疗服务至关重要,它是未来改善数字化医疗服务的重要杠杆。我们相信,我们的研究结果将有助于推动远程会诊的长期采用和使用,包括在当前新冠疫情危机之后,从而实现整体医疗服务的改善和对特殊情况的更好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0136/7695543/6cf25a800715/jmir_v22i11e22081_fig1.jpg

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