Alnasser Yossef, Bacha Tigist, Okereke James, Erum Sarah
Department of Pediatric, Bronxcare Health System, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Mhealth. 2025 Jun 13;11:27. doi: 10.21037/mhealth-24-86. eCollection 2025.
For telemedicine to be implemented and sustained in low- and middle-income countries (LMIC), it must be accessible, equitable, affordable, and compatible with current infrastructures. This study is to evaluate the views of pediatric healthcare practitioners in Ethiopia toward using an instant messaging app (Telegram) to conduct tele-consultations and asynchronous medical education.
The study adopted a qualitative method via in-person interviews or message exchange to get greater insights and deeper meanings of pediatric doctors in Ethiopia about the use of Telegram chat groups for teleconsultations and medical education. Coding and Thematic analysis were applied to identify common themes and data analysis.
The study attracted ten pediatric doctors for in-depth interviews and four text exchanges. All participants expressed positive attitudes toward telemedicine through simpler phone-based platforms. Telegram was the preferred application over WhatsApp and Zoom due to its compatibility with limited internet connections, multidimensional views of data, and an unlimited number of participants. Having a Telegram chat made it easy to get teleconsultation and improve pediatric knowledge. Pediatricians from non-academic institutions and rural areas viewed the chat group as a source of continuous medical education. A rural pediatrician stated, "" Residents found Telegram as a vital tool for their learning, with one resident stating, "" Lack of consultation culture, fear of being judged, and hierarchy limited the number of teleconsultations and participation in educational discussions. Internet availability, digital divide, lack of physical exam, and privacy concerns were the main barriers to using Telegram for teleconsultations. Having international experts to answer consultations was viewed as a challenge and an advantage at the same time. It is a challenge when the international expert does not understand the culture or local resources. It is an advantage as the expert can introduce new updates and innovative interventions. A pediatrician said, "".
Telegram is already used by pediatric providers in Ethiopia for telemedicine and medical education. This affordable intervention can improve access and ease the burden of consultations for all providers while meeting current infrastructure. It has potential to be scaled up and regulated to improve pediatric telemedicine in Ethiopia and many LMIC.
为了在低收入和中等收入国家（LMIC）实施并持续开展远程医疗，它必须是可及的、公平的、可负担的，并且与当前的基础设施兼容。本研究旨在评估埃塞俄比亚儿科医疗从业者对于使用即时通讯应用程序（Telegram）进行远程会诊和异步医学教育的看法。
该研究采用定性方法，通过面对面访谈或信息交流，以更深入了解埃塞俄比亚儿科医生对使用Telegram聊天群组进行远程会诊和医学教育的见解和深层含义。应用编码和主题分析来识别共同主题并进行数据分析。
该研究吸引了10名儿科医生进行深入访谈和4次文本交流。所有参与者都通过更简单的基于电话的平台对远程医疗表达了积极态度。由于Telegram与有限的互联网连接兼容、数据具有多维度视图且参与者数量无限制，因此它比WhatsApp和Zoom更受青睐。拥有Telegram聊天使得进行远程会诊和提高儿科知识变得容易。来自非学术机构和农村地区的儿科医生将聊天群组视为持续医学教育的来源。一位农村儿科医生表示：“住院医生发现Telegram是他们学习的重要工具”，还有一位住院医生称：“缺乏会诊文化、害怕被评判以及等级制度限制了远程会诊的次数和参与教育讨论的情况。互联网可用性、数字鸿沟、缺乏体格检查以及隐私问题是使用Telegram进行远程会诊的主要障碍。让国际专家回答会诊问题同时被视为一项挑战和一项优势。当国际专家不了解当地文化或资源时，这是一项挑战。而当专家能够引入新的进展和创新干预措施时，这又是一项优势。一位儿科医生说：“”
埃塞俄比亚的儿科医疗服务提供者已经在使用Telegram进行远程医疗和医学教育。这种经济实惠的干预措施可以改善所有医疗服务提供者的可及性并减轻会诊负担，同时符合当前的基础设施条件。它有扩大规模并进行规范以改善埃塞俄比亚及许多低收入和中等收入国家儿科远程医疗的潜力。
