Remote working: survey of attitudes to eHealth of doctors and nurses in rural general practices in the United Kingdom.

BACKGROUND Health professionals in rural primary care could gain more from eHealth initiatives than their urban counterparts, yet little is known about eHealth in geographically isolated areas of the UK. OBJECTIVE To elicit current use of, and attitudes towards eHealth of professionals in primary care in remote areas of Scotland. METHODS In 2002, a questionnaire was sent to all general practitioners (n=154) in Scotland's 82 inducement practices, and to 67 nurses. Outcome measures included reported experience of computer use; access to, and experience of eHealth and quality of that experience; views of the potential usefulness of eHealth and perceived barriers to the uptake of eHealth. RESULTS Response rate was 87%. Ninety-five percent of respondents had used either the Internet or email. The proportions of respondents who reported access to ISDN line, scanner, digital camera, and videoconferencing unit were 71%, 48%, 40% and 36%, respectively. Use of eHealth was lower among nurses than GPs. Aspects of experience that were rated positively were 'clinical usefulness', 'functioning of equipment' and 'ease of use of equipment' (76%, 74%, and 74%, respectively). The most important barriers were 'lack of suitable training' (55%), 'high cost of buying telemedicine equipment' (54%), and 'increase in GP/nurse workload' (43%). Professionals were concerned about the impact of tele-consulting on patient privacy and on the consultation itself. CONCLUSIONS Although primary healthcare professionals recognize the general benefits of eHealth, uptake is low. By acknowledging barriers to the uptake of eHealth in geographically isolated settings, broader policies on its implementation in primary care may be informed.

[1]  J. Mckinlay,et al.  Teledermatology in the Highlands of Scotland , 1996, Journal of telemedicine and telecare.

[2]  M Berg,et al.  The theory of use behind telemedicine: how compatible with physicians' clinical routines? , 2002, Social science & medicine.

[3]  B Stanberry,et al.  Telemedicine: barriers and opportunities in the 21st century , 2000, Journal of internal medicine.

[4]  R. Wootton,et al.  Evaluation of a Pilot Telemedicine Network for Accident and Emergency Work , 2002 .

[5]  R. Wootton,et al.  Telemedicine and isolated communities: A UK perspective , 1999, Journal of telemedicine and telecare.

[6]  R. Hodge,et al.  Introducing telemedicine technology to rural physicians and settings. , 2001, The Journal of family practice.

[7]  B. Sibbald,et al.  Telephone versus postal surveys of general practitioners: methodological considerations. , 1994, The British journal of general practice : the journal of the Royal College of General Practitioners.

[8]  Charles P. Friedman,et al.  Development and initial validation of an instrument to measure physicians' use of, knowledge about, and attitudes toward computers. , 1998, Journal of the American Medical Informatics Association : JAMIA.

[9]  M. Clarke,et al.  Increasing response rates to postal questionnaires: systematic review , 2002, BMJ : British Medical Journal.

[10]  Col White,et al.  Patterns of computer usage among medical practitioners in rural and remote Queensland. , 2002, The Australian journal of rural health.

[11]  Claudia Pagliari,et al.  Electronic Clinical Communications Implementation (ECCI) in Scotland: a mixed-methods programme evaluation. , 2004, Journal of evaluation in clinical practice.

[12]  F. Mair,et al.  Resisting and promoting new technologies in clinical practice: the case of telepsychiatry. , 2001, Social science & medicine.

[13]  R. Wootton,et al.  Recent advances: Telemedicine. , 2001, BMJ.

[14]  P Jacklin,et al.  Joint teleconsultations (virtual outreach) versus standard outpatient appointments for patients referred by their general practitioner for a specialist opinion: a randomised trial , 2002, The Lancet.

[15]  J. Dumville,et al.  A survey of computer use in Scottish primary care: general practitioners are no longer technophobic but other primary care staff need better computer access. , 2003, Informatics in primary care.