Exploring the effects of telehealth on medical human resources supply: a qualitative case study in remote regions

BackgroundThe availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions.MethodsA case study in Eastern Quebec was performed to explore this complex phenomenon. The analytical framework was based on two literature reviews and a Delphi study. Data were collected from semi-structured interviews with 41 physicians and 22 managers. Transcripts were produced and interview content was coded independently by two judges and validated by an expert panel.ResultsInterviews have highlighted the potential impact of telehealth on several factors influencing the recruitment and retention of physicians in rural and remote regions. The potential effects of telehealth on physicians' choice of practice location could be seen at the professional, organizational, educational and individual levels. For instance, telehealth could improve work satisfaction by allowing a regional on-call duty system and a better follow-up of patients. However, there are also certain limits related to telehealth, such as the fear that it would eventually replace all continuing medical education activities and onsite specialists in remoteregions.ConclusionTelehealth is likely to have an impact on several factors related to medical workforce supply in remote and rural regions. However, the expected benefits will materialize if and only if this technology is properly integrated into organizations as a support to professional practice.

[1]  J. Morse The Significance of Saturation , 1995 .

[2]  Jean-Paul Fortin,et al.  Evaluation of a telemedicine demonstration project in the Magdalene Islands , 2003, Journal of telemedicine and telecare.

[3]  M. Cutchin Community and self: concepts for rural physician integration and retention. , 1997, Social science & medicine.

[4]  V. Curran,et al.  The role of medical education in the recruitment and retention of rural physicians , 2004, Medical teacher.

[5]  Thomas Hugh Feeley,et al.  Using the theory of reasoned action to model retention in rural primary care physicians. , 2003, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[6]  Matthew B. Miles,et al.  Qualitative Data Analysis: An Expanded Sourcebook , 1994 .

[7]  P Durant,et al.  Can a patient smart card improve decision making in a clinical setting?. , 1995, Medinfo. MEDINFO.

[8]  J. Rourke,et al.  Relationship between practice location of Ontario family physicians and their rural background or amount of rural medical education experience. , 2005, Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada.

[9]  J. Jones,et al.  Workforce retention in rural and remote Australia: determining the factors that influence length of practice , 2002, The Medical journal of Australia.

[10]  S. H. Davis,et al.  Selecting Ethnographic Informants. , 1992 .

[11]  O. Szafran,et al.  Location of family medicine graduates' practices. What factors influence Albertans' choices? , 2001, Canadian family physician Medecin de famille canadien.

[12]  B. Arnetz,et al.  Measuring psychosocial work quality and health: development of health care measures of measurement. , 1997, Journal of occupational health psychology.

[13]  G. Stoddart,et al.  Will increasing medical school enrollment solve Canada's physician supply problems? , 1999, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[14]  R. Yin Enhancing the quality of case studies in health services research. , 1999, Health services research.

[15]  O. Szafran,et al.  Location of family medicine graduates' practices , 2001 .

[16]  Marie J Béland,et al.  Implanting telehealth network for paediatric cardiology: learning from the Quebec experience , 2004, Cardiology in the Young.

[17]  Wendy Armstrong,et al.  Building on Values: The Future of Health Care in Canada , 2005 .

[18]  W. Levinson,et al.  When Most Doctors Are Women: What Lies Ahead? , 2004, Annals of Internal Medicine.

[19]  M. Gagnon,et al.  Telehealth to support practice in remote regions: a survey among medical residents. , 2005, Telemedicine journal and e-health.

[20]  Penny Jennett,et al.  The effect of information technology on the physician workforce and health care in isolated communities: The Canadian picture , 1999, Journal of telemedicine and telecare.

[21]  M. Matsumoto,et al.  Rural doctors' satisfaction in Japan: a nationwide survey. , 2004, The Australian journal of rural health.

[22]  Réjean Landry,et al.  Telehealth and the recruitment and retention of physicians in rural and remote regions: a Delphi study. , 2007, Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada.

[23]  Henriette Bilodeau,et al.  Recension des principaux facteurs d'attraction, d'installation et de maintien des médecins en régions éloignées. , 2003 .

[24]  N. Denzin,et al.  Handbook of Qualitative Research , 1994 .

[25]  Roy Romanow,et al.  Building on Values: Report of the Commission on the Future of Health Care in Canada [Reports] , 2002 .

[26]  J. Morse Designing funded qualitative research. , 1994 .