The attitudes of multiprofessional teams to telehealth adoption in northern Finland health centres

A telehealth network was established between seven health centres, the local university and the university hospital in the Oulu Arc Subregion in a rural area of northern Finland. During the period 2004–2007, the videophone network was used for different types of teleconsultation (orthopaedics, psychiatry, diabetes, rehabilitation), continuing education and various patient care and administrative meetings. Qualitative research with observation and interviews with 30 professionals (physicians, nurses, psychiatric nurses, physiotherapists) was carried out in early 2007 to find out health-care professionals' attitudes toward telehealth and to see how the attitudes were connected to telehealth usage. Overall, the attitudes were more positive than negative, ranging from negative to enthusiastically positive. Diversity of attitudes occurred in relation to time, situation, profession, health centre and telehealth application. Ten different types of telehealth adopters were recognized: enthusiastic user, positive user, critical user, hesitant user, positive participant, hesitant participant, critical participant, neutral participant, negative participant and positive non-participant. Telehealth was especially well accepted in continuing education and in diabetes teleconsultations. The study showed that a negative attitude was not a definite barrier to telehealth adoption, but it did require additional attention from project workers and managers. Project staff and managers need to take into account the diverse attitudes of health professionals, because different people require different actions to adopt telehealth in their work.

[1]  R. Wootton,et al.  User satisfaction with realtime teleneurology , 1999, Journal of telemedicine and telecare.

[2]  R. Wootton,et al.  What constitutes success in telehealth? , 2001, Journal of telemedicine and telecare.

[3]  I. Aas Working with telemedicine: User characteristics and attitudes , 2000, Journal of telemedicine and telecare.

[4]  M. Patton Qualitative research and evaluation methods , 1980 .

[5]  T. Russo,et al.  Diffusion theory and telemedicine adoption by Kansas health-care providers: Critical factors in telemedicine adoption for improved patient access , 2005, Journal of telemedicine and telecare.

[6]  Paul Wallace,et al.  Understanding the normalization of telemedicine services through qualitative evaluation. , 2003, Journal of the American Medical Informatics Association : JAMIA.

[7]  Pamela Whitten,et al.  Providers' acceptance of telehospice. , 2005, Journal of palliative medicine.

[8]  P. Whitten,et al.  A scientific approach to the assessment of telemedicine acceptance , 2002, Journal of telemedicine and telecare.

[9]  P. Barton,et al.  Specialist physicians' knowledge and beliefs about telemedicine: a comparison of users and nonusers of the technology. , 2007, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[10]  Richard J Cohn,et al.  Health Professionals' Attitudes to Videoconferencing in Paediatric Health-Care , 2002 .

[11]  Stefan V. Pantazi,et al.  Success factors for telehealth - A case study , 2006, Int. J. Medical Informatics.

[12]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[13]  Hannele Kerosuo,et al.  Boundary crossing and learning in creation of new work practice , 2003 .

[14]  F. Larsen,et al.  Implementing telemedicine services in northern Norway: Barriers and facilitators , 2003, Journal of telemedicine and telecare.

[15]  T. Nesbitt,et al.  Development of a telemedicine program: a review of 1,000 videoconferencing consultations. , 2000, The Western journal of medicine.

[16]  C. May A rational model for assessing and evaluating complex interventions in health care , 2006, BMC Health Services Research.

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

[18]  M T Arredondo,et al.  User satisfaction with home telecare based on broadband communication , 2002, Journal of telemedicine and telecare.

[19]  Nabeel A. Y. Al-Qirim,et al.  Championing telemedicine adoption and utilization in healthcare organizations in New Zealand , 2007, Int. J. Medical Informatics.

[20]  Réjean Landry,et al.  Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success? , 2006, Implementation science : IS.

[21]  T. Nesbitt,et al.  Evolution of telepsychiatry to rural sites: changes over time in types of referral and in primary care providers' knowledge, skills and satisfaction. , 2006, General hospital psychiatry.

[22]  N. Al-Qirim,et al.  Teledermatology: the case of adoption and diffusion of telemedicine health Waikato in New Zealand. , 2003, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[23]  M. Allen,et al.  Videoconferencing for Continuing Medical Education: From Pilot Project to Sustained Programme , 2002, Journal of telemedicine and telecare.

[24]  G. Doolittle,et al.  Defining the needs of a telemedicine service , 2006, Journal of telemedicine and telecare.

[25]  Denise Polit-O'Hara,et al.  Nursing Research: Principles and Methods , 1978 .

[26]  Richard Wootton,et al.  Realtime telemedicine. , 2006, Journal of telemedicine and telecare.

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

[28]  Patrick Y. K. Chau,et al.  Physician acceptance of telemedicine technology: an empirical investigation. , 1999, Topics in health information management.

[29]  P. Whitten,et al.  Addressing telehealth's foremost barrier: Provider as initial gatekeeper , 2005, International Journal of Technology Assessment in Health Care.

[30]  Pamela Whitten,et al.  Success and failure: a case study of two rural telemedicine projects , 2003, Journal of telemedicine and telecare.

[31]  Donald M Hilty,et al.  Rural versus suburban primary care needs, utilization, and satisfaction with telepsychiatric consultation. , 2007, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.