Psychological antecedents of telehealth acceptance: A technology readiness perspective

The trend of once-off versus follow-up Medicare-reimbursed psychiatric consultations and increased telehealth availability: an interrupted time series analysis

Objective The Australian Medicare Benefits Schedule (MBS) telehealth items were expanded in March 2020 and consolidated in January 2022. We aim to describe the trend of the ratio of MBS psychiatric video items for once-off assessments to follow-up sessions and examine the effect of telehealth consolidation. Methods Psychiatric once-off item to follow-up item ratios in face-to-face (F2F) and video modes were computed from state and territory-level monthly Medicare data (January 2016-December 2023). We performed a multilevel interrupted times series analysis (ITSA) of once-off video consultations with telehealth consolidation as the intervention, followed by subgroup analyses by age groups. Finally, in the young adult group (25-44years), we performed a multiple-group ITSA comparing video once-off to follow-up ratios between genders. Results The once-off to follow-up ratio for video items after telehealth consolidation greatly increased compared with F2F items, with rapid growth in once-off assessments. Sustained high video once-off assessment usage occurred in the youth (15-24years) and young adult (25-44years) groups, while other age groups showed declines following the initial rise. The male group showed a greater initial increase in the video once-off to follow-up ratio among young adults but the ratio continued to rise only in the female group. Conclusions The evolving trends of reimbursed telepsychiatry consultations require further examination given their potential implications concerning service quality, health equity, health attitudes and behaviours, and healthcare costs.

Telehealth perceptions and associated factors among older adults with chronic conditions in Saudi Arabia: a comparative study of users and non-users

Background

Telehealth is a promising approach for healthcare delivery that uses telecommunication technologies to enhance accessibility by providing remote health services. This study aimed to identify psychosocial factors that best predict behavioral intention to use telehealth/telemedicine, as mediated by attitude toward use, among older adults with chronic conditions in the Jazan region of Saudi Arabia, and to compare users and non-users.

Methods

Participants were aged 60 years or above, residing in Jazan, and presenting with at least one chronic condition. This study used a quantitative research approach with a cross-sectional questionnaire survey. We stratified all analyses by telehealth use status (users or non-users).

Results

Our study sample comprised 466 participants aged 60 or above with at least one chronic condition. The most prevalent condition was diabetes (29%), followed by arthritis (23%). Among the telehealth users (n = 256), a high percentage (42%) reported that telehealth was better than in-person appointments. Among telehealth users, we found that perceived usefulness [(users: β = 0.501; p < 0.001) (non-users: β = 0.441; p < 0.001)] and facilitating conditions [(users: β = 0.768; p = 0.001) (non-users: β = 0.807; p < 0.001)] positively affected attitudes to using telehealth. Telehealth users and non-users reported dislike or fear of the service and unavailability of appointments as the most important barriers to using telehealth services.

Conclusion

The results of this study are important for designing new telehealth applications, especially for older adults in Saudi Arabia. Designers and developers must understand that the attributes and capabilities of telehealth applications should be simple and user-friendly to encourage older adults to increase their intention to use telehealth.

Perceived Telehealth Usability for Personalized Healthcare Among the Adult Population in Saudi Arabia: A Cross-Sectional Study in the Post-COVID-19 Era

Background: Due to technological advancements, the demand for easily accessible and convenient healthcare services is rising globally. Thus, telehealth is gaining momentum that was previously unheard of. The Kingdom of Saudi Arabia (KSA) actively embraces digital innovation in the healthcare industry through its ambitious Vision 2030 initiative. This study aimed to assess the perceived usability of telehealth for personalized healthcare among the KSA adult population in the post-COVID-19 era. Methods: This cross-sectional study used a convenience sample of 975 adults from the general population in KSA. A digital survey was used for data collection through Survey Monkey software. It contained two sections: personal and health data and the Telehealth Usability Questionnaire (TUQ). The data was collected over three months (July-September 2024) and investigated using the multinomial logistic regression analysis. Results: This study showed that 59.8% of the participants have initiated telehealth service use before the COVID-19 pandemic, and the most frequently used services are the issuance of sick leave (30.6%), tele-prescription (29.0%), virtual consultation (20.0%), tele-mental health services (19.4%), telemonitoring (18.6), and tele-referral (18.2%). A high total telehealth usability score was observed among 60.4% of the participants: 72.7% perceive telehealth as highly useful, 76.4% perceive it as easy to use, 60.1% have high satisfaction and intention for future use, 57.4% perceive high interface quality, and 51.8% perceive a high interaction quality. Conversely, 45.8% perceive low reliability of the telehealth system. Multinomial logistic regression showed that low education (AOR = 2.04; 95% CI = 1.16-4.85) and using virtual consultation (AOR = 0.98; 95% CI = 0.38-0.99) were predictors of low telehealth usability. However, being female (AOR = 1.67; 95% CI = 1.27-2.55), being in higher education (AOR = 1.47; 95% CI = 1.02-2.34), and living in the central KSA region (AOR = 1.37; 95% CI = 1.10-2.23) were predictors of high telehealth usability. Working status, income, and presence of chronic disease were not statistically significant predictors. Conclusions: Telehealth services have been highly usable in KSA even before the COVID-19 pandemic, with commonly used asynchronous services. Many social, technological, and system-related factors could affect the user experience and system reliability. Hence, telehealth developments are recommended to overcome such barriers, with future initiatives focusing on the flexibility and convenience of telehealth systems.

Embracing the Future of Health Care: Investigating Medical Students' Willingness to Become Online Doctors

Purpose: With the rapid advancement of technology, online health care services are becoming increasingly prominent. This study aims to investigate medical students' perceptions, attitudes, and readiness to adopt online health care services. Methods: Based on a literature review, this study constructed a conceptual model describing the relationships among medical students' perception, personality traits, and usage intention, grounded in the Technology Acceptance Model and Technology Readiness Index (TRI). The data for this study were collected from January to February 2023 through a questionnaire survey at Wenzhou Medical University, China. The proposed hypotheses were tested using structural equation modeling through AMOS software. Results: Out of the 340 respondents, 281 (82.6%) validly responded. Among these, 58.4% of medical students agreed and strongly agreed with the intention to become an online doctor. Within the TRI's motivational factors, optimism positively and significantly affected perceived usefulness (PU) and perceived ease of use (PEOU). Innovativeness also significantly enhanced PEOU. Among the inhibitory factors, insecurity was found to have a negative and statistically significant influence on PU. The rest of the dimensions did not have a significant effect on either PU or PEOU. Importantly, both PU and PEOU demonstrated a direct and substantial effect on usage intention. Conclusions: This study emphasizes the significance of comprehending medical students' readiness to adopt the role of online doctors in shaping the future of health care. By equipping medical students with the necessary skills and competencies, health care institutions can effectively leverage the full potential of online health care services while ensuring the provision of high-quality, accessible, and patient-centered care in the digital era.

Inflammatory Bowel Disease Hospitalizations Are Similar for Patients Receiving Televisit-Delivered Outpatient Care and Those Receiving Traditional In-Person Care

INTRODUCTION

The coronavirus disease 2019 pandemic resulted in widespread expansion of telehealth. However, there are concerns that telehealth-delivered outpatient care may limit opportunities for managing complications and preventing hospitalizations for patients with inflammatory bowel disease (IBD). We aimed to assess the association between outpatient IBD care delivered through televisit (video or phone) and IBD-related hospitalizations.

METHODS

We conducted a case-control study of patients with IBD who had an IBD-related index hospitalization between April 2021 and July 2022 and received their care in the Veterans Health Administration. We matched these hospitalized patients to controls who were not hospitalized based on age, sex, race, Charlson comorbidity index, IBD type, IBD-related emergency department use, IBD-related hospitalizations, and outpatient gastroenterology visits in the preceding year. The variable of interest was the percentage of total clinic visits delivered through televisit in the year before the index hospitalization. We compared the risk of IBD-related hospitalization by exposure to televisit-delivered care using conditional logistic regression.

RESULTS

We identified 534 patients with an IBD-related hospitalization and 534 matched controls without an IBD-related hospitalization during the study period. Patients with IBD with a higher percentage of televisit-delivered (vs in-person) outpatient care were less likely to be hospitalized during the study period (for every 10% increase in televisit use, odds ratio 0.97, 95% confidence interval 0.94-1.00; P = 0.03).

DISCUSSION

Televisit-delivered outpatient IBD care is not associated with higher risk of IBD-related hospitalization. These findings may reassure clinicians that televisit-delivered outpatient care is appropriate for patients with complex chronic diseases such as IBD.

The determinants of public acceptance of telemedicine apps: an innovation diffusion perspective

With the rapid advancement of information technology, telemedicine apps have gradually become an indispensable tool for providing patients with more convenient, efficient, and accessible healthcare services. However, the successful implementation of these apps largely depends on widespread acceptance among the public. To thoroughly investigate the factors influencing the public's acceptance of these apps and the relationships between these factors, this study developed a theoretical model based on the Diffusion of Innovation theory and the Theory of Perceived Value. To validate this model, we conducted a survey of 387 residents in Beijing, China, and employed structural equation modeling to analyze the collected data. The research findings indicate that attributes of innovation diffusion, including relative advantage, compatibility, complexity, trialability, and observability, significantly and positively influence the public's perceived value. Particularly noteworthy is that perceived value partially mediates the relationship between innovation attributes and public acceptance, emphasizing the crucial role of perceived value in the public decision-making process. This study employed a theory-driven approach to elucidate the acceptance of telemedicine apps and offers fresh insights into the existing literature. By integrating the research paradigms of innovation diffusion and customer perceived value, we provide a coherent explanation of how individual cognitive processes lead to acceptance behavior. In summary, this research enriches the existing theoretical studies on the acceptance of telemedicine apps and holds positive implications for healthcare practice.