Knowledge and Attitude Regarding Telemedicine Among Doctors in Karachi

Age of Robotic Surgery and Telemedicine: Is Pakistan Lagging Behind?

Robotic surgery and telemedicine have revolutionized the healthcare industry, offering improved patient outcomes and access to medical knowledge. However, Pakistan lags behind in adopting these cutting-edge technologies due to several challenges, including limited infrastructure, budget constraints, and low awareness among patients and healthcare professionals. This article provides an in-depth analysis of the current state of the healthcare system in Pakistan, highlighting the need for investment and policy reforms to integrate robotic surgery and telemedicine effectively. The potential benefits, including medical tourism, enhanced facilities, and skilled workforce retention, are discussed as incentives for the government to embrace digital medicine and bridge the healthcare gap. Through increased awareness, training programs, and collaborations with other nations, Pakistan can pave the way for a digitally empowered healthcare future.

Assessing Telemedicine Competency Among Doctors in a Tertiary Care Hospital: A Questionnaire-Based Cross-Sectional Study

Background The use of telemedicine in contemporary healthcare has become essential, providing a novel method of delivering care, particularly in rural and underdeveloped areas. This study assesses the telemedicine awareness, knowledge, attitude, skills, and challenges among physicians working in tertiary care hospitals. Methods A cross-sectional study was carried out with 100 doctors from diverse specialties at a tertiary care institution. The questionnaire evaluated five domains: telemedicine awareness and knowledge, telemedicine attitude, telemedicine technology skills, telemedicine utilization patterns, and perceived barriers and educational needs. Results The study indicated that 95% of participants were aware of telemedicine. However, knowledge gaps remained, particularly in legal and ethical concerns (50%) and international rules (40%). Eighty percent of respondents had a favorable opinion of telemedicine, and 85% thought it might improve patient care in rural regions. The proficiency level of telemedicine users was variable: 60% of them had previous experience, and 70% of them rated their proficiency as intermediate or better. According to utilization patterns, 50% of telemedicine users used it at least once a week, primarily for remote monitoring (30%) and video consultations (60%). The study found that 90% of respondents had a high demand for training and educational opportunities. The absence of infrastructure (65%), worries about data security (55%), and patient acceptability (30%) were the main obstacles found. It also highlighted how important it is to have defined policies and collaborate across disciplines. Conclusion The study identifies a good attitude toward telemedicine among doctors as well as a need for improved training and infrastructure. It is essential to tackle these requirements and obstacles in order to successfully incorporate telemedicine into healthcare systems.

Telemedicine Service Adoption During the COVID-19 Pandemic: Physicians' Experience from Nigeria

Introduction: Telemedicine practice experiences during the COVID-19 pandemic have not been well documented in resource-constrained settings, such as Nigeria. We set out to assess knowledge, attitude, and factors associated with telemedicine practice during the COVID-19 lockdown, as well as physician experiences in Kano, Nigeria. Methods: We employed a mixed-methods approach, utilizing structured questionnaires administered to 246 physicians, followed by in-depth interviews with a purposive subsample of 20 individuals. The data were analyzed using logistic regression and the framework approach. Results: Overall, 65.0% of the respondents demonstrated moderate to good knowledge of telemedicine. Before COVID, only 47.6% (n = 117) reported practicing telemedicine, compared with 77.2% (n = 190) during the COVID lockdown (p < 0.05). Factors associated with telemedicine practice included having at least 5 years of work experience, working in pediatrics, undergoing senior residency training, receiving formal telemedicine training, possessing good knowledge of telemedicine, and having a positive attitude toward it. The odds of engaging in telemedicine practice were four times higher (adjusted odds ratio = 4.10, 95% confidence interval: 1.79-9.40) for those who practiced it before the pandemic. Challenges identified included knowledge and skill gaps, slow internet connectivity, unstable electricity, and inadequate equipment. Conclusion: To enhance telemedicine practice in resource-limited settings, it is important to focus on strengthening information and communication infrastructure, providing comprehensive clinician training, implementing careful patient selection processes, and improving practice guidelines.

The Digital Lifeline: Telemedicine and Artificial Intelligence Synergy as a Catalyst for Healthcare Equity in Pakistan

Telemedicine emerges as a critical innovation in Pakistan, aiming to overcome the nation's unique healthcare delivery challenges, including inadequate facilities, professional scarcity, and access disparities. Examining telemedicine's potential to bridge the healthcare gap, particularly in rural and underserved regions plagued by a digital divide and infrastructural deficits, is crucial. There is a critical need for robust digital infrastructure, regulatory frameworks, and digital literacy to facilitate telemedicine adoption. By highlighting the socio-economic and logistical obstacles alongside proposed strategic interventions, the analysis suggests that telemedicine can significantly enhance healthcare accessibility, efficiency, and equity across Pakistan, offering a pragmatic solution to its pressing healthcare needs while also opening room for artificial intelligence in the landscape.

Challenges and solutions for implementing telemedicine in Iran from health policymakers' perspective

BACKGROUND

Despite significant progress in health technology and growing interest among countries in incorporating telemedicine into healthcare delivery, its usage remains limited in Iran. The aim of this study is to investigate the challenges related to telemedicine in Iran and pinpoint potential solutions from the viewpoint of health policymakers, marking the first such endeavor.

METHODS

This qualitative study was conducted in Iran in 2022. Data were gathered from 19 health policymakers who were selected using purposeful and snowball sampling techniques via in-depth and semi-structured interviews. The research findings were analyzed using the content analysis technique, with coding performed using MAXQDA software. The content analysis approach developed by Erlingsson was utilized to analyze the data.

RESULTS

The study revealed eight main challenges that inhibit the widespread use of telemedicine in Iran. These challenges include policy weaknesses, uncertainty around operating mechanisms, inadequate communication and telecommunication infrastructure, insufficient cultural infrastructure, lack of electronic requirements, redundant bureaucracies, legal gaps, and economic factors. Furthermore, four key solutions to these challenges were identified. These include a national commitment to the development of telemedicine, the establishment of a telemedicine roadmap, the enhancement of e-health requirements and infrastructure, and the preparation of the community to accept telemedicine as a viable option for healthcare delivery.

CONCLUSION

The implementation of telemedicine in Iran faces significant challenges, some of which are related to the national healthcare system, while others stem from various policy-related institutions and organizations. Addressing these challenges will require extensive inter-organizational cooperation and strong leadership at the governance level. However, it should be noted that fully resolving these issues is a time-consuming process.

Attitude of mental healthcare providers toward tele-psychiatry services and associated factors at public referral hospitals in Addis Ababa city, Ethiopia

INTRODUCTION

Health systems around the world are struggling with the massive numbers of people with mental disorders who require professional care. The treatment gap for mental disorders is high all over the world, with between 76 and 85% of people in low- and middle-income countries with severe mental disorders receiving no treatment for their mental health conditions. Tele-psychiatry is used as an alternative solution to the problem of limited mental health services and effective Tele-psychiatry service use may be achievable if mental health providers have a good attitude towards it.

OBJECTIVE

To assess the attitude of mental healthcare providers toward Tele-psychiatry services and associated factors at public referral hospitals in Addis Ababa city, Ethiopia, 2022.

METHOD

A Multicenter institution-based cross-sectional study was conducted among 413 mental health professionals working in public referral hospitals in Addis Ababa city, from May 04 to June 10, 2022. Data were collected by using a structured and self-administered questionnaire prepared by reviewing previous related studies. Epi Data version 3.1 and Stata version 14 were used for data entry and analysis respectively. Bivariate and multivariable logistic regression analyses were used to identify factors associated with attitudes toward Tele-psychiatry services. A statistical significance was declared at p-value < 0.05.

RESULT

A total of 413 Participants were enrolled with a response rate of 91.8%. The majority of respondents 230 (55.69%) were male and the mean age of participants was 29 years (SD + 5.02). In this study the majority (49%) of mental health care professionals had a poor attitude toward Tele-psychiatry. Having electronic health technology experience [AOR 16.79; 95% CI (4.26, 29.3)], lack of training in telemedicine applications [(AOR 0.1; 95% CI (0.01, 0.41)], a good computer uses for daily work activities [AOR 3.65; 95% CI (1.14, 11.60)], availability of e-Health technology awareness program [AOR 0.16; 95% CI (0.03, 0.90)], having a positive perception about the importance of e-Health technologies[AOR 0.041; 95% CI (0.01, 0.29)] and having good knowledge of Tele-psychiatry services [AOR 6.89; 95% CI (1.8, 12.0)] were significantly associated with attitude towards Tele-psychiatry services.

CONCLUSION

This study found that mental healthcare providers at a public referral hospital in Addis Ababa city generally had poor attitudes regarding Tele-psychiatry services. Considering the significant factors will improve the attitude to use tele-psychiatry services in Ethiopia.

Awareness and readiness of mental healthcare providers to implement telemental health services and associated factors at public referral hospitals in Addis Ababa City, Ethiopia

OBJECTIVE

To assess the awareness and readiness of mental healthcare providers to implement telemental health services and the associated factors at public referral hospitals in Addis Ababa City, Ethiopia.

STUDY DESIGN

A cross-sectional study was conducted among mental health professionals working at public referral hospitals in Addis Ababa City from 4 May to 10 June 2022.

PARTICIPANTS

A total of 413 (55.7% male and 44.3% female) health professionals participated in the study. The study participants were selected using a simple random sampling technique. All mental healthcare providers working at public referral hospitals in Addis Ababa City were considered as the source population. Mental healthcare providers who meet the inclusion criteria were considered the study population. Having a minimum diploma qualification and 6 months or more of work experience and giving written consent were considered the inclusion criteria.

OUTCOME MEASURE

The main outcome measure was awareness and readiness to implement telemental health services.

RESULT

A total of 413 participants were enrolled, with a response rate of 90.6%. The prevalence of good awareness towards telemental health services was 41% (95% CI 37%, 47%). Being female (adjusted OR (AOR)=0.34; 95% CI 0.15, 0.76), having poor information technology support (AOR=0.32; 95% CI 0.11, 0.99) and having electronic health technology experience (AOR=1.21; 95% CI 1.1, 2.44) were significantly associated with awareness of telemental health services, whereas computer access at the workplace (AOR=0.04; 95% CI 0.003, 0.55) and awareness (AOR=4.34; 95% CI 1.02, 18.48) and attitude (AOR=1.01; 95% CI 1.03, 2.19) towards telemental health services were the variables that showed statistically significant association with readiness of mental healthcare providers for telemental health services.

CONCLUSION

Although majority of healthcare providers in this survey were prepared to implement telemental health services, there was typically little awareness among mental healthcare providers.

Self-reported perceptions and knowledge of telemedicine in medical students and professionals who enrolled in an online course in Peru

BACKGROUND

Telemedicine has become more relevant during the COVID-19 pandemic. However, medical students and professionals do not acquire competences in telemedicine during their training. Our objective was to describe the self-reported perception and baseline knowledge of telemedicine among medical students and professionals enrolled in a virtual course.

METHODS

Cross-sectional study that included physicians or medical students aged 18 years or older who were interested in a free virtual telemedicine course and who completed the data collection questionnaire. We used a Likert scale to assess the self-reported perceptions of four domains related to telemedicine. The participants were grouped into three levels for each domain: low, medium and high. We also objectively assessed telemedicine knowledge by means of 10 questions, with a cut-off point of 50% of correct answers. The Fisher's exact test, the Chi-square test, and the Mann-Whitney U test were used for the comparison of categorical data. A p-value < 0.05 was considered statistically significant.

RESULTS

We included 161 participants: 118 medical students and 43 physicians. We observed no significant differences between medical students and physicians in self-reported perceptions of knowledge, security, or utility of telemedicine. However, students had a high self-reported perception of the disadvantages of telemedicine especially related to patient security (p = 0.018), efficiency of care (p = 0.040), and the possibility of medical malpractice (p = 0.010) compared to physicians. Nearly half of the students (n = 53,44.9%) and physicians (n = 22,51.7%) answered 50% or more of the questions related to telemedicine knowledge correctly.

CONCLUSION

Among the physicians and medical students enrolled in the course, the students perceived the disadvantages of telemedicine more frequently. Although physicians and students have limited knowledge of telemedicine, there appears to be no influence of experience and prior training in telemedicine.

Health Information Technologies in a Resource-Limited Setting: Knowledge, Attitude, and Practice of Health Professionals

The use of health information technology significantly enhances patient outcomes. As a result, policymakers from developing countries have placed strong emphasis on formulating eHealth policies and initiatives. However, there have not been many successful deployments to show for. The role of individual factors in the successful implementation of these technologies is indispensable. Therefore, this study assesses healthcare professionals' knowledge, attitudes, and practice of health information technology. An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital from November 15 to December 29, 2020. A structured, self-administered questionnaire was used to collect data. Student's t-test was used to learn if there were any significant differences in practice habits between participants with and without previous information technology-related training. In addition, first-order partial correlation was conducted to identify the relationship of knowledge and attitude with practice. A total of 347 health professionals responded to the questionnaire, yielding an 87.2% response rate. Most health professionals are not aware of how to use health information technologies. Notably, practice levels were low and needed prompt action from responsible authorities. Previous training did not work very well to improve the practice levels of health professionals. However, the positive attitude of these professionals encourages policymakers and implementers to engage closely.

Impact of the COVID-19 pandemic on knowledge, perceptions, and effects of telemedicine among the general population of Pakistan: A national survey

Background

Telemedicine is the provision of healthcare services through information and communication technology with the potential to mobilize all facets of the health sector to prevent the spread of COVID-19, provide quality healthcare, protect patients, doctors, and the public from exposure to disease, and reduce the burden on the healthcare system. This study aims to identify knowledge, perceptions, willingness to use, and the impact of the COVID-19 pandemic on telemedicine awareness.

Methods

A cross-sectional study was conducted from 27 May 2020 to 17 June 2020 using the convenient sampling technique in the general population of Pakistan. Data were collected by designing an online questionnaire consisting of demographic information, knowledge, attitude perceptions, barriers, utilization, and the impact of the COVID-19 pandemic on telemedicine.

Results

Of the 602 participants included in the study, 70.1% had heard about telemedicine, 54.3% had a good understanding of the definition of "telemedicine," 81.4% had not used telemedicine in the past, 29.9% did not know that telemedicine was available before the COVID-19 pandemic, and 70.4% responded that the COVID-19 pandemic had changed their attitudes toward telemedicine. Gender (p = 0.017) and family income (p = 0.027) had a significant association with the perception of the benefits of telemedicine.

Conclusion

The knowledge and usage of telemedicine are lacking due to inadequate awareness and technology. The need of the hour is to maximize the application of telemedicine to overcome the deficiencies of the healthcare system. Hence, it is essential to increase awareness through various means and develop an appropriate infrastructure to attain maximum benefits from telehealth services.

Health care professionals' knowledge and attitudes toward telemedicine

Background

The utilization of modern communication technology in the healthcare field is known as telemedicine, and it represents an advancement in the healthcare industry. For effective implementation of these technologies, healthcare professionals must possess the appropriate knowledge and hold a positive perspective toward the implementation of telemedicine. The current study aims to evaluate the knowledge and perspective of healthcare professionals in King Fahad Medical City, Saudi Arabia toward telemedicine.

Methods

This study was carried out in a diverse hospital, King Fahad Medical City, Saudi Arabia and it was a cross-sectional study. The study took place from June 2019 until February 2020, during which 370 healthcare professionals, including physicians, nurses, and other healthcare professionals participated. The data was gathered by using a structured self-administered questionnaire.

Results

The analysis of the data revealed that the majority of the healthcare professionals who participated in the study, 237 (63.7%), had limited knowledge of telemedicine. About 41 (11%) participants had a good understanding of the technology, and 94 participants (25.3%) had extensive knowledge. The overall attitude of the participants toward telemedicine was positive, with a mean score of 3.26. The mean attitude scores varied significantly (P < 0.001) among the different professions, with physicians scoring 3.69, allied healthcare professionals scoring 3.31, and nurses scoring 3.07. The coefficient of determination (R2) was used to evaluate the variation in attitude toward telemedicine and it was found that education (12.4%) and nationality (4.7%) had the least impact on the attitude toward telemedicine.

Conclusion

Healthcare professionals are crucial to the successful implementation and continuity of telemedicine. However, despite their positive attitude toward telemedicine, most of the healthcare professionals who participated in the study had limited knowledge of it. There were differences in attitude among different groups of healthcare professionals. As a result, it is necessary to create specialized educational programs for healthcare professionals to guarantee the proper implementation and continuation of telemedicine.

Assessment of Primary Care Physicians' Perception of Telemedicine Use During the COVID-19 Pandemic in Primary Health Care Corporation, Qatar

While telemedicine has been extensively researched throughout the globe, the Middle East has seen relatively little research on the topic. The purpose of this study was to investigate the primary care physicians' perceptions of the use of telemedicine, as well as its hurdles and benefits, during the COVID-19 pandemic in the state of Qatar. In this multicenter cross-sectional study, an internally validated questionnaire was distributed among primary care physicians utilizing telemedicine during the pandemic at Primary Health Care Corporation (PHCC), the main primary care provider in Qatar. A convenience sample was taken due to the pandemic restrictions. Out of 254 analyzed questionnaires, about half of the physicians (48%) had used telemedicine in the past primarily in the form of telephone consultations. Nearly three-quarters (74%) of physicians agreed that telemedicine is an easy way to communicate during the pandemic, but only half (52%) felt it improved job performance and effectiveness. Most physicians (90%) agreed that telemedicine is safe during the pandemic, but opinion was split on whether an optimum assessment of COVID-19 disease could be conducted. The majority also considered telemedicine an effective tool for chronic disease reviews (63%) and other consultations such as blood test results and medicine prescriptions (71%). The most significant barrier to telemedicine use was a language barrier followed by a lack of proper training. About 79% of responders felt that telemedicine improves access to healthcare and assists in contacting difficult-to-reach individuals, and 74% also thought it minimizes no-shows in the clinics. Our study has shown that most physicians felt comfortable and safer using telemedicine as an alternative means to conduct consultations during the pandemic. Keeping in view its advantages, the majority suggested that it could be incorporated into daily practice even beyond the pandemic. However, concerns were raised about its use to assess COVID-19 disease, lack of training, and potential barriers such as language differences. Further studies are needed to assess the efficiency and cost-effectiveness of telemedicine as well as the evaluation of alternative media such as video consultation, which could increase the utility of telemedicine and potentially mitigate some of its disadvantages.

Assessment of knowledge and attitude of healthcare professionals regarding the use of telemedicine: A cross-sectional study from rural areas of Sindh, Pakistan

Background

Telemedicine has proved its significance in the healthcare system, especially during the coronavirus disease 2019 (COVID-19) pandemic as it assists in the provision of early and effective healthcare to those in distant areas. This study aimed to assess the knowledge and attitude of healthcare professionals toward the use of telemedicine in the rural areas of Sindh, Pakistan.

Materials and methods

The cross-sectional study was conducted with 212 healthcare professionals including physicians, consultants, surgeons, residents, dentists, and house officers working in public sector hospitals. The face-to-face method was used for data collection. Chi-square test and logistic regression analysis were applied to find the association between different variables and knowledge and practice of telemedicine using SPSS V 24.

Results

The knowledge of participants regarding the usability of telemedicine and various tools used for the provision of medical services (video consultations, conferencing, use of applications, software, and online groups) was good. A total of 52.2% of participants showed agreement when they were questioned about being aware of online healthcare service provision. In this study, 52.8% of the participants practiced telemedicine by delivering healthcare services through online consultations. The majority of the participants were surgeons (25.9%), residents (23.1%), and physicians (18.9%). The internet (42.4%) and public media (25.9%) were the major sources of information for telemedicine. A total of 70.5% of participants suggested that strategies and efforts should be directed toward the enhanced implementation of telemedicine. Training in telemedicine as a source of information [OR = 13.02 (95% CI = 3.9-43.6), p < 0.001)] and awareness regarding the effect of telemedicine in healthcare quality [OR = 10.25 (95% CI = 2.9-35.4), p < 0.001)] remained the predicting factors for the practice of telemedicine among healthcare workers using multivariate regression analysis.

Conclusion

Telemedicine has technologically revolutionized the medical sciences worldwide. The awareness level and usage of telemedicine were good among healthcare professionals in rural Sindh. Telemedicine should be utilized to provide quality healthcare in underprivileged areas by investing in infrastructure and education.

Healthcare Workers' Knowledge and Attitude Toward Telemedicine During the COVID-19 Pandemic: A Global Survey

Introduction Telemedicine is the utilization of communication technologies to provide healthcare services remotely. It has an increasingly pivotal role in enabling medical professionals to extend the provision of care to patients facing geographical barriers. The benefits of telemedicine have become more apparent during the coronavirus pandemic. To maximize its application, it is crucial to ascertain the understanding and attitudes of healthcare professionals toward its use. The aim of this study is to collect data and evaluate the current knowledge and perceptions of medical staff toward the use of telemedicine. Methods In this cross-sectional study, we conducted a global survey of 1091 healthcare workers. Data were collected through a questionnaire after an extensive literature review. Frequency, percentages, and cumulative percentages were calculated to portray the profile of the participants. Results Of the respondents, the majority had heard about (90.9%), witnessed (65.3%), or were familiar with (74.6%) how telemedicine is used in practice. Seventy-two point two percent (72.2%) were familiar with the tools that may be used in this technology. The familiarity with telemedicine was noted to be consistently higher in those with a medical degree and experience of less than five years. Furthermore, attitudes toward providing healthcare remotely were generally positive with 80% thinking that telemedicine reduced staff workload, 80.6% reporting that it reduces the unnecessary transportation cost, and 83% believing that it saves clinicians' time. However, 20% of respondents said that telemedicine increases staff workload and 40.5% of healthcare workers believed telemedicine threatens information confidentiality and patient privacy. Conclusion Although telemedicine is a novel and emerging practice in many countries, it appears to have a promising contribution to healthcare services. This is particularly important during a pandemic, as it ensures effective healthcare with the maintenance of social distancing measures. Moreover, the respondents of this study showed good knowledge and positivity in their attitude toward telemedicine.

Health professionals knowledge of telemedicine and its associated factors working at private hospitals in resource-limited settings

Introduction

The appropriate implementation of telemedicine in the healthcare system has the potential to overcome global problems such as accessibility and quality healthcare services. Thus assessing the knowledge of health professionals before the actual adoption of telemedicine is considered a prominent solution to the problems.

Objective

This study aimed to assess healthcare professionals' knowledge of telemedicine and its associated factors at private hospitals in low-resource settings.

Method

An institution-based cross-sectional study was conducted among 423 health professionals at private hospitals in low-income settings in Ethiopia, from March to April 2021. Data collection was performed by pretested and self-administered questionnaires. This study employed statistical packages for social sciences software. This study employed multivariable logistic regression to determine dependent and independent variables associated with adjusted odd ratio and 95% CI.

Result

in this study about 65.8% of health professionals have good knowledge on Telemedicine .Computer literacy (AOR = 2.9; 95% CI: 1.8, 4.6), computer training (AOR = 2.0; 95% CI: 1.2, 3.3), Internet availability at workplace (AOR = 2.1; 95%CI: 1.3, 3.4), had private laptop (AOR = 1.7; 95% CI: 1.1, 2.9) were significantly associated with knowledge.

Conclusion and recommendation

In general health professionals had good knowledge of Telemedicine. Inclusive packages of capacity by training among health providers are fundamental for the successful implementation of telemedicine.

Exploring the perception and readiness of Pharmacists towards telepharmacy implementation; a cross sectional analysis

Background

Amid the turbulent nature of the COVID-19 pandemic, telepharmacy has shifted the paradigm of patient care by leveraging digital medicine. Government mandated lockdowns and norms of social distancing have further underscored the need for telepharmacy. Many developed and developing countries implemented such initiatives where pharmacists have provided tele-pharmacy services via telecommunications. However, the implementation and utilization of tele-pharmacy services are quite negligible in resource limited settings due to financial and administrative constraints. This study was aimed to ascertain the perception and readiness of pharmacists working in various sectors of a resource limiting country.

Methodology

A cross sectional study was carried out in all provinces of Pakistan to explore the perceptions of pharmacists towards telepharmacy implementation through a 35-items study instrument. The collected data was analyzed descriptively and scored accordingly. The chi-square test was used for inferential analysis on pharmacist's perception regarding implementation of tele-pharmacy with their demographics.

Results

Of 380 pharmacists, the mean age is 27.67 ± 3.67 years with a preponderance of male pharmacists (n = 238, 62.6%). The pharmacists (n = 321, 84.5%) perceived that telepharmacy implementation improves patient's quality of life and decreases patients' visits (n = 291, 76.6%). Overall, pharmacists (n = 227, 59.7%) had negative perception towards benefits of telepharmacy implementation, but pharmacists had positive perception towards eligibility (n = 258, 67.9%), regulatory issues (n = 271, 71.3%) and telepharmacy during pandemic and beyond (n = 312, 82.1%). In chi-square testing gender (p = 0.03) and age (p = 0.03) had a significant association with perception regarding regulatory issues. Among perception regarding telepharmacy during COVID-19 pandemic and beyond age had a significant association (p = 0.03). Among perception regarding eligibility job location of pharmacists had significant association (p = 0.04).

Conclusion

The majority of pharmacists had a positive perception regarding the eligibility of patients and regulatory issues/legal framework regarding the implementation of tele-pharmacy, as well as its use during the COVID-19 pandemic and beyond. The implementation of tele-pharmacy can play a major role in providing timely and better patient care to remote patient areas and may help in the prevention and treatment of different infectious diseases.

The promise of telemedicine in Pakistan: A systematic review

BACKGROUND

Telemedicine offers the possibility of provision of medical assistance to remote patients, and it has great potential in developing countries like Pakistan. Telemedicine solves logistical barriers, gives support to weak health systems, and helps to establish worldwide networks of healthcare professionals. Because of the high implementation costs, it is not possible yet to adopt telehealth systems for low- and middle-income nations.

OBJECTIVE

To present a revision of region-based telemedical services in Pakistan.

METHODS

Libraries such as PubMed (Medline), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus (EMBASE), and Google Scholar were used for document search. Newcastle-Ottawa Scale (NOS) was adopted to conduct study quality. Many of the studies (n-8) included in the review were of high quality as assessed through the Newcastle-Ottawa scale. Selected study characteristics were further analyzed based on different parameters such as publication year, sample size, study design, methods, motivation, and outcomes.

RESULTS

Search produced 955 articles and 11 items were ultimately selected to conduct the review. These studies were further characterized as region-based telemedicine implementation. Out of 11, eight studies were conducted in the urban region and three studies were conducted in the rural areas of Pakistan. Many studies produced evidence on telehealth interventions by smartphone services such as SMS, apps, and web-based telemedicine.

CONCLUSIONS

Telehealth interventions such as mHealth, eHealth, telemedicine, and telepharmacy in Pakistan were introduced starting from the last two decades. For obtaining the full benefits of these technologies, it is necessary that they but certainly need to become an integral part of Pakistan's current health infrastructure.

Awareness, Knowledge, Attitude, and Practice of Teledentistry among Dental Practitioners during COVID-19: A Systematic Review and Meta-Analysis

Background and Objectives: This systemic review aims to appraise and analyse the awareness, knowledge, attitude, and practice of teledentistry among dental practitioners during COVID-19. Materials and Methods: This review was registered in the PROSPERO database (CRD42021283404). Cross-sectional articles on dental practitioners' perceptions towards teledentistry published between March 2020 and September 2021 were searched in ten online databases (PubMed, Google Scholar, Web of Science, ScienceDirect, Cochrane, EMBASE, SIGLE, EBSCO, LILACS, and Open Grey). The Joanna Briggs Institute critical appraisal tool was employed to analyse the risk of bias (RoB) of each article, whereas the Oxford Centre for Evidence-Based Medicine recommendation tool was used to evaluate the level of evidence. Data were analysed using the DerSimonian-Laird random effect model based on a single-arm approach. Results: Six studies were included and demonstrated Level 3 evidence. A single-arm meta-analysis revealed that dental practitioners had a high level of awareness (70.4%) and attitude (72.5%) towards teledentistry during the COVID-19 pandemic, but their knowledge level (57.9%) was moderate with a poor practice level (35.8%). A substantial heterogeneity was observed with the overall I2 ranging from 90.78% to 98.21%. Furthermore, meta-regression indicated that the sample size of each study had a significant (p < 0.05) impact on the degree of data heterogeneity. Conclusions: Despite their high degree of awareness and attitude, dental practitioners demonstrated moderate knowledge and relatively poor practice of teledentistry during the COVID-19 pandemic. More well-designed studies are warranted to investigate the alternatives for enhancing dental practitioners' knowledge and practice of teledentistry interventions.

The outlook of doctors toward telemedicine: A cross-sectional study of knowledge, awareness, and attitude in central India

Background

In an underdeveloped country like India where there are varied constraints in accessing healthcare, telemedicine can prove to be instrumental in providing access to the scant medical resources and infrastructures. The irony lies in its underutilization, which is multifactorial.

Objective

The present research was planned to evaluate the level of awareness, knowledge, and attitude toward telemedicine among the faculty members of tertiary-care teaching centers in Chhattisgarh, India.

Methods

A questionnaire-based survey was conducted to collect appropriate data, which were utilized for analysis as well as various intergroup analyses (among different designations, age groups, sex, and worksite). The data have been presented as median and percentage, while for intergroup comparison Mann-Whitney Test was performed.

Results

Among the 115 respondents, only 34% were females. The mean age was around 40.7 years, and 58% were <40 years of age. Their median scores of awareness, knowledge, and attitude were estimated to be 06, 14, and +9, respectively. No statistically significant difference was observed in the awareness, knowledge, and attitude among the faculty members belonging to different designations, age groups, and worksites.

Conclusions

Though, in general, the faculty members have demonstrated a favorable attitude toward the use of telemedicine yet most of them scored below the median mark. Furthermore, the estimated level of knowledge and awareness was also mediocre.

Pharmacists and telemedicine: an innovative model fulfilling Sustainable Development Goals (SDGs)

The lack of access to safe medicines and quality healthcare services in peri-urban and rural areas is a major challenge driving a health system to innovate new models of care. This commentary will discuss the implementation and impact of the “Guddi baji” tele-pharmacy model, a project piloted by doctHERs, one of Pakistan’s leading telemedicine organizations. This innovative model has described the reintegration of women into the workforce by leveraging technology to improve the level of primary health care services and contributes to safe medication practice in a remote area. Our intervention proposed the deployment of technology-enabled, female frontline health workers known as the Guddi baji (meaning The Good Sister) in a rural village. They serve as an “access point to health care” that is linked to a remotely located health care professional; a licensed doctor or a pharmacist within this model.

The practice of teleneurology in the Philippines during the COVID-19 pandemic

Background and objectives

The practice of teleneurology provided an accessible and safe method of consultation during the COVID-19 pandemic. We aimed to describe the practice of teleneurology among Filipino neurologists and determine the factors affecting its adoption using the unified theory of acceptance and use of technology (UTAUT) model and its constructs, namely performance expectancy, effort expectancy, social influence, and facilitating conditions.

Methods

This was a cross-sectional survey conducted online last October 2020 involving adult and pediatric neurologists in the Philippines. The internal consistency of the questionnaire adapted from UTAUT model was determined using Cronbach’s alpha. We performed logistic regression analysis to determine which constructs of the UTAUT model were significant factors on the intent to practice teleneurology.

Results

The study yielded a 28.8% response rate. Among the respondents (n₁ = 147), 95.2% (n₂ = 140) practiced teleneurology during the pandemic, and 77.6% (n₁ = 147) planned to continue it after the pandemic. Teleneurology was mostly done on an outpatient basis on social media platforms via videoconferencing due to easier access for both end-users. The UTAUT model explained 80.9% (95% CI 0.76, 0.86a) of the total variation. Performance expectancy and facilitating conditions affect the intent to use teleneurology.

Conclusions

Due to the limited resources and knowledge of its practice, infrastructural support and benefit awareness campaigns would be beneficial to increase its adoption, especially in developing countries.

Perceptions and knowledge of telemedicine in Ecuadorian practicing physicians: an instrument adaptation, validation and translation from English to Spanish

BACKGROUND

During the COVID-19 pandemic, multiple countries have taken measures, such as isolation and quarantine, to prevent person-to-person spread of disease. These actions forced many physicians to adopt new techniques, such as telemedicine, to continue patient care, which has proven to be useful in continued care for those with non-COVID-19 pathologies. Various factors, such as security, confidentiality, cost-effectiveness, comfort, and the risk of malpractice, influence the perception of telemedicine among medical practitioners. The aim of this study was to adapt an existing instrument and validate it into a new Spanish version. The instrument is about the perceptions and knowledge of telemedicine in healthcare professionals.

METHODS

The original questionnaire surveyed 6 domains with 40 questions, and each question was measured with a five-point Likert scale ranging from very high [5] to very low [1]. The survey was translated to Spanish using machine translation. The translation was reviewed independently, and then, a consensus was achieved regarding minor changes in the syntax of the survey to facilitate understanding. After expert feedback and questionnaire review, the research team members proposed reducing the instrument to 13 items in 4 domains due to the similarity of some questions. The sample was divided into 2randomly selected groups. Eligibility criteria included physicians providing private or public services with active medical/clinical practice.

RESULTS

In total, 382 surveys were collected and separated into two random samples, S1 and S2 (198 and 184, respectively). In exploratory factor analysis (EFA), the 13 items were grouped into four theoretical domains, and item 7 presented cross loading between factors and was removed. Confirmatory factor analysis was performed to assess the scale reliability and interscale associations; three models were tested. Global Cronbach's alpha for internal consistency was 0.76 for the EFA. The goodness of fit measures root mean square error of approximation and comparative fit index were 0.009 and 0.999, respectively, for the best model.

CONCLUSIONS

The translated instrument was clear, with adequate internal consistency, readability, and appropriate for application in the physician setting. This validated questionnaire made it possible to evaluate physicians' knowledge of telemedicine to increase its use, especially during the COVID-19 pandemic.

Knowledge, Applicability, and Barriers of Telemedicine in Egypt: A National Survey

Objectives

The study is aimed at evaluating knowledge, attitude, and barriers to telemedicine among the general population in Egypt.

Methods

A questionnaire-based cross-sectional design was carried out among the general Egyptian population. A convenience sampling method was used to approach the eligible participants from University Teaching Hospitals of eight governorates from May to July 2020.

Results

A total of 686 participants filled the questionnaire (49.4% were males, mean age 36.7 ± 11.2 years old). Half of the participants stated that they previously used a telemedicine tool, mainly to follow up laboratory results (67.3%). Video or phone calls (39.3%) and mobile applications (23.7%) were the most commonly recognized telemedicine tools by the participants. The included participants exhibited a high level of knowledge and attitude towards telemedicine. On the other hand, 21.9% stated that telemedicine services could jeopardize patient privacy. 32.8% reported that telemedicine service could lead to disclosing medical information to people who are not authorized to do so. Almost half of the participants agreed to strongly agreed that telemedicine service could increase medical errors. 60.80% of the participants said that they are more likely to prefer telemedicine than traditional ways. However, 13.70% stated that telemedicine is more likely to be challenging to use.

Conclusion

The Egyptian population has high knowledge about the applications of telemedicine. In addition, the vast majority of Egyptians appear to perceive the benefits of telemedicine positively and are willing to use it. However, some barriers that have been found must be taken into consideration to adopt telemedicine successfully, especially for people who are old, are low educated, and live in remote areas. Future studies should address the utility of telemedicine in improving the quality of healthcare and patient's health outcome and quality of life.

Physicians' Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study

Background

To mitigate the effect of the COVID-19 pandemic, health care systems worldwide have implemented telemedicine technologies to respond to the growing need for health care services during these unprecedented times. In the United Arab Emirates, video and audio consultations have been implemented to deliver health services during the pandemic.

Objective

This study aimed to evaluate whether differences exist in physicians’ attitudes and perceptions of video and audio consultations when delivering telemedicine services during the COVID-19 pandemic.

Methods

This survey was conducted on a cohort of 880 physicians from outpatient facilities in Abu Dhabi, which delivered telemedicine services during the COVID-19 pandemic between November and December 2020. In total, 623 physicians responded (response rate=70.8%). The survey included a 5-point Likert scale to measure physician’s attitudes and perceptions of video and audio consultations with reference to the quality of the clinical consultation and the professional productivity. Descriptive statistics were used to describe physicians’ sociodemographic characteristics (age, sex, designation, clinical specialty, duration of practice, and previous experience with telemedicine) and telemedicine modality (video vs audio consultations). Regression models were used to assess the association between telemedicine modality and physicians’ characteristics with the perceived outcomes of the web-based consultation.

Results

Compared to audio consultations, video consultations were significantly associated with physicians’ confidence toward managing acute consultations (odds ratio [OR] 1.62, 95% CI 1.2-2.21; P=.002) and an increased ability to provide patient education during the web-based consultation (OR 2.21, 95% CI 1.04-4.33; P=.04). There was no significant difference in physicians’ confidence toward managing long-term and follow-up consultations through video or audio consultations (OR 1.35, 95% CI 0.88-2.08; P=.17). Video consultations were less likely to be associated with a reduced overall consultation time (OR 0.69, 95% CI 0.51-0.93; P=.02) and reduced time for patient note-taking compared to face-to-face visits (OR 0.48, 95% CI 0.36-0.65; P<.001). Previous experience with telemedicine was significantly associated with a lower perceived risk of misdiagnosis (OR 0.46, 95% CI 0.3-0.71; P<.001) and an enhanced physician-patient rapport (OR 2.49, 95% CI 1.26-4.9; P=.008).

Conclusions

These results indicate that video consultations should be adopted frequently in the new remote clinical consultations. Previous experience with telemedicine was associated with a 2-fold confidence in treating acute conditions, less than a half of the perceived risk of misdiagnosis, and an increased ability to provide patients with health education and enhance the physician-patient rapport. Additionally, these results show that audio consultations are equivalent to video consultations in providing remote follow-up care to patients with chronic conditions. These findings may be beneficial to policymakers of e-health programs in low- and middle-income countries, where audio consultations may significantly increase access to geographically remote health services.

Qualitative Focus Group Study Examining Perceptions of the Community's Important Health Issues, Health Care Needs and Perceived Barriers to Access Among Arabic Speaking Primary Care Clients in the State of Qatar

Objective

This study is a part of the Primary Health Care Corporation’s (PHCC) Health Needs Assessment (HNA) Initiative. It focuses on identifying perceptions of Arabic speaking primary care clients regarding community’s major health issues, their experiences in utilizing health services, and the barriers that limit their access to health care in the State of Qatar.

Study Setting and Design

A total of 10 focus groups sessions were conducted at different PHCC’s health centers between October of 2019 and March of 2020. Sessions were distributed to cover all PHCC’s three geographical regions. Data were analyzed using thematic analysis.

Participants

A total of 89 adult Arabic speaking individuals were recruited. Participants included were in the age groups (18–69), native Arabic speaker, and registered at one of the PHCC’s health centers with a valid health card at time of recruitment.

Results

Areas investigated included perceptions of the community’s health issues, needed health services, and perceived barriers to health care. Priority health issues identified were chronic non-communicable diseases, mental health, timely access to care, cultural competency of delivered services, and integration and coordination across health care settings and sectors. Participants were able to identify socioeconomic and environmental factors such as the need for health and wellness interventions at schools that affects the health of the individual and the community. The importance of raising the community’s awareness about health-related issues and availability of health services was highlighted by study participants.

Conclusion

Collecting qualitative data provides an opportunity to examine people’s perceptions, and motivations and engage the whole community. This process is very important for strategic planning of health services. The study attempts to fill the knowledge gap and should be linked to health policy and the development of socially and culturally appropriate health programs.

Telemedicine Awareness, Knowledge, Attitude, and Skills of Health Care Workers in a Low-Resource Country During the COVID-19 Pandemic: Cross-sectional Study

Background

Since the onset of the COVID-19 pandemic, several health care programs intended to provide telemedicine services have been introduced in Libya. Many physicians have used these services to provide care and advice to their patients remotely.

Objective

This study aimed to provide an overview of physicians’ awareness, knowledge, attitude, and skill in using telehealth services in Libya.

Methods

In this cross-sectional study, we administered a web-based survey to health care workers in Libya in May 2020. The questionnaire collected information on physicians’ general demographic characteristics, ability to use a computer, and telemedicine awareness, knowledge, attitude, and skills.

Results

Among 673 health care workers who responded to the survey, 377 (56%) and 248 (36.8%) reported high awareness and high computer skill scores, respectively, for telemedicine. Furthermore, 582 (86.5%) and 566 (82.6%) health care workers reported high knowledge and high attitude scores, respectively. We observed no significant differences in awareness, knowledge, attitude, and skill scores among physicians employed at public, private, or both types of hospitals. We observed significant differences in the mean awareness (P<.001), attitude (P=.001), and computer skill scores (P<.001) , where the score distribution of the groups based on the ability to use computers was not similar. Knowledge scores did not significantly differ among the three groups (P=.37). Respondents with professional computer skills had significantly higher awareness (χ²₃=14.5; P<.001) and attitude (χ²₃=13.5; P=.001) scores than those without professional computer skills. We observed significant differences in the mean computer skill scores of the groups (χ²₃=199.6; P<.001).

Conclusions

The consequences of the COVID-19 pandemic are expected to persist for a long time. Hence, policy programs such as telemedicine services, which aim to address the obstacles to medical treatment owing to physical distancing measures, will likely continue for a long time. Therefore, there is a need to train and support health care workers and initiate government programs that provide adequate and supportive health care services to patients in transitional countries.

The establishment of a telemedicine center during the COVID-19 pandemic at a tertiary care hospital in Pakistan

Background

Telemedicine involves the innovative application of technology to provide remote patient healthcare services especially those relating to emergency care and contagious disease spread. Telemedicine is less developed in low-and-middle-income countries like Pakistan and there is little published literature on its function and efficiency. Our institution was established to triage patients with COVID-19 symptoms to ease the load on emergency departments.

Objective

To conduct an analysis of the first month of function of a telemedicine/tele-triage center in Pakistan. To determine in which ways it was beneficial to hospital management during the COVID-19 pandemic.

Methods

This study was carried out at the newly established telemedicine/tele-triage center at the Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU) in Islamabad Pakistan between the 26th March and the 25th April 2020. Data were collected over telephone interview using a proforma to provide each caller with a C-Score (a C-score of >3 indicated observe at home 3–5-indicated home isolation with confirmatory testing and >5 indicated testing and transfer to hospital) representing their COVID-19 risk and informing the nature of the advice given to them. Data were presented using descriptive statistics.

Results

The center received total of 857 calls. Fever cough dyspnea and flu were present in 327(38.2%) 268(31.3%) 107(12.5%) and 124(14.5%) callers respectively. Based on the completion of the proforma 774(90.3%) callers had a C-Score of > 75(8.8%) callers had a C-Score of 3–5 and 8 (0.9%) callers had a C-Score of >5. We recommended COVID-19 testing in 83 patients (9.68%) based on C-score. Out of these 83 patients 64 underwent testing and only 1 tested positive for COVID-19.

Conclusion

In a one-month period the center was able to support patients by providing a triage service thereby preventing numerous unnecessary hospital visits and helping to protect healthcare professionals during a global pandemic. Telemedicine has great potential to help patient populations in low-and-middle-income countries.

COVID-19 Rehab Fright Management

Being diagnosed as positive for SARS-2 CoV RNA on PCR generates anxiety and stress as well as depression due to the prospects of being isolated. With genetically varied forms of virus on the rise the widely adopted manner to protect oneself is social distancing. This is frightening for rehabilitation professionals who at times are exposed at close quarters to the patients as rehabilitation is essential. Data in this backdrop is lacking, as this is a recent and ongoing pandemic. As such the current study was conducted with an attempt to review and highlight the causes of fright among rehabilitation professionals and possible management options in the wake of current pandemic of COVID-19 in the perspective of Pakistan. For this purpose literature was searched from major electronic databases including PubMed, Google, Google Scholar and Web-of-science, with keywords "Covid-19, mental health, telehealth, telemedicine, tele-rehabilitation and combination of words". Eighty English, full text articles were studied out of which 36 were used for the literature review. With this literature review we conclude that COVID-19 has resulted in fear of contracting and transmitting this disease among health professionals and can be reduced and managed by provision of tele-rehabilitation and telehealth facilities. Patients emerging from prolonged mechanical ventilations require extensive rehabilitation to restore routine body functions. The role of the otolaryngologist and speech language pathologist (SLP) is formal and direct to ensure appropriate and timely long term intervention and rehabilitation to ensure that these individuals re-enter mainstream activities.