What Do Spanish physicians believe and expect about telemedicine? Results of a Delphi-based survey

The aim of this Delphi-based study was to evaluate the intention of Spanish physicians to accept and use telemedicine as a future useful tool in daily practice. An online Delphi questionnaire was answered by 985 physicians (966 in the second round), representatives from rural and urban areas of the entire country (generalists, internists, cardiologists, endocrinologists, and nephrologists). The participants were 65% males, with a mean age of 46.7 years old and 20.3 years in the profession, mostly coming from primary care centers (91.8%) of urban Spanish areas (72.8%). Some responders (56.4%) reported lack of Internet use at work and 80.2% never participated in a telemedicine project, but 80.9% said they would be interested in participating in the future. As for the benefits of telemedicine, the specialties perceived as the most benefited were cardiology, followed by general medicine, pediatrics, and emergency services. The main reported difficulty for telemedicine implementation was the opinion that patients prefer the physical contact with physicians (77.8% of responders). Interviewed participants expressed strong interest in future telemedicine projects related to online training, distance control of chronic diseases, online communication among specialists, and real-time transmission of images and information. Most Spanish physicians have not implemented telemedicine in clinical practice, but they would be interested in future applications such as on-line training or disease control, although they still prefer physical patient contact.