Clinician Attitudes Toward Adoption of Pediatric Emergency Telemedicine in Rural Hospitals
Kristin N Ray1, Kathryn A Felmet, Melinda F Hamilton
1From the *Division of General Academic Pediatrics, Department of Pediatrics, †Division of Pediatric Critical Care Medicine, Departments of Critical Care Medicine and Pediatrics, Children's Hospital of Pittsburgh, ‡Department of Critical Care Medicine, §Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh, ∥Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, and ¶Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Insights
Adoption of pediatric emergency telemedicine is limited by perceived usefulness and ease of use, influenced by local factors. Strategies like education and simplified technology can improve clinician buy-in for this vital service.
Area of Science:
- Health Services Research
- Telemedicine
- Pediatric Emergency Care
Background:
- Telemedicine shows promise for acute pediatric care in underserved areas.
- However, the adoption of pediatric emergency telemedicine remains low.
- Limited data exist to guide implementation strategies for this technology.
Purpose of the Study:
- To examine clinician stakeholder attitudes towards pediatric emergency telemedicine.
- To identify barriers to adoption in rural settings.
- To explore potential strategies for overcoming these barriers.
Main Methods:
- A sequential mixed-methods approach was employed.
- Semistructured interviews were conducted with clinician stakeholders.
- Thematic content analysis informed a subsequent survey to assess attitudes.
Main Results:
- Key adoption factors include contextual elements, perceived usefulness, and ease of use.
- Belief in telemedicine's relative advantage differentiated proponents from nonproponents.
- Identified strategies include patient education, clinical protocols, faster response times, and simpler technology.
Conclusions:
- Improving pediatric emergency telemedicine adoption requires addressing perceived usefulness and ease of use within local contexts.
- Future research should evaluate the impact of specific strategies on adoption and patient outcomes in rural areas.
Objective:
Although there is growing evidence regarding the utility of telemedicine in providing care for acutely ill children in underserved settings, adoption of pediatric emergency telemedicine remains limited, and little data exist to inform implementation efforts. Among clinician stakeholders, we examined attitudes regarding pediatric emergency telemedicine, including barriers to adoption in rural settings and potential strategies to overcome these barriers.
Methods:
Using a sequential mixed-methods approach, we first performed semistructured interviews with clinician stakeholders using thematic content analysis to generate a conceptual model for pediatric emergency telemedicine adoption. Based on this model, we then developed and fielded a survey to further examine attitudes regarding barriers to adoption and strategies to improve adoption.
Results:
Factors influencing adoption of pediatric emergency telemedicine were identified and categorized into 3 domains: contextual factors (such as regional geography, hospital culture, and individual experience), perceived usefulness of pediatric emergency telemedicine, and perceived ease of use of pediatric emergency telemedicine. Within the domains of perceived usefulness and perceived ease of use, belief in the relative advantage of telemedicine was the most pronounced difference between telemedicine proponents and nonproponents. Strategies identified to improve adoption of telemedicine included patient-specific education, clinical protocols for use, decreasing response times, and simplifying the technology.
Conclusions:
More effective adoption of pediatric emergency telemedicine among clinicians will require addressing perceived usefulness and perceived ease of use in the context of local factors. Future studies should examine the impact of specific identified strategies on adoption of pediatric emergency telemedicine and patient outcomes in rural settings.
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