Telemedicine Practice, Perceived Barriers, and Concerns Among Doctors in Kerala

Telemedicine bridges gaps in accessibility and improves patient care. Its adoption has been progressively rising in India; however, there are considerable barriers to overcome. This study aimed to assess the utilization of telemedicine by doctors in Kerala and identify the perceived barriers and concerns faced by practicing doctors. This cross-sectional study involved 535 doctors currently practicing modern medicine in Kerala. Practitioners of AYUSH systems (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) were excluded. A semi-structured questionnaire was used to collect data from June 2020 to May 2021. Participants were recruited using a nonrandom referral chain sampling method. Data analysis was carried out using IBM SPSS version 20.0 (IBM Corp., Armonk, NY). Chi-square tests were used as tests of significance. Among the participants, 337 (62.9%) doctors used telemedicine in their practice. Male gender (AOR=1.533; 95% CI: 1.028-2.288), availability of facilities for telemedicine practice in the hospital (AOR=3.032; 95% CI: 1.945-4.727), and attendance at a webinar or seminar (AOR=2.327; 95% CI: 1.52-3.542) were found to be associated with telemedicine use among doctors. The main barriers perceived by the doctors included the lack of direct physical contact with patients, 49 (9.2%); underuse of their clinical skills during telemedicine, 36 (6.7%); and lack of clarity regarding telemedicine regulations, 28 (5.2%). Nearly two-thirds of the surveyed physicians reported using telemedicine in their clinical practice. Telemedicine practice was independently associated with male gender, availability of telemedicine facilities within the hospital, and participation in telemedicine-related educational activities. Despite its widespread adoption, physicians reported several barriers, including the inability to perform direct physical examinations, perceived underutilization of clinical skills, and lack of clarity regarding telemedicine regulations. Strengthening institutional telemedicine infrastructure, enhancing training opportunities, and improving awareness of regulatory guidelines may help address these challenges and support the sustainable integration of telemedicine into routine healthcare delivery.