Barriers and Enablers for Telemedical Applications in Family Physicians’ Practices

DOI: 10.3238/zfa.2019.0405-0412

german translation / full article

Alexander Waschkau, Ruben Zwierlein, Jost Steinhäuser

Keywords: ehealth family medicine implementation science telemedicine

BackgroundThe evaluation of telemedical scenarios (TS) has been recommended by different institutions. Prior studies involving citizens, medical assistants, students, and family physicians, have led to the development of two TSs. These scenarios were assessed in a pilot study. The aim of the study was to investigate the acceptance and practicability of the TS and to identify determinants for the successful implementation of telemedicine applications (TA).MethodsFour family physicians and one ophthalmologist practice were equipped with video telephones in their practices to allow videoconferencing in the presence of the patient. Two of the family physicians’ practices were also equipped with a so-called Tele-Medical Backpack, which provides telemedical support for home visits of nurse assistants. Acceptance and practicability were assessed qualitatively. The results were assigned to the categories of the behaviour change wheel (BCW) an instrument for the implementation of evidence-based knowledge in routine care.ResultsThe acceptance and practicability of the two TS was high. Patient acceptance as well as good practicability of the technologies were also key facilitating factors. The biggest barrier was the insufficient remuneration of TA. Apart from restriction and coercion, all BCW categories could be made transparent.ConclusionsThe introduction of TA into family physicians’ practices is closely linked to adequate funding and ease of use of the applications. Findings from implementation science can support these processes.KeywordsFamily medicine; telemedicine; ehealth; implementation science

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