Description of Factors Related to the Use of the Teleconsultation System of a Large Telehealth Service in Brazil – the Telehealth Network of Minas Gerais
Introduction: The teleconsultation service of Telehealth Network of Minas Gerais (TNMG), Brazil, has expanded gradually since its implementation in 2007. However, since 2013, there has been a decline in the number of teleconsultations. The objective of this study was to compare features of user and non-user cities and healthcare practitioners, in order to investigate the factors related to non-use of the TNMG teleconsultation service and assess users’ satisfaction with the service. Methods: Cities were classified as users and non-users according to the utilization of the service from June 2013 to May 2014; 160 healthcare practitioners were interviewed in each group. Among the user cities, 80 user healthcare practitioners (UHP-UC) and 80 non-user healthcare practitioners (NUHP-UC) were selected. Results: There was a significant difference in support and motivation by the local healthcare manager to use the teleconsultation service (67.5% in UHP-UC vs. 34.4% in HP-NUC, p ?0.0001; and 53.8 % in NUHP-UC vs. 34.4% in HP-NUC: p = 0.013), and with respect to training. (67.5% in UHP-UC vs. 45.8% in HP-NUC: p = 0,002). In multinomial logistic regression, (i) male gender, (ii) training and (iii) support and motivation from the local healthcare manager were independently associated with teleconsultation use. Conclusion: This study showed that training, and support and motivation from the local healthcare manager were the most important factors related to the teleconsultation use. This is an important finding that will assist in future development of approaches to increase the use and quality of teleconsultation services.
Constituição da República Federativa do Brasil Brasilia1988. (2015. Available at: http://www.planalto.gov.br/ccivil_03/Constituicao/Constituicao.htm accessed 12 October 2015.
Alkmim MB, Figueira RM, Marcolino MS, et al. Improving patient access to specialized health care: the Telehealth Network of Minas Gerais, Brazil. Bull World Health Org 2012;90(5):373-378.
Macinko J, Harris MJ. Brazil's family health strategy - delivering community-based primary care in a universal health system. New Engl J Med 2015;372(23):2177-2181.
BRASIL. Ministério da Saúde. Secretaria de Políticas de Saúde. Coordenação Geral da Política de Recursos Humanos. Política de Recursos Humanos para o SUS: balanço e perspectivas. Brasília: Ministério da Saúde, 2002.(2015) Available at: http://bvsms.saude.gov.br/bvs/publicacoes/cd03_16.pdf accessed 12 October 2015.
Marcolino MS, Alkmim MB, Assis TGP, Sousa LAPd, Ribeiro ALP. Teleconsultorias no apoio à atenção primária à saúde em municípios remotos no estado de Minas Gerais, Brasil. Revista Panam de Salud Pública 2014;3(5/6):345-352.
Marcolino MS, Alkmim MBM, Assis TGP, et al. A Rede de Teleassistência de Minas Gerais e suas contribuições para atingir os princípios de universalidade, equidade e integralidade do SUS - relato de experiência. R Elet de Com Inf Ino Saúde 2013;7(2).
Wen CL. Telemedicina e Telessaúde – Um panorama no Brasil. Informática Pública 2008;10(2):7-15.
Alkmim MB, Marcolino MS, Figueira RM, et al. Factors associated with the use of a teleconsultation system in Brazilian primary care. Telemed J e-Health 2015;21(6):473-483.
Portal do Governo do Estado de Minas Gerais. 2015. Conheça Minas. Available at: https://www.mg.gov.br/governomg/portal/m/governomg/5146-conheca-minas/5146/5044 accessed June 15 2015
Fagundes M. Pesquisa inédita traça perfil da enfermagem. Brasília: Conselho Federal Enfermagem, 2015. (2015). Available at: http://www.cofen.gov.br/pesquisa-inedita-traca-perfil-da-enfermagem_31258.html accessed 15 October 2015.
Alkmim MBM, Ribeiro AL. Incorporación de la Telesalud en el Sistema Público de Salud de Minas Gerais, Brasil. Santiago de Chile: CEPAL; 2012. (2012). Available at: http://www.cepal.org/es/publicaciones/4024-incorporacion-de-la-telesalud-en-el-sistema-publico-de-salud-de-minas-gerais accessed 15 October 2015.
Hu PJ, Chau PY. Physician acceptance of telemedicine technology: an empirical investigation. Topics Health Inform Manage 1999;19(4):20-35.
Whitten P, Holtz B, Meyer E, Nazione S. Telehospice: reasons for slow adoption in home hospice care. J Telemed Telecare 2009;15(4):187-190.
Ruas SSM. Facilitadores e barreiras à utilização das teleconsultorias off-line: a experiência dos médicos da atenção primária de Belo Horizonte. R Ele. de Com Inf Ino Saúde 2013;1.
Jennett P, Jackson A, Healy T, et al. A study of a rural community's readiness for telehealth. J Telemed Telecare 2003;9(5):259-263.
Jennett P, Jackson A, Ho K, et al. The essence of telehealth readiness in rural communities: an organizational perspective. Telemed J e-Health 2005;11(2):137-145.
Ohinmaa A, Hailey D, Roine R. Elements for assessment of telemedicine applications. Int J Technol Assess Health Care 2001;17(2):190-202.
Whitten P, Love B. Patient and provider satisfaction with the use of telemedicine: overview and rationale for cautious enthusiasm. J Postgrad Med 2005;51(4):294-300.
Whitten P, Holtz B. Provider utilization of telemedicine: the elephant in the room. Telemed J e-Health 2008;14(9):995-997.
Buck S. Nine human factors contributing to the user acceptance of telemedicine applications: a cognitive-emotional approach. J Telemed Telecare 2009;15(2):55-58.
Gagnon MP, Godin G, Gagne C, et al. An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians. Int J Med Inform 2003;71(2-3):103-15.
Hjelm NM. Benefits and drawbacks of telemedicine. J Telemed Telecare 2005;11(2):60-70.
Copyright (c) 2016 Cristiane Pessoa, Lidiane Sousa, Antonio Ribeiro, Teruã Oliveira, José Luiz Silva, Maria Beatriz Alkmim, Milena Soriano Marcolino
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.