Introducing telemedicine technology to rural physicians and settings

OBJECTIVE We investigated rural health providers' perceptions of telemedici ne, developed a framework for assessing their readiness to adopt this type of technology, and offered a guide for its implementation. STUDY DESIGN We collected qualitative data from semistructured interviews w ith thematic analysis. POPULATION The study population included physicians, nurses, and administra tive personnel located in 10 health care practices in 4 communities in 3 ru ral Missouri counties. OUTCOMES MEASURED We measured how often health providers used telemedicine technology and their perceptions of the advantages, disadvantages, barriers , and facilitators involved in adopting it. RESULTS Participants varied widely in their perceptions of telemedicine. Pr oviders in practices affiliated with the university's tertiary center were more likely to use it than those in private practice. Interviews and other data yielded G themes related to a provider's receptivity to technological change: These themes were turf, efficacy, practice context, apprehension, t ime to learn, and ownership. Each theme applies to the computer and videoco nferencing components of: telemedicine, and each may operate as a perceived barrier or facilitator of change. CONCLUSIONS Care providers and administrators consider a range of factors, including economic ramifications, efficacy, social pressure, and apprehensi on, when deciding whether and how fast to adopt telemedicine. Since adoptin g this technology can be a major change, agencies trying to introduce it in to rural areas should take all these factors into account in their approach to health care providers, staff, and communities.