Barriers to the Up-Take of Telemedicine in Australia - A View from Providers

The article reports on the barriers to the up-take of telemedicine, one example of a technology which has advanced in its capacity to increase access to healthcare services, from the perspective of participants in a national study. "A national study was conducted to investigate the current perceived use and usefulness of telemedicine from the perspective of users and providers, and their views on how telemedicine could be expanded in Australia. In one component of this national study, the expert opinion of experienced providers of telemedicine services was elicited ...using semi-structured interviews which were analyzed thematically."

This sample consisted of: five medical practitioners who were employed to provide telemedicine services; two medical practitioners who did so in a voluntary capacity; two academics with a history of conducting research in this area; one internet specialist employed to set up systems for telemedicine; a trainer who conducted the training using telemedicine infrastructure; and a national body which intends using this technology to increase access to their area. The forms of telemedicine currently used by this sample were: email; direct file transfers; videoconferencing; and webinars. All interviewees had everyday contact with medical practitioners who are users or potential users of telemedicine.

From the abstract: "The primary barriers identified were: funding; time; infrastructure; equipment; skills; and preference for the traditional approach. While funding is a well-known barrier to the up-take of telemedicine, the extra time required for a telemedicine consultation has particular implications for the workload of rural doctors. The comparatively poor Internet access available in rural Australia combines with difficulties accessing some items such as a computer, to make equipment an issue. Even though lack of equipment skills was identified as a barrier, the providers in this study reported that rural doctors are adept at using the telephone/teleconferencing and facsimile. A preference for a traditional approach can reflect a lack of interest in learning computer skills or difficulty acquiring this skill set. Conclusions: These results raise issues in the domains of policy, funding priorities, and education and training. This indicates an inter-related set of challenges that would require a targeted multifaceted approach to address. The results suggest that not using telemedicine is, in the current climate, a rational response - it is quicker, easier and more cost-effective not to use telemedicine."