An Empirical Study On Determinants Affecting Telemedicine Services Among Healthcare Professionals In Ghana

The proliferation of information and communication technologies(ICT)in augmenting healthcare services has highlighted the determinants essential to technology acceptance by healthcare professionals.The recent techniques in healthcare deliveries and protection of patient’s digital information through ICT services have led to the formation of nice embroidery of telemedicine services.These telemedicine services does not represent a separate medical profession,but instead,an interconnected systems comprising of several expert health professionals’ knowledge embedded in a system for the delivery of medicine from typical medical confinement to the doors of patients.This usually occurs when distance separates the healthcare professional and patient for exchanges of health information for treatment,diagnosis,research and evaluation,continuing health education,etc.all in the interest of promoting the health of the populace and their communities.The aging and anticipated shortages of expert healthcare professionals in the foreseeable future will create significant access to healthcare problems for people in sub-Saharan African countries and telemedicine services therefore becomes the next line of service to solve most populace healthcare problems.Telemedicine services have been bedeviled with several factors which affect healthcare professionals’ zeal to accept its full utilization.This current study is based on the proposition that to be able to achieve full utilization of telemedicine services by healthcare professionals in patient care,the determinants affecting its utilization must be examined.The Researcher therefore set up the following objectives for this study;the first objective is to assess the effects of internal factors on healthcare professionals’ behavioral intention towards the acceptance and use of telemedicine services.The second objective is to examine the effects of technological factors that threaten healthcare professionals,behavioral intentions to adopt telemedicine services based on threats,and coping appraisals.The third objective is to analyze the influence of predictive factors that stimulates health professionals’ satisfaction with the use of telemedicine services.The fourth objective analyze the effects on the challenges confronting the weak regulatory framework of telemedicine services based on legal,licensure,ethical,and culture as social determinants of health factors and lastly,the fifth objective suggest policy recommendation for effective adoption and utilization of telemedicine services in healthcare delivery in Ghanaian hospitals.The study applied health technology acceptance models,including technology acceptance model(TAM),protection motivation theory(PMT),diffusion of innovation model(DOI),and some regulatory policies to investigate these quandaries affecting telemedicine services in selected hospitals in Ghana.The study employed a mixed-method approach in answering the research questions.The first part employed a quantitative approach where data was collected through questionnaires developed based on health technology acceptance models and administered to respondents.Purposive and convenience sampling methods were used to select healthcare professionals from diverse medical fields.A participant’s sample size of five hundred and forty-three(543)comprising of physicians,physician assistants,nurses,telemedicine service providers,and health service administrators,who utilize and regulate telemedicine services in their routine healthcare activities were selected from four health institutions in the eastern part of Ghana to participate in the research.The researcher analyzed the answered questionnaire using Structural Equation Modeling(SEM)approach with Statistical Package for Social Science(SPSS version 23)and Analysis of Moment Structures(Amos version 23)software’s for the measurement and structural models respectively.Out of the sixteen(16)hypotheses proposed,only(2)were rejected based on the bivariate correlation and regression analysis of the study.All the remaining fourteen(14)hypotheses were positive and significant but at different significant levels and as supported by extant works of literature.In the qualitative section of the study,the researcher focused on the feeble regulatory framework policies governing telemedicine services adoption in the Ghanaian health services.Extant literature is unequivocal about the fact that regulatory policies are also determinants for telemedicine services to succeed in a country.Information about this section of the study was obtained through a post-discussion interaction with high profile healthcare administrators and extant pieces of literature.The data analyzed from the study portrays that very large respondents of the study population have previously gained interest in using telemedicine services in their medical routines.The most predominant telemedicine services used in the hospitals were teleconsultation,telediabetes education,and telesurgery services.These telemedicine services were hampered by factors like regulatory controls,service inaccessibility,privacy and security issues,socio-cultural issues,and lack of motivation from the supervising teams.Secondly,the results expose the receipt and utilization of telemedicine services by health care professionals.Physicians were considered as the primary users of the telemedicine services,and because of the trust relationship between their patients,their acceptance is of great interest to telemedicine services sustainability.Health professionals were relatively independent when making clinical decisions and the influence of other users in the social system had no bearing effects on each other.Again,concerns about the privacy and security of telemedicine services may harmfully affect health professionals’ trust and intimidate the services improvements in effectiveness,usefulness,and accessibility to service deliveries if mishandled.The protection of patients’ data and privacy helps to erode mistrust indulge in the health facilities by their patients,which influences the judgments they make when using telemedicine services.Furthermore,the study revealed that the attributes of the telemedicine systems as extrapolative factors for its acceptance,and health professionals’ behavioral intention are vital constructs in telemedicine services receipt.The study acknowledges that these predictive variables play many important roles in health professionals’ satisfaction with telemedicine services utilizations.The study recommends that hospital administrators should set up proper policies governing telemedicine services reimbursement procedures.This study also proposes a new paradigm of security precautions that ought to be maintained by healthcare administrators to prevent unauthorized users from hacking patient data because patients’ data hacked tarnishes the image of the patient and the hospital as well.The study also proposes some healthcare policies that must be consistent and integrated into the working culture of healthcare professionals using telemedicine services.This study brings to the fore the important roles played by telemedicine services as one of the most versatile methods of maintaining access to specialist healthcare providers,reducing cost and referrals,and also as a method to boost the dearth of trained medical specialists.The study also identifies the key determinants in promoting telemedicine services among health professionals like perceived ease of use,perceived usefulness,threats and coping appraisals,and policies to support the weak regulatory telemedicine framework.The study makes several significant contributions to theory with respect to factors affecting telemedicine services acceptance by healthcare professionals’ in sub-Saharan Africa(Ghana).Additionally,the study makes substantial contributions to empirical knowledge by recognizing the most predictive determinants promoting telemedicine services.The study recommendations have immediate implications for healthcare professionals,administrators,policymakers,and researchers.The study results are of practical and theoretical significance to current and future researchers.The major innovations of the study are:Firstly,the study bonds TAM and DOI theories together to produce a single hybridized model to explore the internal factors that persuade health professionals’ behavioral intention to accept telemedicine services.This is an area where most researchers and health application developers have astonishingly ignored.In addition,the study uses a hybrid of panel data models by combining PMT and TAM theories to produce a model that accesses the impact of the technological factors on the acceptance and use of telemedicine services.Again,the study utilizes robust and recent structural equation modeling approaches to test key hypotheses that provide better statistical inferences crucial for policy formulation and future reforms on telemedicine services acceptance by health professionals and healthcare administrators.Lastly,the study investigates the weak telemedicine regulatory framework policies and countermeasures that ought to be considered in the implementation of telemedicine services.The study again utilized recent methodologies and cybersecurity techniques in safeguarding telemedicine services adoption.