Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemic

Objectives This study explored attitudes, subjective norms, and perceived behavioural control of participants across urban, rural and remote settings and examined intention-to-use telemedicine (defined in this study as remote patient–clinician consultations) during the COVID-19 pandemic.Methods This...

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Main Authors: Leonila Dans, Antonio Dans, Gillian Sandigan, Herbert Zabala, Arianna Maever Loreche, Noleen Fabian, Regine Ynez De Mesa, Carol Tan-Lim, Johanna Lopez, Zharie Benzon, Josephine Sanchez, Nanette Sundiang, Mia Rey
Format: Article
Language:English
Published: BMJ Publishing Group 2024-09-01
Series:BMJ Health & Care Informatics
Online Access:https://informatics.bmj.com/content/31/1/e100837.full
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author Leonila Dans
Antonio Dans
Gillian Sandigan
Herbert Zabala
Arianna Maever Loreche
Noleen Fabian
Regine Ynez De Mesa
Carol Tan-Lim
Johanna Lopez
Zharie Benzon
Josephine Sanchez
Nanette Sundiang
Mia Rey
author_facet Leonila Dans
Antonio Dans
Gillian Sandigan
Herbert Zabala
Arianna Maever Loreche
Noleen Fabian
Regine Ynez De Mesa
Carol Tan-Lim
Johanna Lopez
Zharie Benzon
Josephine Sanchez
Nanette Sundiang
Mia Rey
author_sort Leonila Dans
collection DOAJ
description Objectives This study explored attitudes, subjective norms, and perceived behavioural control of participants across urban, rural and remote settings and examined intention-to-use telemedicine (defined in this study as remote patient–clinician consultations) during the COVID-19 pandemic.Methods This is a cross-sectional study. 12 focus group discussions were conducted with 60 diverse telemedicine user and non-user participants across 3 study settings. Analysis of responses was done to understand the attitudes, norms and perceived behavioural control of participants. This explored the relationship between the aforementioned factors and intention to use.Results Both users and non-users of telemedicine relayed that the benefits of telemedicine include protection from COVID-19 exposure, decreased out-of-pocket expenses and better work–life balance. Both groups also relayed perceived barriers to telemedicine. Users from the urban site relayed that the lack of preferred physicians discouraged use. Users from the rural and remote sites were concerned about spending on resources (ie, compatible smartphones) to access telemedicine. Non-users from all three sites mentioned that they would not try telemedicine if they felt overwhelmed prior to access.Discussion First-hand experiences, peer promotions, and maximising resource support instil hope that telemedicine can help people gain more access to healthcare. However, utilisation will remain low if patients feel overwhelmed by the behavioural modifications and material resources needed to access telemedicine. Boosting infrastructure must come with improving confidence and trust among people.Conclusion Sustainable access beyond the pandemic requires an understanding of factors that prevent usage. Sufficient investment in infrastructure and other related resources is needed if telemedicine will be used to address inequities in healthcare access, especially in rural and remote areas.
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spelling doaj-art-0f9f34521b96472c9b4eb05e092a482e2025-08-20T03:48:51ZengBMJ Publishing GroupBMJ Health & Care Informatics2632-10092024-09-0131110.1136/bmjhci-2023-100837Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemicLeonila Dans0Antonio Dans1Gillian Sandigan2Herbert Zabala3Arianna Maever Loreche4Noleen Fabian5Regine Ynez De Mesa6Carol Tan-Lim7Johanna Lopez8Zharie Benzon9Josephine Sanchez10Nanette Sundiang11Mia Rey126 Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila City, Philippines1 Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines1 Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines4 National Clinical Trials and Translation Center, National Insitute of Health, University of the Philippines Manila, Manila City, Philippines2 College of Nursing, University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines1 Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines3 Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila City, Philippines1 Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines1 Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines1 Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines1 Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines1 Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesObjectives This study explored attitudes, subjective norms, and perceived behavioural control of participants across urban, rural and remote settings and examined intention-to-use telemedicine (defined in this study as remote patient–clinician consultations) during the COVID-19 pandemic.Methods This is a cross-sectional study. 12 focus group discussions were conducted with 60 diverse telemedicine user and non-user participants across 3 study settings. Analysis of responses was done to understand the attitudes, norms and perceived behavioural control of participants. This explored the relationship between the aforementioned factors and intention to use.Results Both users and non-users of telemedicine relayed that the benefits of telemedicine include protection from COVID-19 exposure, decreased out-of-pocket expenses and better work–life balance. Both groups also relayed perceived barriers to telemedicine. Users from the urban site relayed that the lack of preferred physicians discouraged use. Users from the rural and remote sites were concerned about spending on resources (ie, compatible smartphones) to access telemedicine. Non-users from all three sites mentioned that they would not try telemedicine if they felt overwhelmed prior to access.Discussion First-hand experiences, peer promotions, and maximising resource support instil hope that telemedicine can help people gain more access to healthcare. However, utilisation will remain low if patients feel overwhelmed by the behavioural modifications and material resources needed to access telemedicine. Boosting infrastructure must come with improving confidence and trust among people.Conclusion Sustainable access beyond the pandemic requires an understanding of factors that prevent usage. Sufficient investment in infrastructure and other related resources is needed if telemedicine will be used to address inequities in healthcare access, especially in rural and remote areas.https://informatics.bmj.com/content/31/1/e100837.full
spellingShingle Leonila Dans
Antonio Dans
Gillian Sandigan
Herbert Zabala
Arianna Maever Loreche
Noleen Fabian
Regine Ynez De Mesa
Carol Tan-Lim
Johanna Lopez
Zharie Benzon
Josephine Sanchez
Nanette Sundiang
Mia Rey
Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemic
BMJ Health & Care Informatics
title Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemic
title_full Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemic
title_fullStr Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemic
title_full_unstemmed Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemic
title_short Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemic
title_sort perspectives on telemedicine across urban rural and remote areas in the philippines during the covid 19 pandemic
url https://informatics.bmj.com/content/31/1/e100837.full
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