LEVELS AND DETERMINANTS OF OPENNESS TO USING TELEMEDICINE TECHNOLOGY AMONG FAMILY MEDICINE PHYSICIAN AT THE PRIMARY CARE

The use of telemedicine technology (TMT) has been increasing in Saudi Arabia in the past few years. However, its effectiveness is limited by levels of use (LoU) and acceptance, notably among physicians. Furthermore, there is lack of data regarding the acceptance of TMT in primary healthcare (PHC).

Objective: To explore the acceptance of TMT among PHC family medicine physicians (FMP) using the technology acceptance model (TAM), and to analyze eventual external factors.

Method: A cross-sectional study was conducted at the Ministry of Health (MoH) primary healthcare centers (PHCCs) in Riyadh city, Saudi Arabia, during June – October 2021. A cluster sampling method was used to recruit 150 FMPs. An electronic questionnaire was designed based on TAM, and comprised four subscales: current LoU, perceived usefulness or harmfulness (PUH) of TMT in primary care, perceived ease of use (PEoU), and behavioral intention to use TMT. All four subscales enabled calculation of scores.

Result: All subscales showed good reliability. The mean (SD) PUH score was 61.17 (18.69) out of 100, and perceptions were significantly positive for 23 out of the 25 PUH items (mean score >0, p-value<0.05, [one-sample t-test]). The highest mean score was observed in the item related to physicians’ rights (0.75 out of 2), followed by medical confidentiality (0.73), and equitable access to care (0.71). On the other hand, perception was lowest for diagnostic accuracy (0.05) and negative for medical student’s training (-0.20). The multivariate model of PUH showed age category (B = -7.26; 95% CI = -13.47, -1.04; p=0.022) and PEoU score (B = 2.56; 95% CI = 1.93, 3.20; p<0.001) to be independently associated with PUH score, explaining 36.0% of the PUH score variance.

Behavioral intention model sowed PEoU to be the sole independent factor for behavioral intention (B=0.65; 95% CI = 0.54, 0.75; p<0.001), explaining 62.5% of behavioral intention score variance. The mean (SD) PEoU was 17.66 (3.93) and the mean (SD) behavioral intention score was 14.32 (3.42).

Conclusion: FMPs in Riyadh have favorable perceptions towards TMT and its implementation in PHC. However, there are reservations with regards to quality care, training of healthcare professionals, financial, and social stability of the physicians.

Keywords: telemedicine technology, perceived usefulness of harmfulness, behavioral intention, medical students, family medicine physicians, subscales.