An adoption framework for telemedicine care: a study of Nandi county, Kenya

Abstract

Telemedicine is one of the technologies that use the knowledge of Information Communication Technologies (ICTs) to curb geographical barriers while increasing access to healthcare services. This study aimed at design an adoption framework for telemedicine care in Kenya. This study was done in health facilities in Nandi County. The specific objectives of the study were: To examine healthcare needs for telemedicine care in Nandi County -Kenya; to analyze the readiness use status for telemedicine care adoption and to design a suitable telemedicine care adoption framework. Though telemedicine care is in existence, the researcher felt that an adoption framework should be considered to guide in its implementation. This study was conducted using cross- sectional survey design in which study sample of 4 doctors, 59 nurses, 12 clinical officers, 1 pharmacist and 4 pharmaceutical technologists, making it a sample size of 80 from target population of 100 healthcare workers working at the County hospital, two sub county hospitals and 2 health centers. Structured questionnaire was used to collect the data. Pretesting for the instruments was done to ascertain face and content validities. The data collected was analyzed using SPSS software version 20. Analyzed results were presented using table, pie-chart and bar graphs. From the findings it was evident that the most critical health care need in Nandi County is direct patient services (82.5 %) followed by special referral services and Tele-pharmacy which were rated at 77.5 % and 54.5 % respectively. While, the least critical healthcare need areas were medical education and mentoring (53.8%), Tele-nursing (51.3%), remote patient monitoring (45%), Tele-radiology 20%.In view of readiness for Tele-medicine, most of the respondents (46.3%) cited that other technologies started recently in Nandi County in solving healthcare problems. It was further noted that, 50% of the respondents observed that it takes up-to 10 minutes to attend to patients using telemedicine in the County Referral hospital as compared to 18.8% of the respondents who observe that it takes up-to 10 minutes to attend to patients without using telemedicine. These findings were used to design a Telemedicine framework to enhance improved service delivery. The framework designed has illustrated that direct patient services is popular with health workers interviewed at 82.5% and the least Teleradiology at 20%.The health workers can comfortably use telemedicine service. From the research findings; it was noted that stakeholder involvement, human resources capacity building and increased funding can play an important role during adoption. Lastly, the findings has clearly demonstrated that; direct patient services, specialist referral services, and Tele Pharmacy need to be considered for acceleration of telemedicine care.