Date of Award

10-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Masood Kadir

Second Advisor

Dr. Qamar Masood

Third Advisor

Mr. Atif Riaz

Department

Community Health Sciences

Abstract

Background: Today, Pakistan's healthcare system is facing challenges like poor infrastructure, a severe shortage of medical professionals, poor medical facilities in rural regions, a high cost of health services, and limited government spending in the sector. These key problems in the health sector can be addressed with the use of telemedicine. Telemedicine can assist in decreasing inefficiencies in the provision of healthcare, enhance access, reduce costs, and improve quality of life. Many small-scale telemedicine initiatives such as managing chronic diseases such as Diabetes Mellitus through telemedicine services so far have not turned into full-scale implementation in Pakistan leaving it unintegrated in healthcare delivery.
Objectives: The study aimed to explore the experiences and perceptions of the healthcare providers’ and organizations’ heads on the readiness for telemedicine intervention, exploring factors hindering the effective provision of telemedicine services. Furthermore, this study also aimed to explore patients’ perceptions of the telemedicine services being provided and its acceptance among diabetic patients as the primary beneficiaries of the services to have a perspective of both service provision and service uptake and utilization.
Methods: It is a descriptive exploratory qualitative study. The study duration was from July to September 2022. Two private organizations were selected that are providing telemedicine services for diabetic patients. The participants were diabetic patients, healthcare providers, and organization heads who had experience with telemedicine services. To explore the perceptions of participants in-depth interviews were conducted using a semi[1]structured interview guide. Interviews were audio tapped after receiving informed consent from the participants. The qualitative data was first transcribed in Urdu verbatim and translated into English. Translated data were analyzed using the manual thematic analysis method.
Results: The study identified three major themes that include: stakeholders' acceptability towards telemedicine service, technological readiness for telemedicine service provision, and Organizations’ cultural factors influencing telemedicine service provision. These themes addressed challenges like lack of patients’ trust in getting care through telemedicine service due to usability issues, healthcare providers’ concerns with the assessment accuracy via telemedicine service and unorganized process, similar service package compared to in-person care, lack of proper user-friendly portals, lack of organizations’ interest in telemedicine service, lack of standardization of service, technological issues, and lack of collaboration within and between organizations.
Conclusion: There are many telemedicine initiatives that are being introduced in Pakistan. Despite these initiatives telemedicine services remain an unintegrated part of the healthcare delivery model. There is no one standard implementation model for telemedicine service, which can be considered an efficient solution. The study revealed that the stakeholders do have some knowledge about telemedicine service, however, they prefer in-person care and only see telemedicine service as an additional option in cases where hospital visits are not possible. Telemedicine service is perceived to be a supplement to routine care rather than a mainstream care model. Apart from some positive responses regarding telemedicine service, the study findings also reported the challenges and obstacles in the successful integration of telemedicine service into the healthcare delivery model. These challenges affect the readiness level of patients, healthcare providers, and healthcare organizations for telemedicine service provision and uptake. Strategies to prepare for an effective telemedicine service provision and its integration into the healthcare infrastructure consist of the involvement of the government in the establishment of regulatory authorities for service standardization, the introduction of courses related to digital health in medical schools to better-equipped healthcare professionals, training and licensing of the healthcare professionals to practice telemedicine service to ensure accountability and quality of service, stakeholders collaborations to work together in making service effective and efficient and sustainable.

First Page

1

Last Page

96

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