Report On Perception and Use of Telemedicine

Report
Perception and Use of Telemedicine on Healthcare

Utilization among Khulna University Students
Course No.: Econ 2204

Course Title: Rural Development Issues - Fieldwork and Studio
Submitted to
Dr. Khan Mehedi Hasan
Professor
Economics Discipline
&
Faijan Bin Halim Submitted by
Associated Professor Group D
Student No.: 211501,
211504, 211506,
Khulna University
211513, 211515
Year: 2nd; Term: 2nd
Khulna University
Submission Date: October 08, 2023

Table of Contents
................................................................................................................................................................ 4
List of Figures.......................................................................................... Error! Bookmark not defined.
List of Tables ........................................................................................... Error! Bookmark not defined.
Chapter One: Introduction .................................................................................................................. 6
1.1 Background of the study................................................................................................................ 6
1.2 Objective of the study .................................................................................................................... 7
1.3 Research question ......................................................................................................................... 7
1.4 Rationale of The Study .................................................................................................................. 7
1.5 Scope of The Study ........................................................................................................................ 7
1.6 Limitations of the study ................................................................................................................. 8
Chapter Two: Literature Review ........................................................................................................ 8
2.1. Conceptual Framework ............................................................................................................... 9
2.1.1 Telemedicine ................................................................................................................................ 9
2.1.2 Perception and Use of Telemedicine............................................................................................ 9
2.1.3 Healthcare Utilization through the Use of Telemedicine ............................................................ 9
2.2 Review of Related Empirical Studies .......................................................................................... 10
2.3 Research Gap .............................................................................................................................. 11
Chapter Three: Methodology ............................................................................................................ 12
3.1 Study Area ................................................................................................................................... 12
3.2 Sampling Unit ............................................................................................................................. 12
3.3 Sampling Technique .................................................................................................................... 12
3.4 Sample Size ................................................................................................................................. 13
3.5 Major Variables of the Study ...................................................................................................... 13
3.6 Estimation Technique.................................................................................................................. 14
Chapter Four: Data Analysis ............................................................................................................. 14
4.1 Respondent of Telemedicine User by Gender ............................................................................. 15
4.2 Telemedicine usage frequency against family income ................................................................ 15
4.3 Knowledge about telemedicine ................................................................................................... 16
4.4 Device for using telemedicine ..................................................................................................... 17
4.4 Telemedicine Awareness Index ................................................................................................... 18
4.5 Relative Importance Index (RII) ................................................................................................. 19
4.6 Telemedicine Utilization ............................................................................................................. 20
4.7 Impact on Healthcare Utilization .............................................................................................. 21
4.8 Technological Difficulties of Telemedicine .............................................................................. 22
4.9 Legal and Regulatory Barriers .................................................................................................. 23
4.10 Future Preferences of Telemedicine ....................................................................................... 24
Chapter Five: Conclusion................................................................................................................... 25
5.1 Findings...................................................................................................................................... 26
5.2 Recommendations ...................................................................................................................... 26
5.3 Conclusion.................................................................................................................................. 27
Chapter One
Introduction
1.1 Background of the study

The present digital revolution welcomes in a new era for healthcare delivery (Eysenbach and
Jadad, 2001). Patient empowerment and related structural and ideological shifts are currently
transforming conventional, hierarchical face-to-face healthcare by telemedicine (Cabieses et al.,
2013). Telemedicine is the use of electronic information to communicate technologies to provide
and support healthcare when distance separates the participants (Brown, 1995). It allows
healthcare professionals to diagnose, treat, and monitor patients at a distance, typically through
video calls, phone consultations, secure messaging platforms, or other digital communication
tools. According to World Health Organization, 2011 telemedicine is defined as healing at a
distance along with the use of electronic information and telecommunication technology to
enhance patient outcomes by facilitating better access to care and medical information specific to
an individual's requirements.
Around the world, it can be difficult for residents in rural and isolated places to get timely, high-
quality specialist medical treatment. Since specialist doctors are more likely to be found in
densely populated urban regions, residents of these places frequently have poor access to
specialty healthcare. Telemedicine offers the ability to reduce this gap and improve access to
healthcare in thesePage 6 of 25 impoverished regions (Al-Sofiani and Alyusuf, 2021).
Utilizing the Internet and associated technology, telemedicine combines the comfort, cheap cost,
and simple accessibility to health-related information and communication (Vidal-Alaball et al,
2020). Telemedicine has several benefits, including the provision of intra- and inter-hospital
communication, a reduction in the cost of delivering high-quality healthcare, and the elimination
of the need to build new hospital buildings, which are typically lacking in poor nations (Wootton
et al., 2011). Despite the advantages of using telemedicine, responsiveness to medical
development is typically a crucial precondition for continued telemedicine usage (Kirsten et al.,
2019). The character that telemedicine will take will likely be influenced by people's knowledge,
perceptions, and attitudes toward it. This will be a key factor in deciding the success of
telemedicine in the long run (Kirsten et al., 2019).
According to national ICT policy, 2000 Bangladesh has officially implemented a telemedicine
program in its basic healthcare institutions. CRP did this with assistance from the UK's Swinfen
Charitable Trust since 1999. Bangladeshis encountered telemedicine during the start of the
COVID-19 epidemic and benefited greatly, like those in other developing nations (Chowdhury
et al.). However, the telemedicine service whether official or informal has yet to be in use
statewide in nations like Bangladesh despite its seeming promise. Even though the number of
people using telemedicine services has grown due to the epidemic, little is known about how
satisfied, accepting, and generally happy they are with it (Rahman et al., 2021). One of the
country's first telemedicine programs, the Dhaka University Telemedicine Programmed (DUTP)
aims to comprehend the prior knowledge and patient response of the patients or care recipients of
this hotline-based telemedicine program, such as experience, satisfaction level, and acceptance.
1.2 Objective of the study

The objective of the study is to find out perception and use of telemedicine on healthcare
utilization among Khulna University students.
1.3 Research question
 How does telemedicine impact patient satisfaction with healthcare services?

 How does the use of telemedicine impact the frequency, type, and cost of healthcare
services that patients receive?
1.4 Rationale of The Study
Telemedicine is increasingly gaining popularity as a healthcare delivery method, particularly
amid the COVID-19 pandemic, underscoring the importance of comprehending its perception
and utilization among university students. University students frequently encounter distinctive
health challenges like academic stress, restricted healthcare facility access, and mental health
concerns, making telemedicine a potentially convenient solution for addressing these issues.
Previous research on telemedicine utilization and perception has mainly centered on broader
demographics or specific patient populations, highlighting the need to fill a knowledge gap by
investigating Khulna University students to understand their unique attitudes and practices.
1.5 Scope of The Study
This study has focused on understanding how students at Khulna University in Bangladesh use
and think about telemedicine. We have chosen this university because it has a diverse group of
students and easy access to telemedicine services. We have talked to different students from
various departments.
We have collected information from 106 students using a method that helps us choose
participants in a thoughtful way. This number was chosen to make sure our study is practical and
gives reliable results.
We have looked at the information we have collected using basic math methods like averages
(mean), middle numbers (median), and most common numbers (mode). We have also looked at
how spread out the numbers are (standard deviation). Additionally, we have compared groups
and seen if things are related (correlation).
Our main focus has been on two things. First, we have wanted to know how students at Khulna
University use and think about telemedicine. Second, we have wanted to see if using
telemedicine affects their health and well-being positively.
1.6 Limitations of the study
The study's sample size may potentially not accurately represent the entire student population,
potentially impacting the generalizability of findings. Data collection through self-reporting may
be susceptible to response bias, as participants may not accurately represent their telemedicine
usage and perceptions. Findings might be specific to the Khulna University environment and
may not necessarily apply to other student populations or broader demographics. The study's
data may not adequately consider potential changes in telemedicine utilization and perceptions
over time. External factors like socio-economic status or access to healthcare facilities are not
thoroughly explored, potentially impacting the study's conclusions.
Chapter Two: Literature Review

2.1. Conceptual Framework
2.1.1 Telemedicine
The use of telecommunications technologies to deliver medical information and services is
known as telemedicine. It may be as straightforward as a phone call between two medical
professionals discussing a patient's issue, or it might be as complex as employing satellite
technology to broadcast a whole nation using video conferencing equipment. Telemedicine is the
term for the use of telecommunications technology to diagnose and treat patients at a distance
(Stanberry, 2000; Chen et al., 2013; Sims, 2018). The context for health management and
communication is created by this technological instrument (Gustke et al., 2000; Munos et al.,
2016).
2.1.2 Perception and Use of Telemedicine

The usage of telemedicine shows that patient and healthcare provider health communication has
been sped up and made more effective. However, they would hope and anticipate that
telemedicine will be more readily accepted as a tool by all medical professionals who want to
learn about and determine its full potential and utility. In actuality, telemedicine provides the
healthcare system as a whole and practitioners who use its services with a variety of advantages
in terms of health communication. From the patient to the community to the doctors and other
practitioners, telemedicine may help everyone. With this possibility in mind, Jonathan and
Gerald-Mark (2007) addressed and investigated the effects of telemedicine applications, such as
digitize health communication via Web-based services, transcend geographic boundaries,
transcend temporal boundaries, reduce costs, and increase patient comfort, security, and
satisfaction.
2.1.3 Healthcare Utilization through the Use of Telemedicine
Telemedicine can enhance access to medical services that are frequently inconsistently provided
in far-off rural communities by removing constraints caused by distance. The development of
information and communication technology (ICT) has increased access to healthcare services
and practitioners' interactions with patients in developed nations. Healthcare professionals can
now use telemedicine services to effectively consult with medical professionals inside and
outside of their geographic location, deliver healthcare services, and establish ongoing
communication with their patients without distance acting as a barrier (Matawalli and Ibrahim,
2014).
E-Health, according to the World Health Organization (2009), is the secure and cost-effective
use of information and communication technologies (ICT) in support of the health and fields
closely related to it, such as healthcare services, health surveillance, health literature, and health
education, knowledge, and research.
2.2 Review of Related Empirical Studies
The expense of telemedicine equipment, user acceptance, patient data privacy and
confidentiality, and a lack of established norms and regulations for telemedicine are all
mentioned as hurdles for adopting telemedicine services in Bangladesh by Nessa et al. (2010).
They additionally disclosed that the incorporation of telemedicine in already-established health
centers can make it simpler and less expensive to deliver healthcare to people in rural places, as
well as create new employment opportunities for them.
Given the lack of solid evidence, Ahmed et al. (2014) noted in their research that it is still
unclear how eHealth and mHealth will be incorporated into the current healthcare system.
Additionally, they warned that involving the public sector would aid in gathering data on the best
ways to incorporate mHealth and eHealth into healthcare systems. They also showed that there
are very few people in Bangladesh who have received training in eHealth, and that there is a high
need for capacity building and experience exchange, particularly for implementation and policy
making.
Khatun and Sima (2015) noted a development in the provision of ICT health services at Sadar
Hospital. Additionally, they noted in their study that Sadar Hospital and other institutions
struggle to provide e-health services because of a shortage of experienced workers, patients who
are unaware of how to use these services, and insufficient central government oversight.
A study was conducted in 2008 by Banjoko and Omoleke to evaluate knowledge and perception
of telemedicine and e-health. 200 healthcare professionals, including doctors, nurses,
pharmacists, laboratory scientists, medical records officers, radiographers, senior nursing and
senior medical students, participated in this study. Interviews and a semi-structured questionnaire
were used to assess their knowledge and perception. Only 42 (21%) of the respondents were
aware of the nation's intended telehealth program, and 83 (41.5%) had poor awareness about
telehealth. 138 people (69%) will advise others to use telehealth services, while 141 (70.5%) will
use them themselves. Due to the current lack of information, this outcome highlighted the
necessity for extensive stakeholder participation and public education prior to the creation of
government policy on telemedicine.
2.3 Research Gap
Undoubtedly, the majority of the existing research on telemedicine services in Bangladesh has
focused on evaluating the general state of the sector, its sustainability, and potential future
improvements. Despite the fact that these studies have offered insightful information, they
frequently ignored an important factor: the influence of people's views on the availability and use
of telemedicine services in the nation. Particularly, there is a substantial gap in the research when
it comes to the viewpoints of important parties, such as patients, medical professionals, and
doctors. By concentrating on the perception and use of telemedicine for Khulna university
students in Bangladesh, this study aims to close this gap. By doing this, it hopes to offer insight
on how this group's attitudes and beliefs may affect how widely and successfully telemedicine is
used across the nation, helping us gain a more complete picture of the country's telemedicine
environment.
Chapter Three: Methodology
3.1 Study Area

The study was conducted at Khulna University, which is located in Khulna, Bangladesh's third-
largest city. For in-depth research and advanced studies in the field, this university is very
significant. It's a great place to examine how students view and utilize telemedicine services
because they come from a variety of backgrounds and are in various financial situations.
Telemedicine is similar to in-person doctor visits, but over a video call. This study is worth
mentioning because it provides insight into the attitudes of young people toward using digital
health services, who are instrumental in popularizing technology in healthcare.
3.2 Sampling Unit

The population for this study comprises all students currently enrolled at Khulna University. This
includes students from all levels (undergraduate, postgraduate, etc.) and from all schools and
disciplines. Students must be enrolled in the study, have some engagement with telemedicine, be
willing to participate, and be at least 18 years old in order to take part. To ensure precise and
relevant findings about students' perceptions of and use of telemedicine, the study will not take
into account non-students, people who are unaware of telemedicine, unwilling participants, or
anyone outside the student community.
3.3 Sampling Technique

In this study, the authors aimed to investigate how Khulna University students view and utilize
telemedicine for their healthcare requirements. In order to accomplish this successfully,
they selected their participants using a multistage sampling technique. First, because they were
particularly interested in comprehending the behaviors and perceptions of Khulna University
students, they chose purposive sampling technique method. Next, they chose 106 students from
all 29 university disciplines using a method known as stratified disproportional sampling to
ensure that all disciplines, regardless of size, were represented in the study.
3.4 Sample Size
A total of 106 students from Khulna University were chosen as the sample for this study. This
sample size was carefully chosen to be both practical for data collection and analysis and to
accurately reflect the diverse student population.
3.5 Major Variables of the Study
The authors find out various type of variables to study this paper. There are various types of
variables such as socio-demographic, household information, perception and usage of
telemedicine, impact of healthcare utilization, telemedicine utilization, challenges and future
preferences related. And these variables are divided into different categories such as dummy,
categorical, continuous, and like art scale.
Table No. 3.1: Variable List
Variable Measurement Unit
Age In years
Gender Male=1, Female=0
Marital status Yes=1, No=0
Education level Hons 1st year=1, Hons 2nd year=2, Hons
3rd year=3, Hons 4th year=4
Credit access Yes=1, No=0
Income In BDT
Expenditure In BDT
Family size In numbers
Number of Earning Members In numbers
House ownership Own=1, Rent= 0
Number of Educated Family Members In numbers
Family size In numbers
Number of Earning Members In numbers
Awareness source Peer group=1, Parents=2, Friends=3, Online
platform=4
Device used Phone=1, Laptop=2, Smart Watch=3, Other
Digital Devices=4
Frequency of Use In numbers
Perception and Usage of Telemedicine Likert Scale
Strongly Agree=5, Agree=4, Neutral=3,
Disagree=2, Strongly Disagree=1
Impact of Healthcare Utilization Likert Scale
Telemedicine Utilization Audio call=1, Videocall=2, Apps=3,
SMS=4
Future Preferences Likert Scale
3.6 Estimation Technique

The following estimation techniques have been used to assess the real scenario of this study:
Research Question 1: To measure the level of awareness of telemedicine of Khulna University
students, the authors have created telemedicine awareness index. It indicates the respondents
whether they are aware or unaware based on his score. The score of a particular respondent has
been evaluated against the mean of all combined score. If the respondent has a score greater than
the mean, he is considered as well-aware or if his score is less, he will be regarded as unaware.
Research Question 2: The obstacles and challenges of telemedicine have been measured with the
help of a histogram and line graph. The authors have plotted histogram and line graph based on
the information collected from the students to locate the major obstacles and difficulties.
Chapter Four: Data Analysis

4.1 Respondent of Telemedicine User by Gender
Telemedicine as a method of delivering healthcare is gaining popularity these days. Everyone
uses this facility heavily, regardless of gender. The authors want to determine the gender-specific
percentage of telemedicine users. The goal is to determine how frequently people of different
genders use this facility. A pie chart has been made using the sample data. Figure 4.1, which is
shown below, shows how telemedicine use differs by gender in a clear and understandable way.
Figure 4.1: Respondent of Telemedicine User by Gender
Respondent of Telemedicine User by

Gender
42% Male
58%
(Source: Authors’ compilation, 2023)
The percentage of responders who use telemedicine for both genders is displayed in a pie chart.
Males make up 58% of telemedicine users, while females make up 42%. This indicates that men
are more likely than women to use telemedicine services. This pie chart offers an insightful
overview of the present gender distribution of telemedicine use.
Affordable healthcare is available through telemedicine. By paying a fair price, people of all
income levels can use this amenity. The authors compared the respondents' household income to
how frequently they used telemedicine. In figure 4.2, which is provided below, a scatter diagram
is used to measure this relationship.
4.2 Telemedicine usage frequency against family income
The scatter plot shows different income ranges starting from 0 to 100000 BDT. Respondents
whose family income is up to 20000 use telemedicine 36 times in the last six months. When the
respondent’s family income is between 20000 to 40000, use of telemedicine is 40 times.
Figure 4.2: Telemedicine usage frequency against family income
Again, respondent’s family lies between 40000 to 60000, 60000 to 80000 and 80000 to 100000
have the frequency of using telemedicine are 32, 5 and 2 times respectively during the last six
months. Healthcare facilities through the use of telecommunication is the outcome of modern
technology. The idea of giving medical treatment by ignoring the distance is an innovative one.
People came to know about this facility through various sources. The respondents for this
research work have given multiple answers for the question of their first idea about the existence
of telemedicine.
4.3 Knowledge about telemedicine

According to this histogram, 4 out of 106 have come to know about telemedicine from their peer
group. The frequencies of students being introduced with this facility by their parents, friends
and online platform are 9, 28 and 65 respectively. So, majority of the students came to know
about telemedicine from online platform.
Figure 4.3: Knowledge about telemedicine
To get the benefit of telemedicine one must have modern devices. These devices can be of
various types. When the students of Khulna University were asked about their medium of using
telemedicine, they gave more or less same answer. On the basis of their answers, table 4.1 has
been created which is given below.
4.4 Device for using telemedicine

From Table 4.4, it is clear that most of the students use phone as the medium of using
telemedicine which is 87 out of 106 respondents and the percentage is 82.08%.
Table 4.1: Device for using telemedicine

Device for using Frequency Percent
telemedicine
Phone 87 82.08%
Laptop 16 15.09%
Other Digital Devices 3 2.83%
Total 106 100%
Another 15.09% use laptop and the frequency for this is 16. Only three students use other digital
devices for taking medical treatment through telemedicine.
4.4 Telemedicine Awareness Index
This analysis evaluates the telemedicine awareness index. It indicates the respondents whether he
is aware or unaware based on his score. The authors calculate this to measure the awareness level
of telemedicine among the students. It has been given in table 4.2:
Table 4.2: Telemedicine Awareness Index

Respondents Score Stats Respondents Score Stats
1 30 Unaware 54 36 Well Aware
2 34 Well Aware 55 34 Well Aware
8 36 Well Aware 61 13 Unaware
14 32 Unaware 67 31 Unaware
30 16 Unaware 83 14 Unaware
Total Score = 3581
Mean = 33.7830
The analysis ascertained that 78 students out 106 are well aware of telemedicine which is around
74%. Rest of the 29 are unaware as their score lies below the average level and it is around 26%.
4.5 Relative Importance Index (RII)

The Relative Importance Index (RII) is a numerical representation of the importance of different
factors related to the perception and usage of telemedicine. In this specific dataset, factors such
as comfort in using telemedicine, concerns about quality, trust in diagnosing accuracy, security
and privacy confidence, patient-doctor relationships, and others have been evaluated. The RII
values have been calculated based on the importance ratings assigned by respondent’s responses.
A higher RII value indicates greater perceived importance. It has been given below in table 4.3:
Table 4.3: Relative Importance Index (RII)

Perception and Usage of Telemedicine RII Importance
Comfortable of using telemedicine 0.745283 5
Concern about the quality 0.777358 3
Varying degrees of comfort of using telemedicine 0.79434 1
Trust on the accuracy of diagnosing 0.720755 8
Confidence on security and privacy 0.716981 9
Strong patient-doctor relationship 0.724528 6
Providing comparable level of care to in-person visits 0.722642 7
Suitable alternative for routine check-ups 0.769811 4
Reliable internet connectivity 0.784906 2
Here in this table, "Varying degrees of comfort of using telemedicine" received the highest RII
and is ranked as the most important factor, suggesting that respondents prioritize comfort when
using telemedicine. Conversely, "Confidence on security and privacy" received the lowest RII,
indicating it is considered less crucial. These RII values and rankings provide valuable insights
into how individuals perceive and prioritize aspects of perception and usage of telemedicine,
which can inform healthcare providers and policymakers when implementing and improving
telemedicine services.
4.6 Telemedicine Utilization

The facilities of telemedicine are given using various medium. The common services of
telemedicine are appointment, test, report sharing, doctor’s consultation etc. and these services
are generally given through audio call, video call, apps and SMS. A table has been generated on
the basis of student’s responses regarding this. It is given below in table 4.4:
Table 4.4: Telemedicine Utilization
Medium Audio Call Video Call Apps SMS
Service
Type
Appointment 54 (42.86%) 8 (6.35%) 22 (17.46%) 42 (33.33%)
Test 7 (10.14%) 27 (39.13%) 25 (36.23%) 10 (14.49%)
Report Sharing 9 (9.47%) 23 (24.21%) 33 (34.74%) 30 (31.58%)
Doctor Consultation 36 (26.28%) 50 (36.50%) 27 (19.71%) 24 (17.52%)
This table provides a quantitative breakdown of healthcare service types distributed across
different communication mediums, offering insights into how healthcare services are delivered
and preferred by patients. Notably, "Appointment" services are prevalent across all mediums,
with audio calls (42.86%) and SMS (33.33%) being the primary channels for such appointments.
"Doctor Consultation" is another commonly provided service, especially through video calls
(36.50%), highlighting the increasing use of video communication in healthcare. "Report
Sharing" finds a substantial presence through apps (34.74%) and SMS (31.58%). Meanwhile,
"Test" services are frequently conducted via video calls (39.13%) and apps (36.23%). This data
underscores the diverse ways in which healthcare services are accessed, with varying preferences
for communication mediums across different service types, potentially reflecting patient needs
and technological capabilities in the healthcare sector.
4.7 Impact on Healthcare Utilization

This table presents quantitative data on the impact of various factors on healthcare utilization,
along with their weighted mean values and descriptive values. The weighted mean values
represent the average ratings given to each factor, with higher values indicating a more positive
impact. The formula for calculating weighted mean is given below:
W =wixi
∑
It is given below in table 4.5:

Table 4.5: Impact on Healthcare Utilization
Impact on Healthcare Utilization Weighted Mean Descriptive Value
Reliable information 3.698113208 Agree
Consume less time in consultation 3.933962264 Agree
Cost effective 3.858490566 Agree
Immediate response of specialist 3.650943396 Agree
Convenient follow up and procedure 3.773584906 Agree
Opinion of more than one doctor 3.91509434 Agree
24/7 access specialist 3.641509434 Agree
Reducing unnecessary visits to hospital 3.943396226 Agree
Easy scheduling and talking 3.877358491 Agree
Patient satisfaction 3.688679245 Agree
Composite mean 3.798113208 Agree
Here in this table, "Reducing unnecessary visits to the hospital" has a high weighted mean of
3.943, suggesting that respondents consider it highly beneficial for healthcare utilization. The
descriptive values indicate a general agreement among respondents, with all factors receiving an
"agree" rating. This collective agreement signifies that respondents perceive these factors as
positively influencing healthcare utilization. The composite mean, which averages all the factors,
is 3.798, further emphasizing the overall positive perception of these factors in relation to the
impact of healthcare utilization. In summary, this table provides a quantitative assessment of the
perceived impact of specific factors, indicating that respondents believe these factors are
beneficial and contribute positively to healthcare utilization.
4.8 Technological Difficulties of Telemedicine

Telemedicine is a rapidly growing field of healthcare that allows patients to receive care from
their providers remotely, using video conferencing and other technologies. While telemedicine
offers many benefits, it also faces a number of challenges, including technological difficulties.
The respondents were asked about the difficulties that they face while using telemedicine. On the
basis of their responses a histogram has been plotted. It is in figure 4.4 which is given below:
Figure 4.4: Technological Difficulties of Telemedicine
Technological Difficulties of
60 Telemedicine
50
Frequency 40
30
20
10
0
Internet Complex Digital illiteracy Unavailability of
connection functions of necessary
device devices

It can be seen from the histogram, the most common technological difficulty for telemedicine is
internet connection which is faced by 55 students. Another common technological difficulty for
telemedicine is the complexity of the devices and platforms used. About 17 students face this
difficulty. Additionally, some students may not have the digital literacy skills necessary to use
telemedicine devices and the number of this student is around 8. Finally, 26 students do not have
access to the necessary devices for telemedicine, such as smartphones, tablets, or computers.
Technological difficulties can have a significant impact on the quality and effectiveness of
telemedicine care.
4.9 Legal and Regulatory Barriers

There are some barriers for the further development of telemedicine. These barriers can be in
various forms. The authors have gathered data related the barriers from the students focusing on
four common difficulties. It can be seen in the figure 4.5 given below.
Figure 4.5: Legal and Regulatory Barriers

Legal and Regulatory Barriers
48
Frequency
24
19
15
LICENSING AND PUBLIC PERCEPTION MEDICAL PRIVACY AND

CREDENTIALING AND ACCEPTENCE MALPRACTICE SECURITY
This graph shows the frequency of legal and regulatory barriers of telemedicine. The most
common legal and regulatory barriers to telemedicine are licensing and credentialing. About 48
students identify this as the major barrier. Other barriers are public perception and acceptance
(24), medical malpractice (19), and privacy and security (15).This graph suggests that legal and
regulatory barriers are a significant barrier to the use of telemedicine. Addressing these barriers
will be essential to making telemedicine more accessible and effective.
4.10 Future Preferences of Telemedicine
Telemedicine will become more popular medium of taking healthcare services in coming times.
Students are very optimistic about the future prospects of telemedicine. By minimizing the
current difficulties of using telemedicine, it has the potential for further growth. The students
have expressed their views on the future preferences of telemedicine. It can be seen in figure 4.6.
Figure4.6: Future Preferences of Telemedicine

Future Preferences of Telemedicine
Sum of Strongly
Tool in disaster response Disagree
Sum of Disagree
Primary mode of consultation
Government support Sum of Neutral
Reduce healthcare disparities Sum of Agree
Medical records Sum of Strongly

agree
0% 50% 100%
This graph shows the future preferences of telemedicine, according to the number of people who
are willing to use it. About 74% of the respondents believe that telemedicine will become a
primary tool in disaster response. 81% of the students have agreed with the concept of
telemedicine being primary mode of consultation. Again 72% of the respondents believe that
telemedicine will get support from the government for further development. Telemedicine will
reduce healthcare disparities and will help to keep a good medical record, 72% and 69% students
have agreed with this idea. Overall, the graph suggests that there is a strong preference for
telemedicine in the future.
Chapter Five: Conclusion

5.1 Findings
This study focuses on Khulna University’s students’ perception and use of telemedicine on
healthcare utilization. The main finding of this study is that the telemedicine platform is
acceptable and usable to students, proved with the minimum and slight difference between the
average scores of each students and the combined mean. About 78 students out of 106 are well
aware of telemedicine facility. Meanwhile, comfort of using telemedicine is given the most
priority by the students when it comes to measure the awareness regarding telemedicine.
Uses of various medium can be seen for different services of telemedicine. Audio call has been
used most of the times for appointment. On the other, video call has been used most of the times
for both test and doctor’s consultation. Most of the reports have been shared through the use of
apps. The weighted mean is calculated for variables like reliable information, consume less time
in consultation, cost effectiveness and patient satisfaction under the impact on healthcare
utilization. Now, the composite mean of impact on healthcare utilization is 3.798. Descriptive
value against this composite is “agree”. It emphasizes an overall general positive perception of
the students regarding the impact. Among various difficulties “internet connection” is the most
important one. Because most of the students face problems related to internet connectivity while
using telemedicine. It has been seen that “privacy and security” is considered as the most
common barrier for the further development of telemedicine.
For future preferences, students are very optimistic about the future of telemedicine. The
percentages of “agree” for variables like key tool in disaster response, primary mode of
consultation, government support are very high. Since these variables are the determinants of the
future preferences of telemedicine, it gives a positive scenario. Today, most students considered
telemedicine platforms as an accessible and convenient way to receive healthcare services.
5.2 Recommendations
Based on the findings from this study, the following recommendations are made:
1. There is need for basic telecommunication devices and a strong internet communication
system in order to facilitate the use of telemedicine application and system.
2. Students need to be acquainted with the existence of this healthcare facility through modern
technology.
3. Health communication professionals should devise methods of approaching educational
institution to encourage them to integrate basic knowledge about telemedicine into their
programs that instruct the students on the most commonly used forms of telemedicine and the
forms likely to be used in the future.
4. Privacy and security of telemedicine needs to be increased for future development.
5. The surveyed Khulna University should embark on drastic development of telemedicine in
line with global trend in order to promote effective utilization of telemedicine services.
5.3 Conclusion
This study analyzed the perception and use of telemedicine among Khulna University students,
with a focus on its impact on healthcare utilization patterns. The study found that the
telemedicine platform is acceptable and usable to students, with comfort of use being the most
important factor for students when choosing a telemedicine platform.
Students use telemedicine for a variety of services, including appointments, tests, and doctor's
consultations. The most common method of communication is video call, followed by audio call
and apps. Students have an overall positive perception of the impact of telemedicine on
healthcare utilization, with the weighted mean for all variables under impact on healthcare
utilization being 3.798, which is interpreted as "agree."
The most important difficulty faced by students while using telemedicine is internet connection,
followed by privacy and security concerns. Despite these challenges, students are very optimistic
about the future of telemedicine and believe that it has the potential to become a key tool in
disaster response and the primary mode of consultation for students.
The study recommends the following policies to promote the use of telemedicine among
students:
 Improve internet connectivity in and around Khulna University.
 Address the privacy and security concerns of students.
 Raise awareness of the benefits of telemedicine among students.
 Make telemedicine services more affordable for students.
These policies could have a positive impact on policy making by encouraging the government
and other stakeholders to invest in telemedicine and make it more accessible to students.
Overall, this study suggests that telemedicine is an acceptable and usable platform for Khulna
University students, with a positive impact on healthcare utilization. The study also identifies
some challenges that need to be addressed, such as internet connectivity and privacy concerns.
By implementing the recommended policies, the government and other stakeholders can promote
the use of telemedicine among students and improve their access to healthcare services.
References:
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Perception and Use of Telemedicine on Healthcare

Course No.: Econ 2204

Submission Date: October 08, 2023

1.1 Background of the study

1.2 Objective of the study

 How does telemedicine impact patient satisfaction with healthcare services?

Chapter Two: Literature Review

2.1.2 Perception and Use of Telemedicine

3.1 Study Area

3.2 Sampling Unit

3.3 Sampling Technique

3.6 Estimation Technique

Chapter Four: Data Analysis

Respondent of Telemedicine User by

(Source: Authors’ compilation, 2023)

4.3 Knowledge about telemedicine

4.4 Device for using telemedicine

Table 4.1: Device for using telemedicine

Table 4.2: Telemedicine Awareness Index

4.5 Relative Importance Index (RII)

Table 4.3: Relative Importance Index (RII)

4.6 Telemedicine Utilization

4.7 Impact on Healthcare Utilization

It is given below in table 4.5:

4.8 Technological Difficulties of Telemedicine

(Source: Authors’ compilation, 2023)

4.9 Legal and Regulatory Barriers

Figure 4.5: Legal and Regulatory Barriers

LICENSING AND PUBLIC PERCEPTION MEDICAL PRIVACY AND

(Source: Authors’ compilation, 2023)

Figure4.6: Future Preferences of Telemedicine

Government support Sum of Neutral

Reduce healthcare disparities Sum of Agree

Medical records Sum of Strongly

(Source: Authors’ compilation, 2023)

Chapter Five: Conclusion

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