Telemedicine- A study on attitude and

awareness of people within Ahmedabad

Prepared by,
Kishna Patel(157780592074)
Rushabh Shah(157780592095)
MBA,Sem 4, SLIBM
 1. INTRODUCTION
 Telemedicine- fusion of ICT with medical science having potential of
healthcare delivery to rural area.
 Definition according to WHO.
 Distance healing
 Greek word “Tele” means distance
 Latin word “mederi” means to heal.
 Use of technology by using computers, software, telecommunication
system etc.
 2. LITERATURE REVIEW
 The pharma innovation - Journal vol. 2 no. 4 2013 telemedicine- an innovating healthcare
system in India Debjit Bhowmik , S.Duraivel, Rajnish Kumar Singh, K.P.Sampath Kumar)
 Telemedicine is a developing application of clinical medicine where phone and internet are used.
 Use of communication and IT for delivery of clinical care.
 More beneficial for rural people where distance is crucial factor.

 Telemedicine: A New Horizon in Public Health in India, Indian Journal community Med 33
(1):2008; January.
 Email-based telemedicine
 Telediagnosis

 Ramesh. Gamasu M.Tech Research Scholar, Department of Electrical and Electronics

Engineering, SACET, Cherala (A.P), India).
 Utilizing sophisticated satellite technology to broadcast consultations between healthcare
professionals who are oceans apart or only a few miles away.
 3. PROBLEM DEFINITION

 The people who are living in rural & remote areas are still struggling to get proper healthcare
services at proper time.
Due to the innovations in computing and telecommunication technology, many elements of
medical practice can be accomplished when the patient and health care provider are geographically
separated.
This separation could be as small as across town, across a state, or even across the world.
Telemedicine is like a boon for this kind of struggling if implemented properly.
 4. RESEARCH OBJECTIVES
To find out whether the people of Ahmedabad are aware about telemedicine or not.
To find out their attitude towards telemedicine; whether they are ready to avail it or not.

5. RESEARCH METHODOLOGY
 Research design- Descriptive Research
 Data source- Primary data
 Research instrument- Survey questionnaire
 Sample respondent profile -Doctors and people within Ahmedabad
 Sampling- Convenient random sampling
 Sample size- General public- 500
Doctors-20
 4.DATA ANALYSIS AND INTERPRETATION
(Questionnaire for General Public)
 Graphical interpretation
Age Group:- Gender:-
Annual family income Occupation
1) Did you ever come across the term “Telemedicine” before this survey?

00
YES
No

45%
55%
 2) What do you understand by Telemedicine services?
a) Healthcare services for emergency situation
b) Healthcare services where distance is critical factor
c) Healthcare services for Rural area.
d) Other________

Options No. of Respondents

Healthcare services for emergency situation 80
Healthcare services for emergency situation,
Healthcare services where the distance is a
critical factor 15
Healthcare services for emergency situation,
Healthcare services where the distance is a
critical factor, Healthcare services for Rural
area 75
Healthcare services for Rural area 65
Healthcare services where the distance is a
critical factor 160
Healthcare services where the distance is a
critical factor, Healthcare services for Rural
area 105
Grand Total 500
 3) Have you ever experienced
Telemedicine services? If yes then, would you recommend it to others?
4) Telemedicine can improve access 5) Do you think communication skills
of healthcare services. will affect on the Telemedicine session?

No. Of respondents
200

180

160

140

120

100
No. Of respondents
80

60

40

20

0
Strongly Agree Neutral Disagree Strongly
Agree Disagree
6) Does service provided over 7) Do you think it should be used only
Telemedicine will be as effective as
visit done in-person? in emergency situation?
8) In future, are you going to avail Telemedicine If yes then, why you are going to avail Telemedicine
Services? services?

No. Of
Options Respondents
Cost effectiveness 21
Cost effectiveness, I will use it only in emergency situation 10
I will use it only in emergency situation 88
Time saving 94
Time saving, Cost effectiveness 142
Time saving, Cost effectiveness, I will use it only in emergency situation 110
Time saving, Cost effectiveness, To overcome travelling 5
Time saving, I will use it only in emergency situation 30
Grand Total 500
 If no then, why you are not going to avail Telemedicine services.

Some of Reason:-
 Because it becomes complicated.
 Because physical visit to doctor is more effective than this.
 Because some people are not much aware about this so they don’t know how to
use.
B. CONTINGENCY ANALYSIS: - CHI-SQUARE TEST OF INDEPENDENCE

 Hypothesis 1
 Association between occupation and awareness about Telemedicine:-
 H0- There is no relationship occupation and awareness about Telemedicine
 H1- There is relationship occupation and awareness about Telemedicine
 Level of significant- 5%
 Decision Rule – If asymptotic significant (2-sided) is less than the level of
significant then we reject the null hypothesis.
 Here,
 Asymptotic Significant- 0.0000
 Level of significant- 0.005

 So, We reject the null hypothesis and accept the alternate hypothesis.
 So we can say that there is relationship between occupation and awareness about
awareness about Telemedicine.
Hypothesis 2

Association between occupation and attitude about Telemedicine:-

 H0- There is no relationship occupation and attitude about Telemedicine
 H1- There is relationship occupation and attitude about Telemedicine
 Decision Rule – If asymptotic significant (2-sided) is less than the level of
significant then we reject the null hypothesis.
 Here, Asymptotic Significant- 0.0000
Level of significant- 0.005
 So, We reject the null hypothesis and accept the alternate hypothesis.

 So we can say that there is relationship between occupation and awareness about
attitude about Telemedicine.
5. Data Analysis & Interpretation (Questionnaire for Doctors)

AGE: GENDER
 (1.) Telemedicine will help in easy access
 EMPLOYEMENT:-
of healthcare services for rural area:
2) Telemedicine will give benefits only to the 3) Telemedicine will help to save patient’s time
urban community. and money.
(5.) Telemedicine should be implemented (4.) Telemedicine can never replace face to
in all hospital equipped with internet face consultation.
facility.
6.) According to you, which of the following application of
telemedicine would be beneficial to patients?

Options YES NO
1.) Teleconferencing with patient by telephone. 17 3
2.) Monitoring patients at home. 18 2
3.) Making outpatient appointments using internet. 19 1
4.) Videoconference consultation between patients and doctor. 19 1
(7.) According to you, which of the following are issues for
implementation of telemedicine??

Options YES NO
1) High cost for equipments. 12 8
2) Lack of suitable training to use equipments. 5 15
3) Lack of user-friendly software. 5 15
4) Concerns regarding multistate licensing requirement. 18 2
5) Monitoring the quality of telemedicine services. 17 3
(8.) What is their overall thinking about this "Telemedicine" concept?
B. CONTINGENCY ANALYSIS: - CHI-SQUARE TEST OF INDEPENDENCE

Relationship between Employment and overall view about Telemedicine:-

 H0 – There is no relationship between Employment and overall view about Telemedicine:-
 H1 - There is relationship between Employment and overall view about Telemedicine:-.

CONTENGENCY TABLE: OBSERVED VALUE

Options Good Idea Neutral Grand Total

Non-teaching Hospitals 2 0 2
Private Clinic 11 1 12
Teaching Hospitals 4 1 5
JR in govt. Hospital 1 0 1
Grand Total 18 2 20
 EXPECTED VALUE

Options Good Idea Neutral Grand Total

Non-teaching Hospitals 1.8 0.2 2
Private Clinic 10.8 1.2 12
Teaching Hospitals 4.5 0.5 5
JR in govt. Hospital 0.9 0.1 1
Grand Total 18 2 20

Expected value=
 Calculated the χ2value.

Options Good Idea Neutral Grand Total

Non-teaching Hospitals 0.022 0 0.022

Private Clinic 0.003 1.2 1.20

Teaching Hospitals 0.055 0.5 0.55

JR in govt. Hospital 0.011 0 0.011

Grand Total 0.092 1.7

1.792

χ2 =0.22+0+0.003+0.055+0.011+1.2+0.5+0=1.792

• The critical table value for α=0.05 is χ2(0.05,3) =7.814

Decision rule: - Reject the null hypothesis if the observed chi-square is greater than 7.814.

• The observed chi square is less than the tabulated value

So we accept the null and reject the alternate.
Research Findings from surveying public:
1.) It was found that even before this survey, 55% of the people were aware about the term 'Tele-Medicine' and Only about
22% people have experienced telemedicine service in ahmedabad.
2.) out of 500 around 40% people say that healthcare services where the distance is a critical factor, hence important for
rural regions.
3.) 91% of general population thinks that communication skill factor is important for telemedicine services.
4.) About 2/3rd of the population believes that it should be used in all kind of health care situation, not only in emergency
situations.
5. 60% of total surveyed population will avail telemedicine services when received.
Research Findings from surveying doctors:
1.) By surveying, we found out that 80% of doctors clearly agrees that telemedicine will help to get easy access of healthcare for rural
areas; whereas only 5% disagrees with the opinion.
2.)We also found out that 85% of doctors strongly agrees that telemedicine will help to save patient’s time and money.
3.) After analyzing, we saw that 100% of doctors agreed in favor of implanting telemedicine in hospitals which are equipped with internet.
4.) Furthermore, when we found out that the issues that can be a hinder in implementing telemedicine services were high cost of
equipment, multistate licensing, quality service monitoring, & funding done by government and other private institutions for
telemedicine.
5.)When we surveyed 20 professional doctors about the usefulness of applications of telemedicine to patients, we came to know that:
 Out of 20, 17 doctors agree that teleconferencing with patient will be of great use; whereas 3 of them simply declined.
 When asked about monitoring them via use of technology, 18 agreed with it and 2 of them denied.
 19 out of 20 doctors agreed that it will be better for patients taking appointment using internet instead of old traditional methods.
 When asked about videoconferencing consultation we found out majority of the doctors, i.e. 19 of them agreed with the idea.
 Transmission of important documents via technology was accepted by all 20 doctors.
6.) Overall, 90% of doctors found telemedicine as a really good idea and worth applying.
Recommendation:
1.) Physicians and other health practitioners delivering telemedicine services must abide by state licensure and medical practice laws
and requirements in the state where the patient receives services
2.) Creation of technology and location neutral insurance policies.
3.) Collaboration by state prescription drug monitoring programs.
4.) Telemedicine services should be based on a valid patient-physician relationship established prior to providing telemedicine
services, which can be established through a face-to-face examination by any mean.
5.) Patients seeking care delivered via telemedicine must be offered a choice of provider. Further, patients receiving telemedicine
services must have access to the licensure and board-certification qualifications of the health care practitioners providing care in
advance of their visit.
6.) The standards and scope of telemedicine services should be consistent with related in-person services. In addition, the delivery of
telemedicine services must follow evidence-based practice guidelines, to the degree they are available, to ensure patient safety, quality
of care, and positive health outcomes.
7.) The patient's medical history must be collected as part of the provision of any telemedicine service, the services provided must be
properly documented, and a visit summary must be provided to the patient.
8.) The provision of telemedicine services must include care coordination with the patient's medical home and/or existing treating
physicians, which includes, at minimum, identifying the patient's existing medical home and treating physician(s) and providing such
physician(s) with a copy of the medical record.
Conclusion:
 It was seen that attitude towards telemedicine by general population and doctors was quite
positive. They thought that this method can help to increase serviceability of hospitals to a great
extent.
 People would like to use it for saving time, increase cost efficiency and most important at time
of emergency situations.
 Even, doctors felt like our country needs such kind of methods to people diagnose patients in
most remote area as well as in times of emergencies.
 Thus, to conclude it does not require too much of a stretch of imagination to realize that
telemedicine will soon be just another way to see a health professional. Just with smart balance
of computer solutions and human intelligence many lives can be saved.
Thank You!