Examining Health Care Providers’ Participation in Telemedicine System Design and Implementation

Abstract

The study objective was to determine whether the extent of health care providers’ participation in the design, development and implementation of a telemedicine system impacts their overall satisfaction with this system, their perception of patients’ satisfaction and the frequency of system usage. Questionnaires were mailed to 156 telemedicine providers and 68 questionnaires were returned. User participation in system implementation was strongly correlated to health care providers’ satisfaction with the telemedicine system (r=0.68, p<0.001) and the perceived patients’ satisfaction with the system (r=0.72, p<0.001). The findings suggest that even if end-users cannot be included in the definition and physical design of the system, their active inclusion in the implementation stage can still lead to high levels of satisfaction and system usage.

Introduction

It is a widely accepted notion that user participation in the design and development of information systems increases the likelihood of successful implementation and utilization of these systems¹. End-user participation is a key component in cases where the implementation of a system impacts the processes of health care delivery. Such is the case with telemedicine applications where health care providers adopt and utilize a new mode of communication to interact with patients and deliver care. The study objective is to determine whether the extent of health care providers’ participation in the design, development and implementation of a telemedicine system impacts their overall satisfaction with this system and its utilization.

Methods

We used a purposive sample of telehealth centers of networks affiliated with academic health centers. The centers were contacted to identify health care providers who are users of their system and were employees of the organization when the system was first introduced. We excluded users of only store-and-forward telemedicine systems that did not include live interaction. Questionnaires were mailed to the identified users. We used a validated questionnaire² that measures user participation in the system design, development and implementation and included three questions, pertaining to overall satisfaction with the system, users’ perceptions of patients’ satisfaction and the frequency of system utilization.

Results

Seven telehealth networks or centers affiliated with academic health centers were contacted and 156 users were identified. Questionnaires were mailed to these users and 68 usable questionnaires were returned (43.6 % response rate). Only 10 of the respondents were involved in the system development team. None of the respondents had responsibility for estimating development costs, or developed, evaluated or approved system controls and/or security procedures. The great majority (88.2%) stated that they were trained in the use of the system. Half of the respondents trained other users to use the telemedicine system. User participation in system implementation was strongly correlated to health care providers’ satisfaction with the telemedicine system (r=0.68, p<0.001) and the perceived patients’ satisfaction with the system (r=0.72, p<0.001). User participation in system implementation was also correlated to the frequency of usage of the telemedicine system (r=0.39, p<0.05). Overall, user participation as captured by the complete survey correlates to health care providers’ satisfaction with the telemedicine system (r=0.62, p<0.001), the perceived patients’ satisfaction (r=0.68, p<0.001) and frequency of usage of the telemedicine system (r=0.37, p<0.05).

Discussion

User participation in system development does affect health care providers’ satisfaction, their perception of patients’ satisfaction and utilization frequency. Findings also indicate that while it may not be possible to include all users in the design and definition of the system, it is feasible and useful to include end users in the implementation phase.