Table 4.

Contextual Factors Impacting Telemedicine Perceived Usefulness by Patients and Families

DOMAIN	QUOTES
Patient contexts
Medical complexity/technology dependence	Especially when you have a little guy like mine where a ton of equipment comes with them everywhere they go so it's not easy to just pack them up and take them somewhere, so like I said, just having that option would be really, really great.
Developmental needs	Especially when it's these kind of follow-up appointments where I basically go to an appointment and they say, “How's she been doing? She looks great. Okay, keep doing what you're doing; we'll see you in six months,” and I had to sit in a waiting room for an hour with a child who's screaming and hitting themselves, and having an anxiety attack—yeah. If I could not do that, that would be so great. It would really—it would actually change our lives.
Communication needs	It's important not to go like behind her back. So that's why face-to-face are good for her because of her being deaf.
Immune status	I would absolutely be open to it as an option because I do know that especially when your child is immunosuppressed from chemotherapy, you're exposing them to potential germs and viruses by going to an emergency room or a doctor's office, and if that could be avoided, that would be great.
Acute illness	But I think that would be much more convenient, especially … if your kids are deathly ill and you don't want to take them out of the house and don't have to, so I think that would make a huge difference.
	Obviously if it's something really, really serious, you have to take them in in person, but there are a lot of times with especially preemies, they—I mean, every day it's something, so it's not always something that you have to hop in the car and run to ER for. And to have that option to be able to [teleconference] with a doctor that day rather than freaking out and trying to decide how to get your kid to the ER … that would make a big difference.
Goals of encounter	Let's say, you want to have a more of like a discussion of kind of maybe where you are in the process, you know, are we kind of making those, making the strides in areas we want to, you know, that could be something that's done over a video chat. I think it all really kind of centers still around what do you hope to get out of that appointment.
	Usually there's a necessity to see him physically because of needing x-rays and things like that.
Family contexts
Travel time	I don't see the need really for teleconferencing for myself. I mean, I am within easy, have very easy access, it's pretty much a direct route, maybe 20 minute's traffic.
Comfort with technology	I like to really like see my doctors. Me, email, and via text, and all that stuff, like, I'd rather do a face-to-face than any of that.
Internet access	A lot of households might not have Internet connection. Like we don't have the Internet. And it's just not something we can financially do right now.
Insurance coverage	I would be worried about if it would be … like the cost of it and if it was covered by insurance.