Table 3.

Analysis of Clinician Perspectives in Accordance with the Technology Acceptance Model

Concept	Facilitators and Benefits	Barriers and Disadvantages
Experience	•As providers used telemedicine more frequently, their satisfaction scores increased (Perri et al14)	—
Job relevance	•Improve timeliness of resident's care (Driessen et al25) •Improve service gap (Driessen et al25) •Increased connection and validation between NH nurses and providers (Stephens et al34) •Better valuation of NH staff's work (Piau et al31)	•Difficulty coping with change, feeling of intrusion (Piau et al31)
Output quality	•Improves productivity (Cheng et al24) •Able to see each other, comfort level appropriate (Perri et al14)	•Audio quality—unable to hear each other (Perri et al14)
Result demonstrability	•Majority of providers in the study said they were willing to use telemedicine again (Perri et al14) •Clinicians initially feared dehumanization of medicine, but did not report this after 2 y of use (Piau et al31) •Involvement of families in care (Piau et al31)	•Unable to complete all functions clinician wants done (Cheng et al24)
Perceived Usefulness	•Measured by TUQ (Cheng et al24) •Aid making decision to transfer (Stephens et al34) •Patient may be able to see provider more often (Stephens et al34) •Improved access to specialist advice, cost reductions, improved quality of care (Helmer-Smith et al28) •Tackles lack of specialized care in remote areas (Piau et al31) •Able to use resident's activity monitor to easily check heart rate; more aware of sleep patterns (De Vito et al36)	•NH staff preferred in-person wound care visits and were more engaged (Stern et al32)
Perceived ease of use	•81% found software easy or moderately easy to learn (Cheng et al24) •Ease of sending a message to a specialist; increased confidence in care decisions (Helmer-Smith et al28)	•Amount of time it takes to connect, adds median 3 min (Perri et al14) •Challenges in capturing resident complexity in a written question (Helmer-Smith et al28) •Activity monitor cleaning and charging added 5 min per resident during their shift (De Vito et al36)
Intention to use	•Technical support person available in the moment (Perri et al14) •Integration into electronic health record greatly improved uptake of asynchronous eConsults (Helmer-Smith et al28)	•Physician and APP reimbursement and licensure (Driessen et al25) •Lack of time and workforce for telemedicine (Piau et al31)
Usage behavior	•Facility leadership critical to ensuring implementation (Stern et al32)	•Inadequate allocation of staff time to implementation (Stern et al32) •Residents more frequently removed activity monitors in late afternoon or evening due to agitation (De Vito et al36)

APP, advanced practice provider; TUQ, Telemedicine Usability Questionnaire.