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Toward a Discourse Community for Telemedicine: a Domain Analytic View of Published Scholarship Louiza Patsis Long Island University, Louiza [email protected]

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Toward a Discourse Community for Telemedicine: a Domain Analytic View of Published Scholarship Louiza Patsis Long Island University, Louiza Patsis@Yahoo.Com Long Island University Digital Commons @ LIU Selected Full Text Dissertations, 2017- LIU Post 2017 Toward a Discourse Community for Telemedicine: A Domain Analytic View of Published Scholarship Louiza Patsis Long Island University, [email protected] Follow this and additional works at: https://digitalcommons.liu.edu/post_fultext_dis Part of the Health and Medical Administration Commons, and the Health Information Technology Commons Recommended Citation Patsis, Louiza, "Toward a Discourse Community for Telemedicine: A Domain Analytic View of Published Scholarship" (2017). Selected Full Text Dissertations, 2017-. 2. https://digitalcommons.liu.edu/post_fultext_dis/2 This Dissertation is brought to you for free and open access by the LIU Post at Digital Commons @ LIU. It has been accepted for inclusion in Selected Full Text Dissertations, 2017- by an authorized administrator of Digital Commons @ LIU. For more information, please contact [email protected]. Toward a Discourse Community for Telemedicine: A Domain Analytic View of Published Scholarship A Dissertation Submitted to the Faculty of Long Island University by Louiza Patsis in partial fulfillment of the requirements for the degree of Doctor of Philosophy May 1, 2018 i Acknowledgments This dissertation is a culmination of years of hard work, including reading, writing, thinking critically, researching and attempts at dissertation topics. I would like to acknowledge my advisor David Jank, Ph.D. for spending hours with me on methodology and the dissertation. I would like to thank my external advisor Elizabeth Krupinski, Ph.D. for being readily available to answer telemedicine questions via email and guidance with her expertise in telemedicine. I thank the remaining members of my committee: Greg Hunter, Ph.D. for believing in me, his careful edits and seeing this through to the end, and Stephanie White, Ph.D. and Mary Wasserman, Ph.D. for being on my committee, believing in me and giving me helpful feedback on the dissertation proposal and dissertation. Laura Manzari, the chief librarian of the Palmer School of Library and Information Science, was especially helpful in journal searches and database questions throughout the years. Last but not least, I thank my colleagues with whom I engaged in lively and intelligent classroom conversation and debate. ii Table of Contents LIST OF FIGURES v LIST OF TABLES vi ABSTRACT vii CHAPTER 1: INTRODUCTION 1 1.1 Telemedicine as a topic in information science 1 1.2 Prominent topics in information science 2 1.3 Main areas of telemedicine 4 1.4 History of telemedicine 5 1.5 Definition of telemedicine and related terms 7 1.5.1 Telemedicine and telehealth 11 1.5.2 Telemedicine and telecare 14 1.5.3 E-Health 17 1.5.4 Mobile health 31 1.5.5 Telemonitoring 37 1.6 Importance of telemedicine 46 1.6.1 Telemedicine as part of health care reform 51 1.6.2 Problems of health care in the United States 53 1.6.3 Shortage of specialists 55 iii 1.6.4 How telemedicine can help 56 1.6.5 Two examples of telemedicine areas 57 1.6.5.1 Telepsychiatry 57 1.6.5.2 Telesurgery 61 1.7 Future 64 1.8 Summary 66 CHAPTER 2: BENEFITS AND DRAWBACKS OF TELEMEDICINE 70 2.1 Benefits of telemedicine 70 2.1.1 Quality of care 71 2.1.2 Access 74 2.1.3 Equity of health care 76 2.1.4 Time element 78 2.1.5 Length of hospital stay 79 2.1.6 Referrals and outpatient stay 79 2.1.7 Medical education 79 2.1.8 Information sharing and second opinion 82 2.2 Drawbacks of telemedicine 85 2.3 Summary 87 CHAPTER 3: PAST EVALUATION STUDIES 89 3.1 State of evaluation 89 iv 3.2 Evaluation studies 92 3.3 Diagnostic accuracy 115 3.4 Technology 124 3.5 Store-and-forward and real-time telemedicine 129 3.6 Health professional confidence 132 3.7 Physician-patient relationship 133 3.8 Physician satisfaction 137 3.9 Patient satisfaction 138 3.10 Summary 144 CHAPTER 4: ORGANIZATION MANAGEMENT 146 AND IMPLEMENTATION 4.1 Organization Management 146 4.2 Implementation 150 4.3 Privacy 156 4.4 Security 159 4.5 Policy 160 4.6 Costs 166 4.6.1 Costs of telemedicine 166 4.6.2 Cost effectiveness of telemedicine 167 4.6.3 Reimbursement 169 4.7 Summary 172 v CHAPTER 5: TAXONOMY 175 5.1 Tulu, Chatterjee and Maheshwari Taxonomy 177 5.2 Bashshur, Shannon, Krupinski, and Grigsby Taxonomy 184 5.3 Nepal, Liang-Jaccard and Alem taxonomy 193 5.4 Comparison of taxonomies 197 5.5 Proposed taxonomy 199 5.6 Summary 201 CHAPTER 6: METHODOLOGY HISTORY 203 6.1 Telemedicine bibliometric and content analysis article 203 6.2 Bibliometrics history 204 6.2.1 Bibliometric techniques 206 6.3 Content analysis 207 6.4 Summary 208 CHAPTER 7: METHODOLOGY 210 7.1 Objective of study 210 7.2 Problem statement 211 7.3 Research questions 211 7.4 Research strategy 217 7.4.1. Factor Analysis 217 7.4.2 Determining Sample Size for Research 219 7.4.3 Compiling Data 220 vi CHAPTER 8: DATA COLLECTION AND RESULTS 222 8.1 Research Question 1 222 8.2 Research Question 2 223 8.3 Research Question 3 228 8.3.1 Biological Sketches of Leading Authors 231 8.3.2 Contributing Source Titles in Sample Set 232 8.4 Research Question 4 235 8.5 Research Question 5 238 8.6 Research Question 6 242 CHAPTER 9: SUMMATIVE INFORMATION 246 9.1 Limitations of Research 246 9.2 Future Research 248 9.3 Conclusion 251 APPENDIX I GLOSSARY 252 APPENDIX II Author Bios 255 APPENDIX III Outline of Dissertation Steps 266 APPENDIX IV Examples of Random Sample Records 269 APPENDIX V Working Ontology 276 CITED WORKS 282 vii List of Figures Figure Page Figure 1: Spike in Telemedicine Publications 48 Figures 2 and 3: Parallel Increase in Articles Retrieved Using 49 “Telemedicine” and “Internet” Figure 4: Telemedicine Taxonomy 179 Figure 5: Tulu, Chatterjee, and Maheshwari 180 Figure 6: Three-Dimensional Model for the Evaluation of Telemedicine 183 Figure 7: ICT Health Domain 185 Figure 8: Telehealth Domain 187 Figure 9: E-Health Domain 188 Figure 10: Domain 189 Figure 11: The Dimensions of the Telemedicine Taxonomy and 191 Their Components Figure 12: Three-Dimensional Telemedicine Taxonomy Model 192 Figure 13: Nepal, Liang-Jaccard and Alem 194 Telehealth Taxonomy Figure 14: Nepal, Li, Jang-Jaccard and Alem 195 Health Services Ontology Figure 15: Nepal, Li, Jang-Jaccard and Alem 196 Socioeconomic Factors in Telemedicine Figure 16: Proposed Taxonomy 200 viii Figure 17: Sources by Year 225 Figure 18: Country of Research and Number of Records 226 Figure 19: Count of Document Types 235 Figure 20: Epistemological Categories of Documents 236 Figure 21: Taxonomy Keywords by Percentage of Total Keywords 240 Figure 22: Authors per Source 244 ix List of Tables Table Page Table 1: E in E-Health 18-19 Table 2: Definitions of E-Health 21-30 Table 3: What Was Learned from Past Health Care Reforms 55 Table 4: Agreement Rating Scale 118 Table 5: Management Agreement Rating Scale 118 Table 6: Top Five Environmental Settings 182 Table 7: Facet Analysis 218 Table 8: Sources by Year 224 Table 9: Contributions per Country in 327 Records 226 Table 10: Frequency Distribution of Authors 229-230 Table 11: Zipf Test 230 Table 12: Bradford Test 232-233 Table 13: Epistemological Category Analysis 237 Table 14: Taxonomy Keywords 239 Table 15: Proposed Telemedicine Ontology 242 Table 16: Authors per Source 243-244 x Abstract In the past 20 years, the use of telemedicine has increased, with telemedicine programs increasingly being conducted through the Internet and ISDN technologies. The purpose of this dissertation is to examine the discourse community of telemedicine. This study examined the published literature on telemedicine as it pertains to quality of care, defined as correct diagnosis and treatment (Bynum and Irwin 2011). Content analysis and bibliometrics were conducted on the scholarly discourse, and the most prominent authors and journals were documented to paint and depict the epistemological map of the discourse community of telemedicine. A taxonomy based on grounded research of scholarly literature was developed and validated against other existing taxonomies. Telemedicine has been found to increase the quality and access of health care and decrease health care costs (Heinzelmann, Williams, Lugn and Kvedar 2005 and Wootton and Craig 1999). Patients in rural areas where there is no specialist or patients who find it difficult to get to a doctor’s office benefit from telemedicine. Little research thus far has examined scholarly journals in order to aggregate and analyze the prevalent issues in the discourse community of telemedicine. The purpose of this dissertation is to empiricallydocument the prominent topics and issues in telemedicine by examining the related published scholarly discourse of telemedicine during a snapshot in time. This study contributes to the field of telemedicine by offering a comprehensive taxonomy of the leading authors and journals in telemedicine, and informs clinicians, librarians and other stakeholders, including those who may want to implement telemedicine in their institution, about issues telemedicine. xi Chapter 1 Introduction Medical information is critical in the diagnosis and treatment of disease and in the accumulation of scientific knowledge that leads to cures. Falconer (in Wootton, 1999) wrote that medicine has relied on communication systems between and among patients, doctors, and other health care professionals to deliver health care to the patient for years. In the past 20 years or so, the Internet has become an integral part of this communication. An important part of telemedicine is the communication and technology components that relay medical information among clinicians, patients, technologists and stakeholders.
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