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The Barriers Encountered in Telemedicine Implementation by Health Care Practitioners Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2015 The aB rriers Encountered in Telemedicine Implementation by Health Care Practitioners Olantunji Obikunle Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Business Commons, and the Health and Medical Administration Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Management and Technology This is to certify that the doctoral study by Olatunji Obikunle has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Kenneth Gossett, Committee Chairperson, Doctor of Business Administration Faculty Dr. Roger Mayer, Committee Member, Doctor of Business Administration Faculty Dr. Charles Needham, University Reviewer, Doctor of Business Administration Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 Abstract The Barriers Encountered in Telemedicine Implementation by Health Care Practitioners by Olatunji Obikunle Project Management Professional (PMP), 2001 MSc Business Systems Analysis and Design, City University, London, England, 1994 MSc Geography, University of Ibadan, Nigeria, 1987 BSc Geography, University of Ibadan, Nigeria, 1985 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University December 2015 Abstract Patients in rural areas in the United States do not have adequate health care facilities for illnesses and injuries not serious enough for emergency care, but telemedicine could have a positive impact both economically and medically to control rapidly rising health care costs, which is a significant percentage of the gross national product. The purpose of this case study was to explore the barriers physicians encountered in telemedicine implementation. Participants included 4 physicians who took part in face-to-face interviews in a clinical setting in Ohio to explore strategies used in implementing telemedicine. The results of these interviews, coupled with observations and document reviews, were analyzed. Complex adaptive systems theory was used to conceptualize the existing association between individual behavioral patterns and the social system in which the patterns take place. Significant themes showed (a) how physicians utilize the technology and (b) how the application allows physicians to build relationships with patients. The characterization strategies aimed to mitigate barriers in adopting telemedicine technology in rural markets were consistent with the study findings and the literature review. The results of this research study might contribute to positive social change through economic and health benefits to rural inhabitants by reducing the distance barrier to physicians’ offices and increasing timely and effective patient diagnosis in the selected location. The Barriers Encountered in Telemedicine Implementation by Health Care Practitioners by Olatunji Obikunle Project Management Professional (PMP), 2001 MSc Business Systems Analysis and Design, City University, London, England, 1994 MSc Geography, University of Ibadan, Nigeria, 1987 BSc Geography, University of Ibadan, Nigeria, 1985 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University December 2015 Dedication This dissertation is dedicated to God who has made it possible for me to reach this milestone in life. Nothing can be achieved without Him. I also dedicate this study to the memory of my father. May his soul rest in peace. Acknowledgments I would not have been able to complete this study without the backing of my doctoral committee chair, Dr. Kenneth Gossett, who provided me with deep encouragement, and a high level of unrelenting support. Dr. Gossett always assured me that there is light at the end of the tunnel. I am also thankful to my second committee chair, Dr. Roger Mayer, for his objective reviews; methodologist, Dr. Gene Fusch, for his constructive contribution, the URR reviewer, Dr. Charles Needham, and program director, Dr. Freda Tuner, for their guidance. Also, my gratitude goes to my wife, Frances, and our children, Tomi, Tolu, Temi, and Tani, all of whom provided me with an unswerving support, encouragement, and humor at each stage of my doctoral journey. My thanks also go to my friends Kayode, Yinka, Muyiwa, Babalola, and Tolu. Table of Contents List of Figures ......................................................................................................................v Section 1: Foundation of the Study ......................................................................................1 Background of the Problem ...........................................................................................1 Problem Statement .........................................................................................................2 Purpose Statement ..........................................................................................................3 Nature of the Study ........................................................................................................3 Research and Interview Questions .................................................................................5 Conceptual Framework ..................................................................................................6 Operational Definitions ..................................................................................................7 Assumptions, Limitations, and Delimitations ................................................................8 Assumptions ............................................................................................................ 8 Limitations .............................................................................................................. 9 Delimitations ........................................................................................................... 9 The Significance of the Study ......................................................................................10 Review of the Professional and Academic Literature ..................................................11 Academic Sources Used to Conduct the Review .................................................. 11 Conceptual Framework ......................................................................................... 12 Telemedicine and Systems Theory ....................................................................... 13 Telemedicine and Accessibility in Health Care .................................................... 15 Telemedicine in Other Countries and Cross-National Application ...................... 20 The Role of Telemedicine in Bridging the Gap .................................................... 23 i Shortage of Rural Health Care Workers and the Role of Telemedicine ............... 28 Telemedicine and Quality of Health Care ............................................................ 31 Barriers to Telemedicine Adoption in Clinical Settings ....................................... 33 Licensing, Legal, and Regulatory Issues in Telemedicine ................................... 35 Ethical, Confidential, and Privacy Issues in Telemedicine................................... 36 Telemedicine and Mortality Rate Reduction in Remote and Rural Areas............ 38 Computer Equipment Costs, Training, and Education in Telemedicine .............. 39 Transition and Summary ..............................................................................................41 Section 2: The Project ........................................................................................................42 Purpose Statement ........................................................................................................42 Role of the Researcher .................................................................................................43 Participants ...................................................................................................................46 Research Method and Design ......................................................................................48 Research Method .................................................................................................. 48 Research Design.................................................................................................... 50 Population and Sampling .............................................................................................52 Ethical Research...........................................................................................................53 Data Collection ............................................................................................................55 Data Collection Technique ..........................................................................................57 Data Organization Techniques .....................................................................................59 Data Analysis Technique
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