Implantación de programas de telemedicina en la sanidad pública de España: experiencia desde la perspectiva de clínicos y decisores / Implementation of telemedicine programs in Spain: experience of the main actors involved in the decision-making process

Objetivo: Identificar los principales beneficios y riesgos en el proceso de implantación de los programas de telemedicina en España, a partir de la experiencia de los profesionales que influyen en la toma de decisiones. Participantes y métodos: Estudio cualitativo basado en entrevistas semiestructuradas grabadas telefónicamente, con análisis temático inductivo. Se realizaron 11 entrevistas que incluyeron la perspectiva de 4 facultativos, 3 gestores, 2 investigadores y 2 responsables de producto de la industria de telecomunicaciones. Se llevó a cabo un muestreo teórico. Resultados: Se identificaron una serie de factores necesarios para alcanzar con éxito la resolución del problema mediante un programa de telemedicina: el compromiso de las personas involucradas, los aspectos tecnológicos, el apoyo económico e institucional, la aceptación por parte de clínicos y pacientes, la existencia de protocolos que se adapten al contexto, la necesidad de informarse y formarse previamente, la visión de futuro e innovación, la normalización del programa en el sistema organizativo, y la necesidad de mantener el principio de equidad con relación a clínicos y usuarios. Conclusiones: Para que un programa de telemedicina tenga éxito es necesario desarrollarlo en un contexto favorecedor, en el cual se puedan prever los riesgos. El factor humano se revela como la clave principal. Los factores identificados en este estudio cualitativo deberían considerarse a la hora de elaborar estrategias que permitan incrementar las posibilidades de éxito en la implantación de futuros programas de telemedicina en nuestro medio (AU)

Objective: To identify the main benefits and risks related to the implementation of telemedicine programs in Spain, based on the experience of the actors influencing the decision-making process. Participants and methods: We performed a qualitative study based on audiotaped semi-structured telephone interviews. Eleven interviews were carried out, and the perspective of four physicians, three administrators, two researchers and two telecommunications industry workers were included. Theoretical sampling was used and thematic inductive analysis was performed. Results: The following factors were identified as necessary to successfully resolve problems by using telemedicine programs: the commitment of the persons involved, technological aspects, economic and institutional support, acceptance by healthcare professionals and patients, the existence of protocols adjusted to the context, the need for information and training prior to the development of telemedicine programs, a forward-looking approach, routine use and full acceptance of telemedicine programs in the organization, and the need to defend equity for professionals and users. Conclusions: Successfully developing a telemedicine program requires a favorable environment in which risk can be foreseen. The main key element seems to be the human factor. The factors identified in this study should be considered when developing strategies to increase the chances of success of telemedicine programs in Spain (AU)

[Implementation of telemedicine programs in Spain: experience of the main actors involved in the decision-making process]. / Implantación de programas de telemedicina en la sanidad pública de España: experiencia desde la perspectiva de clínicos y decisores.

OBJECTIVE: To identify the main benefits and risks related to the implementation of telemedicine programs in Spain, based on the experience of the actors influencing the decision-making process. PARTICIPANTS AND METHODS: We performed a qualitative study based on audiotaped semi-structured telephone interviews. Eleven interviews were carried out, and the perspective of four physicians, three administrators, two researchers and two telecommunications industry workers were included. Theoretical sampling was used and thematic inductive analysis was performed. RESULTS: The following factors were identified as necessary to successfully resolve problems by using telemedicine programs: the commitment of the persons involved, technological aspects, economic and institutional support, acceptance by healthcare professionals and patients, the existence of protocols adjusted to the context, the need for information and training prior to the development of telemedicine programs, a forward-looking approach, routine use and full acceptance of telemedicine programs in the organization, and the need to defend equity for professionals and users. CONCLUSIONS: Successfully developing a telemedicine program requires a favorable environment in which risk can be foreseen. The main key element seems to be the human factor. The factors identified in this study should be considered when developing strategies to increase the chances of success of telemedicine programs in Spain.