title: Diffusion theory and telemedicine adoption by Kansas health-care providers: critical factors in telemedicine adoption for improved patient access.
abstract: Twenty counties in Kansas were randomly selected from those designated as rural on the basis of their populations. A sample of 356 physicians and physicians' assistants in these counties was chosen. A postal survey was sent to the identified providers up to three times. One hundred and eighty-six of the questionnaires were returned (a response rate of 52%). In all, 76% of the respondents were physicians, 76% were men and 42% were family practitioners. Practitioners were classified as adopters or non-adopters of telemedicine, based on their report of whether they had ever referred one or more patients for a health-care consultation via telemedicine. Of the 167 participants who marked this item, 30 (18%) were adopters and 137 (82%) were non-adopters. Among the adopters, 16 (53%) said that they expected to use telemedicine with about the same frequency or more often in the future. In contrast, 61 (45%) non-adopters reported that they did not expect to refer patients by telemedicine in the future and 51 (37%) were unsure. Neither age (r = 0.16, P = 0.44) nor gender (chi2 = 2.35, P = 0.13) was related to the adoption variable or the number of referrals made to telemedicine clinics. The results suggest that adopters and non-adopters of telemedicine perceive its value very differently, and that an opportunity exists to promote the concept to non-adopters more effectively.
authors.affiliation: Center for Telemedicine and Telehealth, University of Kansas Medical Center, Kansas City 66160, USA. rspaulding@kumc.edu
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Spaulding
authors.forename: Tracy
authors.initials: T
authors.lastname: Russo
authors.forename: David J
authors.initials: DJ
authors.lastname: Cook
authors.forename: Gary C
authors.initials: GC
authors.lastname: Doolittle
mesh_terms: D000367:Age Factors; D001291:Attitude of Health Personnel; D004059:Diffusion of Innovation; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007615:Kansas; D007857:Leadership; D008297:Male; D012017:Referral and Consultation; D012423:Rural Health; D012737:Sex Factors; D017216:Telemedicine