title: The slow pace of interactive video telemedicine adoption: the perspective of telemedicine program administrators on physician participation.
abstract: We conducted semistructured interviews with telemedicine program administrators as part of a national survey of physicians and managers regarding attitudes toward, and knowledge of, telemedicine. Telemedicine administrators were interviewed regarding factors affecting physician adoption of interactive video (IAV) telemedicine. The seven networks with which these managers were affiliated represented "traditional" telemedicine programs, primarily providing specialty teleconsultation via IAV. These programs were located in different geographic regions, and included both consulting and referring sites. We include data only for well-established networks for which multiple administrators responded. Data were analyzed using standard qualitative research methods. We conclude that reimbursement issues are important determinants of the rate of adoption, but that by themselves they do not fully account for the slow diffusion of IAV telemedicine. Likewise, appeals to physicians as rational decision-makers are necessary but insufficient means of increasing the volume of telemedicine within a network. Telemedicine networks and administrators that have been effective in persuading physicians to practice telemedicine or to refer patients demonstrate an emphasis on aggressive recruitment of physicians who will be involved actively in one or the other role. Most efforts to encourage physicians to adopt telemedicine, however, have focused on the supply of specialists, rather than stimulating demand among primary care providers who have patients to refer. Habit was identified as an important, albeit overlooked, factor explaining physician adoption of telemedicine.
authors: Department of Anthropology and Sociology, Eastern Oregon University, LaGrande, Oregon 97850-2899, USA. bgrigsby@eou.edu
authors: Bill
authors: B
authors: Grigsby
authors: Angela G
authors: AG
authors: Brega
authors: Rachael E
authors: RE
authors: Bennett
authors: Patricia A
authors: PA
authors: Devore
authors: Marsha J
authors: MJ
authors: Paulich
authors: Sylvia G
authors: SG
authors: Talkington
authors: Natasha R
authors: NR
authors: Floersch
authors: Phoebe L
authors: PL
authors: Barton
authors: Susannah
authors: S
authors: Neal
authors: Tesfa M
authors: TM
authors: Araya
authors: Jeff L
authors: JL
authors: Loker
authors: Neil
authors: N
authors: Krohn
authors: Jim
authors: J
authors: Grigsby
mesh_terms: D000367:Age Factors; D004059:Diffusion of Innovation; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007349:Insurance, Health, Reimbursement; D010820:Physicians; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D017216:Telemedicine / Q000706:statistics & numerical data*; D049269:Videoconferencing / Q000706:statistics & numerical data*