Determinants Influencing the Adoption of Telemedicine by Health Care Practitioners a Case Study of Kenyatta National Hospital

Abstract

The purpose of this study was to determine factors that influence adoption of telemedicine by healthcare practitioners at Kenyatta National Hospital. Despite various studies arriving at several factors that influence adoption of telemedicine, it was important to look at user-specific factors which have scarcely been investigated. Therefore, this study focused on the investigation of user-specific factors through the specific objectives of determining whether perceived ease of use of telemedicine, perceived usefulness of telemedicine and whether individual user attitude and personality influence adoption of telemedicine by healthcare practitioners at KNH. This study’s background was drawn from the existing literature on the status of telemedicine adoption internationally, continentally, and nationally. The problem statement was founded on the realization that despite presence of adequate literature and overwhelming evidence on the benefits, applicability, viability, sustainability, clinical usefulness and scalability of telemedicine in provision of healthcare in Kenya, still, major referral hospitals in the country are have a low adoption rate of telemedicine in healthcare delivery. The study employed the Technology Acceptance Model (TAM) which assumes that beliefs about usefulness and ease of use are always the primary determinants of information technologies adoption in organizations or by individuals. Literature review indicated that the use of telemedicine is largely adopted in scenarios where the physicians’ satisfaction and recall levels are increased due to perception in ease of use/ access and perceived usefulness of ICT. The study adopted a mixed methods approach where both qualitative and quantitative research techniques were used in data collection and analysis. The targeted research population included 1,260 clinicians (doctors and nurses) and administrators working at KNH. To reach a feasible sample size, the study used the Cochran’s method of sample size determination. An estimate of 196 respondents was drawn from the population. Stratified sampling method was then used in selection of the 196 respondents from the accessible population. To verify the reliability or trustworthiness of the data collected, the study employed the triangulation of data sources through usage of different respondents. Additionally, a pre-test of the interview schedule was done for four key informants who were purposively selected from the accessible population, enabling the researcher to review and adjust the interview questions/schedule before the interviews were conducted with the selected sample group. All ethical considerations of informed consent, assent, voluntary participation, confidentiality and anonymity, were ensured while conducting the study. The data collected was analyzed by use of excel and R software. The results from the analyses were summarized and presented by use of frequency tables and graphs. The study findings showed that the respondents’ age ranged from 20 to 59 years with majority of the respondents being between ages 30 to 49 years. Furthermore, female represented a bigger percentage of the respondents accounting for 59.24%. Investigation into the respondents’ level of education revealed 88 (48%) of the respondents attended colleges while 92 (52%) attended universities revealing the high education levels. The respondents were estimated to have adequate professional experience as they averagely had 12 years of professional experience. From the findings of the analysis, the three factors of perceived ease of use, usefulness and user attitude and personality were found to have a correlation with adoption of telemedicine. The major factors influencing the low adoption levels included the personal beliefs; attitudes towards ICT mediated healthcare, and the perception of increased workload especially for the older medical practitioners, despite the perceived usefulness of telemedicine.