Adoption of telemedicine in hospitals in Nairobi county
Telemedicine has been advocated as a way of reducing geographical and distance barriers in healthcare service delivery to enable patients in distant locations access healthcare services through the use of information and communication technologies (lCT). According to World Health Organization WHO (2010), telemedicine simply means healing at a distance using information and communication technologies. Though various studies have reported that adoption of telemedicine in sub-Saharan Africa is low, there is little knowledge on attitude of doctors towards telemedicine in sub-Saharan Africa. This research was therefore undertaken with three objectives of determining the attitude of doctors towards telemedicine, the extent of adoption of telemedicine in hospitals in Nairobi County and the factors influencing adoption of telemedicine in hospitals. Descriptive survey method was used in this research. The target population was both public and private hospitals in Nairobi County. Respondents were doctors in these hospitals. The sampling frame was obtained from the list of hospitals in Nairobi County that are registered with National Hospital Insurance Fund (NHIF). Sample size of 36 hospitals was targeted. The research instrument used was structured questionnaire on a five point Likert scale. The data was analyzed using frequency, percentages, mean scores, standard deviation and factor analysis. The data was presented using tables and graphs. On the first objective regarding attitude towards telemedicine, the research findings established that doctor's attitude to telemedicine is positive. The research established that doctors agree that telemedicine is beneficial and compatible with healthcare service delivery. Doctors also agreed that telemedicine reduces the need for patients travelling to see the doctor, increases the speed of healthcare service delivery and that telemedicine can be used by doctors for getting second opinion regarding patient's diagnosis. On the second objective regarding extent of adoption of telemedicine in hospitals, the research established that in hospitals, telemedicine had been adopted to a small extent in doctor consultations, laboratory, radiology and pharmacy. In other hospital service areas such as dental, dermatology, physiotherapy, cardiology, ophthalmology, surgery etc, telemedicine had not been adopted. In general, the extent of adoption of telemedicine in hospitals is low. In regards to factors influencing adoption of telemedicine, the research established that Availability of ICT connectivity (internet links), cost of ICT connectivity, Data transmission speed and reliability of ICT systems influence adoption of telemedicine to a large extent. Resistance by hospital administration and hospital staff was also reported to affect adoption of telemedicine in hospitals. In conclusion, the research established that the attitude of doctors towards telemedicine is favorable; however the adoption of telemedicine in hospitals is low. The low adoption of telemedicine in hospitals despite the positive attitude of doctors towards telemedicine could be attributed to ICT infrastructure issues mentioned above and lack of commitment by hospital administration to implement telemedicine.