T22-03-00061 Telemedicine Design Principles Survey Practical Test HIS2

UNIVERSITY OF DODOMA
SCHOOL OF NURSING AND PUBLIC HEALTH,
DEPARTMENT OF PUBLIC HEALTH AND COMMUNITY NURSING.
REGISTRATION NUMBER: T22 – 03 – 00061
STUDENT NAME: RAJABU M. SIMBA
COURSE NAME: TELEMEDICINE DESIGN AND PRINCIPLES
COURSE CODE:
HI 212
DEGREE PROGRAM: BSc. HIS 2 (2023/2024)
DATE OF SUBMISSION: 9th February 2024
NATURE OF WORK: TELEMEDICINE DESIGN PRINCIPLES SURVEY
PHONE NUMBER: +255 653 470 622
1
Table of Contents
Introduction ........................................................................................................................................................................... 3
Methodology ......................................................................................................................................................................... 4
Data Collection ..................................................................................................................................................................... 5
Qualitative Data collection.................................................................................................................................................... 5
Data analysis ......................................................................................................................................................................... 5
Qualitative Data Analysis ..................................................................................................................................................... 5
FINDING .............................................................................................................................................................................. 6
Demographic Data ................................................................................................................................................................ 6
THEME 1: Familiarity with telemedicine technologies and applications ............................................................................ 6
THEME 2: Key design principles that should be prioritized in telemedicine systems ......................................................... 7
THEME 3: Challenges or concerns encountered in using telemedicine for patient care ...................................................... 8
Discussion: .......................................................................................................................................................................... 10
THEME 1: Familiarity with telemedicine technologies and applications .......................................................................... 10
THEME 2: Key design principles that should be prioritized in telemedicine systems ....................................................... 10
THEME 3: Challenges or concerns encountered in using telemedicine for patient care .................................................... 10
Conclusion: ......................................................................................................................................................................... 11
References ........................................................................................................................................................................... 12
Appendices.......................................................................................................................................................................... 13
Structured Telephone Interview Guide ............................................................................................................................... 14
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Introduction
Telemedicine is the practice of providing healthcare services across geographic distances by means of electronic
information and communication technology. In order to improve healthcare, experts have studied cutting-edge
computer and telecommunications technology for more than thirty years. Diverse applications are made possible
by the convergence of traditional and cutting-edge technology in telemedicine. Telephone consultations and
radio hookups for emergency medical assistance are examples of commonplace telemedicine. Cutting edge
experimental inventions such as telesurgery guide remote surgical procedures using tactile and visual cues. The
difficulties and uses of telemedicine in Tanzanian healthcare settings are still mainly unexplored, despite these
developments. Understanding telemedicine's uptake and difficulties in Tanzanian healthcare is essential, given
its potentially revolutionary effects. Through an examination of these facets, this research endeavors to illuminate
the viability and efficacy of telemedicine within contemporary healthcare systems. Haleem, A. (2021).
To increase access to healthcare, particularly in rural regions, telemedicine in Tanzanian hospitals must be
investigated. Policy-making and budget allocation for the development of healthcare infrastructure can benefit
from an understanding of the telemedicine field's uses and problems. The application and limitations of
telemedicine in Tanzanian medical settings are still little understood, despite worldwide improvements in the
field, which makes it difficult to fully realize the potential advantages. Gizaw, Z. (2022).
The purpose of this study is to close this information gap by examining the use, difficulties, and potential uses
of telemedicine in Tanzanian hospitals. By doing this, it hopes to offer insights for strengthening healthcare
delivery in the area and telemedicine deployment. Akintunde, T. Y. (2021).
Broadly Objectives
To investigate various aspects related to telemedicine design principles as perceived and experienced by
healthcare professionals.
Specific Objective

To determine the extent to which healthcare professionals are familiar with telemedicine technologies and
their usage in clinical practice.

To explore healthcare professionals' perspectives on key design principles essential for user-friendly and
effective telemedicine platforms.

To identify the challenges faced by healthcare professionals when utilizing telemedicine for patient care,
including technical issues and patient/provider resistance.
3
Methodology
This was a qualitative method research that took place over the course of one week at ten Tanzanian mainland
health facilities: one national hospital, two zonal hospitals, three regional referral hospitals, two district hospitals,
two primary health centers, and one clinic.
Key elements of telemedicine design concepts were addressed in structured telephone interviews with the 40
participants. The purpose of the interviews is to learn more about the participants' experiences with telemedicine
technology, their perspectives about design principles, the difficulties they faced, and their predictions for the
field's future. The methodical approach guarantees uniformity in the gathering and evaluation of data.
The distribution of interviewed participants in this study shown in Table below
S/N Healthcare Setting Name
Level
Region
National
Dar es Salaam
2.
Muhimbili National
Hospital
KCMC Hospital
Zonal
Moshi
3.
Bugando Hospital
Zonal
Mwanza
4.
Mount Meru Regional
Referral Hospital
Regional
Arusha
5.
Dodoma Regional Referral
Hospital
Morogoro Regional
Referral Hospital
Regional
Dodoma
Regional
Morogoro
7.
Bahi District Hospital
District
Dodoma
8.
Njiro District Hospital
District
Arusha
9.
Levelosi Health Centre
Health
Centre
Arusha
10.
Kaloleni Health Centre
Health
Centre
Arusha
11.
Polyclinic Centre
Clinic
Arusha
1.
6.
No. of
Professional Cadre
Respondents
04
2=Medical Doctor, 2=
Registered Nurse
04
2= Surgeon
2= Medical Recorder
03
1= Medical Recorder
2= Physician
06
1= Medical Recorder
1= Community Health
Worker
1= Pharmacist
1= Medical Lab
1=Medical Doctor
1= Nurse
04
2= Medical Recorder
2= Radiologist
03
1= Medical Recorder
1= Dentist
1= Gynecologist
03
2= Medical Doctor
1 = Health Attendant
02
1= Health Attendant
1= AMO
06
2= Clinical Officer
2= Nurse
2= Health Attendants
04
2= Medical Doctor
1= Ophthalmologist
1= Dentist
01
1= Cardiologist
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Data Collection
Qualitative Data collection
The approach used to acquire the qualitative data was structured telephone interviews. Data was gathered from
40 medical experts employed at Tanzanian mainland hospitals, primary health centers, district hospitals, zonal
hospitals, regional referral hospitals, and national hospitals.
A telephone interview guide with open-ended questions was used to gather qualitative data. The interview guide
was created using information on current telemedicine technology, user perspectives regarding design principles,
and difficulties faced. Sirili, Nathanael et al (2018).
Data analysis
Qualitative Data Analysis
Thematic analysis was used to examine qualitative data in order to find themes and patterns pertaining to the
participants' experiences with telemedicine technology, their views on design principles, the difficulties they
faced, and 40 After analyzing the first 22 of the 40 interviews for information pertaining to the telemedicine
concepts and difficulties faced, the data saturation point was achieved during the qualitative data analysis
process. Recent data from a thorough review of qualitative studies supports this. Campling, N.C. (2017).
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FINDING
Demographic Data
The range of ages included experienced people in their 40s, 50s, and beyond, as well as young professionals in
their 20s and 30s. There was equal participation from both genders in terms of representation. Geographically
speaking, the respondents were spread throughout both urban and rural areas. Experience ranged from new
college grads to seasoned medical professionals with decades of experience. The participants' varied medical
specializations, which represented a broad range of healthcare knowledge, including physician, Radiologist,
Dentist, and nursing.
THEME 1: Familiarity with telemedicine technologies and applications
The participants' knowledge with telemedicine technology varied; some used them often in their practice, while
others had just minimal exposure. This difference highlights possible inequities in access and utilization and
highlights the different adoption rates among healthcare professionals. Comprehending these distinctions is
essential for executing telemedicine programs efficiently and tackling obstacles to uptake.
Question 1: How frequently does your practice make use of telemedicine technologies?
"I use telemedicine almost daily in my practice, especially for remote consultations with patients in rural areas."
– Gynecologist from National Hospital
Question 2: Could you please provide a brief description of your position and area of experience in the
healthcare industry?
"I've heard about telemedicine, but I haven't had the opportunity to put it to use. In our hospital context, it's still
really fresh."- Physician from Regional Referral Hospital and District Hospital
Question 3: What particular telemedicine apps or platforms are you knowledgeable about?
Participants' varied experiences and preferences were evident from their answers to questions about certain
telemedicine platforms or applications.
"I'm most familiar with Intelehealth because it's what our hospital has adopted for telemedicine consultations."
- Medical Recorder from Health Centre and Regional Referral Hospital
"I've used a few different telemedicine apps, but I find zoom for healthcare to be the most user-friendly and
reliable." – Radiologist from clinic health centre
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THEME 2: Key design principles that should be prioritized in telemedicine systems
The participants determined a number of essential components of an efficient and user-friendly telemedicine
platform. These included dependability, interoperability with current systems, and simplicity of use.
Question 1: What elements, in your opinion, are most crucial for a successful and user-friendly
telemedicine platform?
"A user-friendly interface is crucial for telemedicine platforms to be widely adopted by healthcare providers." Registered Nurse and Medical Doctor from Primary Health Centre and Clinic health centre
Question 2: What elements of the design would foster the best possible interaction and cooperation
amongst medical professionals during a telemedicine consultation?
"Compatibility with our electronic medical record system is essential for seamless integration and workflow
efficiency."- Clinical Officer, Medical Recorder from District Health Centre
Question 3: How should telemedicine systems respond to security and privacy issues raised by patients?
Patient security and privacy issues become important factors to take into account while designing telemedicine
systems. In order to safeguard patient information, participants underlined the significance of strong security
measures.
"Patient privacy is paramount, so telemedicine platforms must have strong encryption and authentication
measures." – Dentist from Zonal Hospital
"We have an obligation to protect patient data as healthcare professionals. When designing telemedicine,
security should come first." - Community Health Worker from Health Centre and Clinic Health care
Question 4. How might data analysis and user input help improve telemedicine design, in your opinion?
The significance of continual assessment and development was emphasized as participants talked about how
data analysis and user input drive continuous progress in telemedicine design.
"User feedback allows us to understand the needs and preferences of both patients and providers, leading to
iterative improvements in telemedicine platforms." – Ophthalmologist, AMO from National and Regional
Hospital
"Data analysis helps identify usage patterns and areas for optimization, guiding the development of more
efficient and effective telemedicine solutions." – Cardiologist from District Hospital and Clinic health care
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Question 5: What are some ways that telemedicine platforms may meet the different demands of patients
who have different levels of technology knowledge and physical ability?
Participants underlined how crucial it is for telemedicine platforms to be able to meet the various demands of
patients with differing levels of physical and digital literacy.
"Telemedicine platforms should offer simple interfaces and clear instructions to cater to patients with limited
technological skills." Medical Doctor from Health centre and Zonal Hospital
"For patients with physical disabilities, features like video captioning and keyboard navigation can enhance
accessibility." Physician from Regional Hospital and District Hospital
THEME 3: Challenges or concerns encountered in using telemedicine for patient care
Question 1: Which difficulties have you faced the most while utilizing telemedicine to treat patients?
The largest obstacles to implementing telemedicine for medical treatment, according to participants, were
connection concerns, technological difficulties, and patient or provider opposition.
"We frequently have connectivity problems, particularly in isolated locations with inadequate internet service.
It may be annoying for patients as well as professionals." Radiologist from Regional Hospital
"Some patients are hesitant to try telemedicine, preferring face-to-face interactions with their healthcare
providers." Gynecologist from National hospital and Regional Hospital
Question 2: Does telemedicine work particularly effectively or poorly for any particular patient
population?
In order to meet the varied demands of patients with differing levels of technology knowledge and physical
ability, participants emphasized the necessity for telemedicine platforms. This involves helping patients who
might have trouble utilizing digital devices.
"Not all patients are tech-savvy, so telemedicine platforms should be intuitive and easy to use for everyone." –
Physician from clinic and health centre
"We need options for patients who may have disabilities or limitations that make it difficult for them to engage
with telemedicine." Ophthalmologist from Regional Hospital and National Hospital
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Question 3: What do you think about the moral issues raised by the use of telemedicine?
Participants discussed ethical issues related to the use of telemedicine, such as worries about informed consent,
patient confidentiality, and fair access to treatment.
"In telemedicine, protecting patient privacy is essential. The same norms of secrecy and privacy must be upheld
as in in-person conversations." – Dentist from District Hospital
"Patients should have the right to informed consent and be fully aware of how their data will be used in
telemedicine consultations." Physician, Gynecologist from Zonal Hospital and National Hospital
Question 4: Are there any other comments or recommendations you would want to make addressing the
fundamentals of telemedicine design?
Participant reflections on the moral ramifications of employing technology to provide healthcare services were
included in discussions of the possible advantages and disadvantages of telemedicine.
"Telemedicine has the potential to expand access to care for underserved populations, but we must be mindful
of potential disparities in access and quality of care." Community Health Worker from Health Centre
"We need to strike a balance between leveraging technology to improve patient care and ensuring that we do
not compromise on patient safety or ethical standards." Health Attendant, Clinical Officer from Clinic and
Health Centre
Question 5: What do you think telemedicine's future holds? Which cutting-edge discoveries or technology
have the potential to enhance patient care via telemedicine?
Participants were upbeat about the possibility of new ideas and technology advancing telemedicine and helping
patients receive better treatment.
"I believe telemedicine will continue to evolve and become an integral part of healthcare delivery, especially
with advancements in virtual reality and artificial intelligence." Radiologist, Gynecologist, Health Attendant
from Regional Hospital and Health Centre
"Innovations like remote monitoring and tele-rehabilitation hold promise for expanding the scope of
telemedicine beyond traditional consultations." Registered Nurse, Physician from National Hospital, Zonal and
Regional Hospital
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Discussion:
The research's conclusions offer insightful information on how healthcare professionals see and use telemedicine
technology and design principles.
THEME 1: Familiarity with telemedicine technologies and applications
The participants' differing degrees of experience with telemedicine technology draw attention to differences in
access and use within the healthcare sector. While some medical professionals use telemedicine into their
routines on a regular basis, others do not have as much expertise. Considering the potential benefits of
telemedicine programs in terms of bettering access to treatment, especially in underserved or distant locations,
it is imperative that these discrepancies be addressed in order to ensure their efficient implementation and broad
adoption.
THEME 2: Key design principles that should be prioritized in telemedicine systems
The participants determined a number of crucial design tenets that are necessary to create telemedicine systems
that are both efficient and user-friendly. The aforementioned principles encompass ease of use, compatibility
with current systems, strong privacy and security protocols, and features that facilitate accessibility. Giving
priority to these design components can improve telemedicine platforms' usability, effectiveness, and patient and
provider adoption.
THEME 3: Challenges or concerns encountered in using telemedicine for patient care
The participants engaged in a discourse about a range of obstacles and worries related to the practice of
telemedicine, such as problems with connectivity, technological hindrances, patient resistance, and ethical
implications. To assure the moral and fair provision of telemedicine services, addressing these issues calls for
all-encompassing approaches that include policy formulation, user education, infrastructure upgrades, and
ethical norms.
Participants in the discussion of the ethical issues surrounding the use of telemedicine emphasized the
significance of patient confidentiality, informed consent, and equal access to treatment. Maintaining ethical
standards and making ensuring that patients' rights are upheld in virtual care environments are crucial as
telemedicine grows.
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Conclusion:
Using digital solutions to improve healthcare delivery presents both potential and problems, as discussed in
relation to telemedicine technology and applications. While some medical practitioners are adept at employing
telemedicine technologies, others run into issues with connectivity, patient acceptability, and technological
uptake. Building platforms that are easy to use and have strong privacy and security features is essential to
building user acceptance and confidence. Moreover, cooperation between healthcare professionals, legislators,
and technology developers is needed to overcome problems including connection problems, patient resistance,
and ethical dilemmas.
Future telemedicine technology developments might potentially improve patient outcomes, decrease healthcare
inequities, and increase access to care. Artificial intelligence, virtual reality, and remote monitoring are some of
the innovations that might revolutionize telemedicine and broaden its application beyond standard consultations.
To fully achieve telemedicine's promise in enhancing healthcare delivery for everyone, regardless of geography
or background, issues with infrastructure, accessibility, and ethics must be resolved. Al Kuwaiti, A.et all. (2023).
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References

Akintunde, T. Y., Akintunde, O. D., Musa, T. H., Sayibu, M., Tassang, A. E., Reed, L. M., & Chen, S.
(2021). Expanding telemedicine to reduce the burden on the healthcare systems and poverty in Africa for a
post-coronavirus disease 2019 (COVID-19) pandemic reformation. Global health journal (Amsterdam,
Netherlands), 5(3), 128–134. https://doi.org/10.1016/j.glohj.2021.07.006

Campling, N.C., Pitts, D.G., Knight, P.V. et al. A qualitative analysis of the effectiveness of telehealthcare
devices (i) are they meeting the needs of end-users?. BMC Health Serv Res 17, 455 (2017).
https://doi.org/10.1186/s12913-017-2408-8

Gizaw, Z., Astale, T. & Kassie, G.M. What improves access to primary healthcare services in rural
communities? A systematic review. BMC Prim. Care 23, 313 (2022). https://doi.org/10.1186/s12875-02201919-0

Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities,
features,
barriers,
and
applications. Sensors
international, 2,
100117.
https://doi.org/10.1016/j.sintl.2021.100117

Sirili, Nathanael & Frumence, Gasto & Kiwara, Angwara & Mwangu, Mughwira & Anaeli, Amani &
Nyamhanga, Tumaini & Goicolea, Isabel & Hurtig, Anna-Karin. (2018). Retention of medical doctors at
the district level: A qualitative study of experiences from Tanzania. BMC Health Services Research. 18.
10.1186/s12913-018-3059-0.

Al Kuwaiti, A., Nazer, K., Al-Reedy, A., Al-Shehri, S., Al-Muhanna, A., Subbarayalu, A. V., Al Muhanna,
D., & Al-Muhanna, F. A. (2023). A Review of the Role of Artificial Intelligence in Healthcare. Journal of
personalized medicine, 13(6), 951. https://doi.org/10.3390/jpm13060951
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Appendices
PRACTICAL TEST: TELEMEDICINE DESIGN PRINCIPLES SURVEY
1. Choose a diverse group of healthcare practitioners, including physicians, nurses, and specialists from
different departments (e.g., radiology, cardiology, general medicine). Ensure representation from various
healthcare settings, such as hospitals, clinics, and primary care facilities.
2. Prepare a structured telephone interview guide: develop a set of open - ended questions addressing key
aspects of telemedicine design principles. find people who practice medicine and ask them questions via a
phone
Questions may include:
a. How familiar are you with telemedicine technologies and applications?
b. In your opinion, what are the key design principles that should be prioritized in telemedicine systems?
c. Can you share any challenges or concerns you have encountered in using telemedicine for patient
care?
3. Summarize the findings from each interview, emphasizing common themes and variations in opinions.
Identify recurring challenges and opportunities mentioned by healthcare practitioners.
Compile a comprehensive report based on the gathered insights, including a summary of key findings, direct
quotes from practitioners, and any notable patterns observed. Present the data in a clear and organized
manner, making it accessible for review and analysis.
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Structured Telephone Interview Guide
Introduction:
We appreciate your participation in this interview. Rajabu M. Simba is my name, and I work as a researcher on
telemedicine design concepts. The future of telemedicine technology will benefit greatly from your thoughts. It
will take ten to fifteen minutes for this interview. Before we start, do you have any questions?
0. Demographic Data of Respondents:
Q0a. Could you please share your age group? …………………………………………………..
Q0b. Gender of Respondent: …………………………………………………………………….
Q0c. To understand your experience, could you tell me the general region where you work (e.g., country,
state/province)?.................................................................................................................
Q0d. In what type of healthcare setting do you primarily practice? (Example: national hospital, regional clinic,
private practice, Primary health facility) ………………………………………….
Q0e. How many years of experience do you have in the healthcare field?........................................
Q0f. What area of medical expertise do you focus on, if any?..........................................................
1. General Background:
Q1a. How frequently does your practice make use of telemedicine technologies?
Q1b. Could you please provide a brief description of your position and area of experience in the healthcare
industry?
Q1c. What particular telemedicine apps or platforms are you knowledgeable about?
2. Telemedicine Design Principles:
Q2a. What elements, in your opinion, are most crucial for a successful and user-friendly telemedicine platform?
Q2b. What elements of the design would foster the best possible interaction and cooperation amongst medical
professionals during a telemedicine consultation?
Q2c. How should telemedicine systems respond to security and privacy issues raised by patients?
Q2d. How might data analysis and user input help improve telemedicine design, in your opinion?
Q2e. What are some ways that telemedicine platforms may meet the different demands of patients who have
different levels of technology knowledge and physical ability?
14
3. Challenges and Opportunities:
Q3a. Does telemedicine work particularly effectively or poorly for any particular patient population?
Q3b. Does telemedicine work particularly effectively or poorly for any particular patient population?
Q3c. What do you think about the moral issues raised by the use of telemedicine?
Q3d. Are there any other comments or recommendations you would want to make addressing the fundamentals
of telemedicine design?
Q3e. What do you think telemedicine's future holds? Which cutting-edge discoveries or technology have the
potential to enhance patient care via telemedicine?
15