Overcoming the Challenges of Overcrowding in Public Care Hospitals through Telemedicine – A Quantitative Study

Abstract

Globally, a substantial portion of the populace lacks access to essential healthcare services, with at least 400 million people missing out on basic services like family planning, maternal health, and immunization. Over one million deaths of children under 5 years are estimated annually. The statistics explicitly display the devastated and fragile healthcare systems across the world. Pakistan is a developing republic that ranks as the sixth most populous country in the world, characterized by a rich tapestry of social and cultural credentials. The majority of its population experiences inadequate healthcare service projects, primarily due to an overwhelmed healthcare system with acute deficiency of human and technical resources, negative attitude towards technological advancements and poor management practices. Many healthcare facilities across the country suffer from outdated equipment, inadequate staffing, well below the recommended level of hospital density, socio-cultural barriers and insufficient funding. The ineffectiveness of repeatedly attempted traditional strategies in healthcare projects, such as adjusting the balance of primary, secondary and tertiary healthcare services, has become increasingly apparent. It hence now calls for an urgent transition to the use of modern Health Information and Communication Technology like Telemedicine, for its prospects to provide appropriate, timely and cost effective sustainable healthcare in both developing as well as under developed countries. Evaluation of the perceptions, social values and societal variables in specific environments of people, using technology evaluation models is hence found imperative as literature unfortunately also discloses numerous studies of abortive public sector smart healthcare ventures which were initially expected to revolutionize healthcare delivery. Ultimate evidence about the performance of Telemedicine practice in Pakistan is yet to be furnished. The main objective of this research study is to explore dimensions as how to develop healthcare management via ICT by incorporating telemedicine. The study is thus undertaken to evaluate the causal relationship between the identified key constructs of an extended Unified Theory of Acceptance and Use of Technology model including the added constructs towards Telemedicine practice in existing health infrastructure in Pakistan. This is being achieved by undertaking a cross sectional study of novel hybrid data of randomized 554 healthcare seekers and 427 healthcare providers from major cities all across Pakistan using Purposive sampling. The analysis of the study has been carried out through empirically testing the hypothesis by means of standard multivariate analysis methods, including regression, factor analysis, correlation and analysis of variance through AMOS and SPSS. The study also conducted a survey of existing telemedicine employment with challenges at a regional canvas. The findings of the study support the majority of the proposed hypothesis. Fundamental variables of UTAUT model i.e. Performance Expectancy, Effort Expectancy, Cost Effectiveness (Social Influence) and Health Literacy (Facilitating Conditions) are found to enhance the Healthcare seeker’s Satisfaction and Healthcare Provider’s Clinical Productivity. The impact of eHealth Readiness and moderation of Implementation Leadership needs further evaluation. The study recommends appreciable EBPs in the form of further studies with same and different constructs before launching any pilot project as initial step towards expansion of HICTs in health delivery to underserved and remote rural and urban populace. M-health is recommended as one amongst effective methodologies for adoption of telemedicine in Pakistan. Use of existing healthcare infrastructure of BHUs as “Spokes” and tertiary/secondary hospitals as “Hubs” can also result in gradual amalgamation of telemedicine in existing health infrastructure of Pakistan.