Analysis of Requirements for Developing a Telehealth-Based Health Management Platform in Iran

Parastoo Amiri, Hamid Sharifi, Moslem Soofi, Kambiz Bahaadinbeigy, Ali Mohammadi
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Abstract

Introduction: The COVID-19 pandemic has had a profound impact on Iran and numerous other nations, resulting in a surge in infections and fatalities. In response to the COVID-19 crisis, a range of policies and initiatives were enacted, including the deployment of telehealth services. This study aims to outline the requirements for establishing an all-encompassing platform capable of delivering telemedicine services in Iran.

Material and Methods: This cross-sectional study was carried out using a researcher-made electronic questionnaire during the period of July to August 2022. All experts in the field of medical informatics and health information systems based in three provinces (Kermanshah, Kerman, and West Azerbaijan) were contacted to fill out the questionnaire, 15 participants completed and returned the questionnaire. Data were analyzed by SPSS using descriptive statistics.

Results: The requirements for the design and implementation of the systems could be divided into internal (technical and infrastructural, security-legal, and environmental), and external categories (technical and infrastructural, and security-legal). The majority of internal and external requirements were related to technical and infrastructure aspects, accounting for 83% and 95%, respectively.

Conclusion: Telemedicine development tools are available to enhance healthcare services in Iran, but there is a need to strengthen the infrastructure and technical equipment to enable the utilization of this technology for improving therapeutic and educational objectives within the healthcare system.

Keywords

Telemedicine; Tele-Health; COVID-19; Requirements; Iran;

References

Jurayev NM, Turgunov BA. Requirements for telecommunication systems in the development of telemedicine in Uzbekistan. Scientific Bulletin of Namangan State University. 2020; 2(1): 138-44.

Nandan M, Mitra S, Parai A, Jain R, Agrawal M, Singh UK. Telemedicine (e-Health, m-Health): Requirements, challenges and applications. In: Bagga T, Upreti K, Kumar N, Ansari AH, Nadeem D (Eds). Designing intelligent healthcare systems, products, and services using disruptive technologies and health informatics. CRC Press; 2022.

Khemapech I, Sansrimahachai W, Toachoodee M. Telemedicine–meaning, challenges and opportunities. Siriraj Medical Journal. 2019; 71(3): 246-52.

Husnayain A, Fuad A, Su EC-Y. Applications of Google search trends for risk communication in infectious disease management: A case study of the COVID-19 outbreak in Taiwan. Int J Infect Dis. 2020; 95: 221-3. PMID: 32173572 DOI: 10.1016/j.ijid.2020.03.021

Schäfer M, Stark B, Werner AM, Tibubos AN, Reichel JL, Pfirrmann D, et al. Health information seeking among university students before and during the corona crisis: Findings from Germany. Front Public Health. 2021; 8: 616603. PMID: 33585388 DOI: 10.3389/fpubh.2020.616603

Alghatani K. Telemedicine implementation: Barriers and recommendations. Journal of Scientific Research and Studies. 2016; 3(7): 140-5.

Lin C, Lin I-C, Roan J. Barriers to physicians’ adoption of healthcare information technology: An empirical study on multiple hospitals. J Med Syst. 2012; 36(3): 1965-77. PMID: 21336605 DOI: 10.1007/s10916-011-9656-7

Weinstein RS, Krupinski EA, Doarn CR. Clinical examination component of telemedicine, telehealth, mHealth, and connected health medical practices. Med Clin North Am. 2018; 102(3): 533-44. PMID: 29650074 DOI: 10.1016/j.mcna.2018.01.002

Jankowski M, Wieczorek A. Telemedycyna w polsce: Mozliwosci i szanse rozwoju. Fundacja im Lesława A Pagi Warszawa; 2016.

Rogove HJ, McArthur D, Demaerschalk BM, Vespa PM. Barriers to telemedicine: Survey of current users in acute care units. Telemed J E Health. 2012; 18(1): 48-53. PMID: 22082107 DOI: 10.1089/tmj.2011.0071

Council on Competitiveness. Highway to health: Transforming US healthcare in the information age [Internet]. 1996 [cited: 5 Mar 2023]. Available from: http://nii.nist.gov/pubs/pubs.html

Allaire P, Young J, Vest C. Breaking the barriers to the national information infrastructure. A Conference Report. Council on Competitiveness; 1994.

Ryan P, Sawin KJ. The individual and family self-management theory: Background and perspectives on context, process, and outcomes. Nurs Outlook. 2009; 57(4): 217-25. PMID: 19631064 DOI: 10.1016/j.outlook.2008.10.004

Logue MD, Effken JA. An exploratory study of the personal health records adoption model in the older adult with chronic illness. Inform Prim Care. 2012; 20(3): 151-69. PMID: 23710840 DOI: 10.14236/jhi.v20i3.21

Abbate S, Avvenuti M, Light J. Usability study of a wireless monitoring system among alzheimer's disease elderly population. Int J Telemed Appl. 2014; 2014: 617495. PMID: 24963289 DOI: 10.1155/2014/617495

Perednia DA, Allen A. Telemedicine technology and clinical applications. JAMA. 1995; 273(6): 483-8. PMID: 7837367

Alzheimer's Association. 2020 Alzheimer's disease facts and figures. Alzheimers Dement. 2020; 14(3): 367-429. PMID: 32157811 DOI: 10.1002/alz.12068

World Health Organization. Telemedicine: Opportunities and developments in member states. Report on the Second Global Survey on eHealth. World Health Organization; 2010.

Ghasemizad A, Gholtash A. Explanation of a process-based model for crisis medicine: A qualitative study. Ebnesina. 2019; 21(3): 4-11.

Kernan WD. Health-related impediments to learning among dental and oral surgery students. J Prev Interv Community. 2019; 47(1): 32-44. PMID: 30806191 DOI: 10.1080/10852352.2018.1547307

Brauchli K, Oberholzer M. The iPath telemedicine platform. J Telemed Telecare. 2005; 11(Suppl 2): S3-7. PMID: 16375782 DOI: 10.1258/135763305775124795

Creswell JW, Creswell JD. Research design: Qualitative, quantitative, and mixed methods approaches. Sage Publications; 2017.

Cai H, Wang H, Guo T, Bao G. Application of telemedicine in Gansu province of China. PLoS One. 2016; 11(6): e0158026. PMID: 27332894 DOI: 10.1371/journal.pone.0158026

Wang T-T, Li J-M, Zhu C-R, Hong Z, An D-M, Yang H-Y, et al. Assessment of utilization and cost-effectiveness of telemedicine program in western regions of China: A 12-year study of 249 hospitals across 112 cities. Telemed J E Health. 2016; 22(11): 909-20. PMID: 27314300 DOI: 10.1089/tmj.2015.0213

Burke BL, Hall R, Dehnel PJ, Alexander JJ, Bell DM, Bunik M, et al. Telemedicine: Pediatric applications. Pediatrics. 2015; 136(1): e293-308. PMID: 26122813 DOI: 10.1542/peds.2015-1517

Trettel A, Eissing L, Augustin M. Telemedicine in dermatology: Findings and experiences worldwide–a systematic literature review. J Eur Acad Dermatol Venereol. 2018; 32(2): 215-24. PMID: 28516492 DOI: 10.1111/jdv.14341

Kahn EN, La Marca F, Mazzola CA. Neurosurgery and telemedicine in the United States: Assessment of the risks and opportunities. World Neurosurg. 2016; 89: 133-8. PMID: 26852710 DOI: 10.1016/j.wneu.2016.01.075

Xu T, Pujara S, Sutton S, Rhee M. Peer reviewed: Telemedicine in the management of type 1 diabetes. Prev Chronic Dis. 2018; 15: E13. PMID: 29369757 DOI: 10.5888/pcd15.170168

Kruse CS, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. Telehealth and patient satisfaction: A systematic review and narrative analysis. BMJ Open. 2017; 7(8): e016242. PMID: 28775188 DOI: 10.1136/bmjopen-2017-016242

Dorsey E, Topol E. State of telehealth. N Engl J Med. 2016; 375(2): 154-61. PMID: 27410924 DOI: 10.1056/NEJMra1601705

Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence. BMC Public Health. 2020; 20(1): 1193. PMID: 32738884 DOI: 10.1186/s12889-020-09301-4

Ashfaq A, Memon SF, Zehra A, Barry S, Jawed H, Akhtar M, et al. Knowledge and attitude regarding telemedicine among doctors in Karachi. Cureus. 2020; 12(2): e6927. PMID: 32190480 DOI: 10.7759/cureus.6927

Das N, Narnoli S, Kaur A, Sarkar S, Balhara YPS. Attitude to telemedicine in the times of COVID‐19 pandemic: Opinion of medical practitioners from India. Psychiatry Clin Neurosci. 2020; 74(10): 560-2. PMID: 32652668 DOI: 10.1111/pcn.13109

Portnoy J, Waller M, Elliott T. Telemedicine in the era of COVID-19. J Allergy Clin Immunol Pract. 2020; 8(5): 1489–91. PMID: 32220575 DOI: 10.1016/j.jaip.2020.03.008

Morenz AM, Wescott S, Mostaghimi A, Sequist TD, Tobey M. Evaluation of barriers to telehealth programs and dermatological care for American Indian individuals in rural communities. JAMA Dermatol. 2019; 155(8): 899-905. PMID: 31215975 DOI: 10.1001/jamadermatol.2019.0872

Tahir MJ, Waheed S, Ullah I, Ramalho R. Telepsychiatry and mental healthcare referrals: Recommendations for low‐and middle‐income countries. Perspect Psychiatr Care. 2021; 57(4): 2035-6. PMID: 33533044 DOI: 10.1111/ppc.12732

Bali S. Barriers to development of telemedicine in developing countries. In: Heston TF (Ed). Telehealth. Intech Open; 2018.

Kaplan B. Revisiting health information technology ethical, legal, and social issues and evaluation: Telehealth/telemedicine and COVID-19. Int J Med Inform. 2020; 143: 104239. PMID: 33152653 DOI: 10.1016/j.ijmedinf.2020.104239

Khilnani A, Schulz J, Robinson L. The COVID-19 pandemic: New concerns and connections between eHealth and digital inequalities. Journal of Information, Communication and Ethics in Society. 2020; 18(3): 393-403.

Serper M, Cubell AW, Deleener ME, Casher TK, Rosenberg DJ, Whitebloom D, et al. Telemedicine in liver disease and beyond: can the COVID‐19 crisis lead to action? Hepatology. 2020; 72(2): 723-8. PMID: 32275784 DOI: 10.1002/hep.31276

Jnr BA. Use of telemedicine and virtual care for remote treatment in response to COVID-19 pandemic. J Med Syst. 2020; 44(7): 132. PMID: 32542571 DOI: 10.1007/s10916-020-01596-5

Howgego G, Sharma I, Kalu P. The rules for online clinical engagement in the COVID era. J Plast Reconstr Aesthet Surg. 2020; 73(12): 2127-35. PMID: 33051176 DOI: 10.1016/j.bjps.2020.08.045

Tashkandi E, Zeeneldin A, AlAbdulwahab A, Elemam O, Elsamany S, Jastaniah W, et al. Virtual management of patients with cancer during the COVID-19 pandemic: Web-based questionnaire study. J Med Internet Res. 2020; 22(6): e19691. PMID: 32501807 DOI: 10.2196/19691

Shaw S, Wherton J, Vijayaraghavan S, Morris J, Bhattacharya S, Hanson P, et al. Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study. Health Services and Delivery Research. 2018; 6(21): 1-165. PMID: 29939519 DOI: 10.3310/hsdr06210

Mostafa PI, Hegazy AA. Dermatological consultations in the COVID-19 era: Is teledermatology the key to social distancing? An Egyptian experience. J Dermatolog Treat. 2022; 33(2): 910-5. PMID: 32602763 DOI: 10.1080/09546634.2020.1789046

Moss HE, Lai KE, Ko MW. Survey of telehealth adoption by neuro-ophthalmologists during the COVID-19 pandemic: Benefits, barriers, and utility. J Neuroophthalmol. 2020; 40(3): 346-55. PMID: 32639269 DOI: 10.1097/WNO.0000000000001051

Caetano R, Silva AB, Guedes ACCM, Paiva CCNd, Ribeiro GdR, Santos DL, et al. Challenges and opportunities for telehealth during the COVID-19 pandemic: Ideas on spaces and initiatives in the Brazilian context. Cad Saude Publica. 2020; 36(5): e00088920. PMID: 32490913 DOI: 10.1590/0102-311x00088920

De Simone V, Guarise P, Guardalben S, Padovani N, Tondelli S, Sandrini D, et al. Telecardiology during the Covid-19 pandemic: Past mistakes and future hopes. Am J Cardiovasc Dis. 2020; 10(2): 34-47. PMID: 32685262 PMCID: PMC7364274

Sinha S, Kern LM, Gingras LF, Reshetnyak E, Tung J, Pelzman F, et al. Implementation of video visits during COVID-19: Lessons learned from a primary care practice in New York city. Front Public Health. 2020; 8: 514. PMID: 33042950 DOI: 10.3389/fpubh.2020.00514

Jones MS, Goley AL, Alexander BE, Keller SB, Caldwell MM, Buse JB. Inpatient transition to virtual care during COVID-19 pandemic. Diabetes Technol Ther. 2020; 22(6): 444-8. PMID: 32396395 DOI: 10.1089/dia.2020.0206

Krenitsky NM, Spiegelman J, Sutton D, Syeda S, Moroz L. Primed for a pandemic: Implementation of telehealth outpatient monitoring for women with mild COVID-19. Seminars in Perinatology. Elsevier; 2020.

Barrett PM, Bambury N, Kelly L, Condon R, Crompton J, Sheahan A. Measuring the effectiveness of an automated text messaging active surveillance system for COVID-19 in the south of Ireland, March to April 2020. Euro Surveill. 2020; 25(23): 2000972. PMID: 32553064 DOI: 10.2807/1560-7917.ES.2020.25.23.2000972

Bokolo AJ. Exploring the adoption of telemedicine and virtual software for care of outpatients during and after COVID-19 pandemic. Ir J Med Sci. 2021; 190(1): 1-10. PMID: 32642981 DOI: 10.1007/s11845-020-02299-z

Bardus M, Keriabian A, Elbejjani M, Al-Hajj S. Assessing eHealth literacy among internet users in Lebanon: A cross-sectional study. Digit Health. 2022; 8: 20552076221119336. PMID: 35968030 DOI: 10.1177/20552076221119336

Raposo VL. Telemedicine: The legal framework (or the lack of it) in Europe. GMS Health Technol Assess. 2016; 12: Doc03. PMID: 27579146 DOI: 10.3205/hta000126

Bafghizadeh M, Najjarzadeh Z, Imanzadeh M. The role of GIS in the optimal establishment of remote medical systems. Journal of آospital. 2013; 12(4): 1-9.

Ahmadi M, Meraji M, Mashoof Jafarabad E. Evidence on telemedicine in Iran-systematic review. Journal of Paramedical Sciences & Rehabilitation. 2018; 7(1): 112-24.




DOI: https://doi.org/10.30699/fhi.v13i0.537

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