Acceptance of Care Offers for exclusive Remote Treatment Illustrated by the Telemedical Model Project docdirekt with a Mixed-Methods Design

Abstract

Objective Current telemedical services, such as the docdirekt project in Baden-Württemberg (BW), are evaluated for optimizing their implementation. Based on the results of this evaluation, strategies for adapting these services for exclusive remote treatment are identified that enable their integration in regular medical care. Methods In the first part of the study, citizens from BW were individually interviewed on their expectations regarding such a project, and the advantages and barriers in the use of services for exclusive remote treatment. Determinants were explored by means of Mayring's qualitative content analysis. In the second part of the study, these determinants were prioritized by using a quantitative survey of randomly selected citizens from BW. Results A total of 27 subjects (mean age 51 years, min: 23 years, max: 86 years) participated in the interviews. Most importantly, they found the direct accessibility of healthcare professionals a great advantage. A 24/7 hotline was found to be beneficial, as well as the possibility to get electronic prescriptions or medical sickness certificates. Privacy and a missing physical examination were perceived as barriers. In the questionnaire, the participants (n=217, return 10.9%, mean age: 53 years, min: 19 years, max: 88 years) rated a direct medical contact as the most important, followed by the possibility to get a specialist and to receive a first therapy suggestion. In total, n=71 (34.6%) rejected the future use of such a service. The willingness to use the service decreased with increasing age and decreasing digital skills. Conclusion The study shows that there is an interest in the use of services for exclusive remote treatment. People who intend to use telemedical service prioritize the fast-initial medical assessment and the comfort aspects and, among other things, consider the inclusion of additional services as beneficial. The next step is to incorporate these determinants into the existing telemedical service.