Telemedicine Healthcare Service Adoption Barriers in Rural Bangladesh

Abstract

This article investigates potential barriers to telemedicine adoption in centres hosted by rural public hospitals in Bangladesh. Little is known of the barriers related to telemedicine adoption in this context. Analysis of data collected from rural telemedicine patients identified seven broad categories of barriers: lack of organisational effectiveness, information and communication technology infrastructure, quality of care, allocation of resources, health staff motivation, patient satisfaction and trustworthiness. Their significance is explored. This research is based on the quantitative analysis of a data set of 500 telemedicine patients, from rural areas in Bangladesh. A conceptual model showing the interaction of pre-determined classes of barriers was established and hypotheses set up and tested using partial least squares structural equation modelling. Exemplary barriers to telemedicine adoption were identified and confirmed (p<.01) namely, lack of organisational effectiveness, health staff motivation, patient satisfaction, and trustworthiness collectively explaining 62% of the variance in barriers to adoption and providing for the first-time empirical support of their existence. These barriers offer considerable resistance to the adoption and maintenance of current telemedicine projects in rural Bangladesh. Further, lack of information and communication technology infrastructure, allocation of resources and quality of care are indirect barriers affecting successful deployment of telemedicine in rural settings. These findings illuminate adoption impediments faced by existing telemedicine projects and institutionalise favourable policy guidelines to improve Bangladesh’s and similar emerging economies’ healthcare industries. Policy interventions and recommendations are provided, including current research limitations leading to opportunities for future research.