SUCCESSFUL FACTORS OF SERVICES AND FUNCTIONS OF TELEMEDICINE APPLICATION IN OPHTHALMOLOGY IN THAILAND

Abstract

The COVID-19 pandemic and growing healthcare inequality have resulted in reduced access to basic healthcare, both globally and in Thailand. Fear of contracting COVID-19 has made patients more hesitant to visit hospitals, especially the elderly, who may even avoid emergency care. In addition, studies have found that healthcare inequality in Thailand is worsening, as many doctors are opting to work in larger, more affluent cities like Bangkok. This has created a healthcare crisis and a shortage of medical personnel in rural areas. This trend is also evident in ophthalmology, where the number of patients far outweighs the number of available doctors. This study aims to investigate to identify the critical success factors and barriers to implementation of telemedicine for ophthalmology consultations. Specifically, the study will focus exclusively on telemedicine in ophthalmology and its application within this specialty. The study employed qualitative method via in-depth interviews with 30 people from both service providers and patients. Our findings demonstrated that the opinions and viewpoints towards ophthalmology and telemedicine varied significantly depending on factors such as the participant's demographics, educational level, and gender. In general, those aged 50 years and above expressed lower interest in using telemedicine for their consultations with underlying reasons categorized as unfamiliarity, lack of trust, and the perceived absence of personal touch. However, those younger than 50 years were more inclined to using telemedicine mainly due to convenience, and time-saving measure. One of the main barriers identified included the lack of a developed infrastructure and technological advancement currently available to provide a fully in-depth ophthalmological examination and investigation. Another main barrier was the issue of patient confidentiality in regard to patient-related information and images. Additionally, the need for complex investigations and technical machine was also another identified barrier for teleopthalmology implementation and use. Critical success factors identified included convenience, cost, usability of the application as well as the availability of high quality of digital infrastructure coupled with high digital literacy and training. This study is the first of its kind to investigate the utilization of telemedicine applications in ophthalmology in Thailand, taking into account the perspectives of both service providers and users. The research has significant implications, as it has provided ground-breaking insights into the attitudes of patients and clinicians, key success factors, and barriers to the adoption of teleophthalmology in Thailand. These findings hold great potential for practical application, with the ultimate aim of improving healthcare availability and equality, as well as preventing the transmission of diseases during future pandemics.