Development of Telemedicine Service Model, Prachuap Khiri Khan Province

Abstract

This study is research and development with the objectives to (1) study the situation and models of telemedicine services in Prachuap Khiri Khan Province during the years 2022-2024, (2) develop service models, and (3) evaluate the developed service models. The tools used for the study were developed from the Technology Acceptance Model theory combined with the six building blocks of health system framework. The study was divided into three phases. In Phase 1, the development began using the quality management cycle, which included work planning, creating work methods, implementation, and performance evaluation. It was found that only 3 out of 8 hospitals had service performance. Phase 2 involved improving the work models using the quality management cycle, carrying out activities based on work promotion measures derived from focus group discussions with stakeholders. These measures included setting departmental and managerial performance targets, awarding outstanding performers, involving executive personnel in listening, solving problems, and regularly monitoring operations, knowledge exchange between model hospitals, empowering visits to all hospitals, and instilling confidence in personnel to see the benefits and understand that telemedicine is not difficult to implement. Phase 3 involved evaluating the developed service model by assessing: (1) volume and access to services, finding that the average number of service instances per month increased by 5.83 times and was applied to more illnesses; (2) the relationship between variables using Spearman Sign rank test, which found that the levels of perceived ease of use, perceived usefulness overall, and perceived benefits of telemedicine in relation to the six building blocks of health system framework had a positive correlation with the intention to use at a confidence level of 0.05. The Biserial correlation was used to test the relationship between staff’s intention to use and their actual usage behavior post-development, showing a positive correlation at a confidence level of 0.05. The Wilcoxon sign ranks test evaluated the levels of perceived benefits, perceived ease of use, and intention to use before and after development, and showed that all variables had significantly increased scores at a confidence level of 0.05. Lastly, patient satisfaction was found to be at a high to highest level. The study concludes that the theoretical framework can explain the behaviors and variables studied, and the developed model used for improving services was effective.