Adoption of telemedicine from the healthcare management perspective

Purpose The objective of this study was to assess the challenges of adopting and using telemedicine from the perspective of healthcare management, in which the Innovation Diffusion Theory (IDT) was used as a reference complemented by the Technology-Organization-Environment (TOE) framework. Design/methodology/approach The methodology was structured into two steps: (1) a systematic literature review guided by the PRISMA protocol and Mendeley software, and (2) a qualitative study (in-depth interviews) with healthcare managers responsible for telemedicine at ten large and medium-sized Brazilian hospitals. Findings The results showed some critical points, namely: social issues, such as delivering telemedicine to low-income and elderly segments; the challenge of promoting a unified patient data interoperability, but without breaking the many ethical and legal restrictions; and the limits of telemedicine vis-à-vis the work of medical professionals. IDT and TOE proved effective in connecting the individual and organizational aspects of the theory of adoption and use of innovation. Research limitations/implications An important limitation of the study is the small number (i.e. ten) of healthcare managers who participated in the in-depth interviews. Practical implications Telemedicine can overcome geographical limitations by connecting state-of-the-art medicine practiced at leading hospitals to remote public healthcare units (UPA/UBS); public systems like the National Health Data Network (RNDS), which centralizes patient information, are providing important contribution to interoperability in healthcare; training can positively change the attitudes of medical professionals towards telemedicine; telemedicine is still perceived as a “cheaper” service than in-person care; and internet access is still a problem. Originality/value The study is expected to contribute to a better understanding of the difficulties in adopting telemedicine and what might improve the potential use of the technological infrastructure available in healthcare organizations, thus benefiting populations, especially those not assisted by regular healthcare services.