Telemedicine adoption in Ecuador: an assessment of physician perceptions and knowledge towards its benefits and limitation

Telemedicine is a growing field with the potential to improve healthcare delivery, however it is important for a proper implementation to understand how physicians perceive the benefits and limitations related to their use. With this study our aim is to assess the perceptions and knowledge of telemedicine among a sample of Ecuadorian healthcare providers. We conducted a cross-sectional online survey-based study where participants answered a 12-item survey assessing their knowledge and perceptions towards telemedicine. Demographic variables were analyzed applying descriptive statistics, and a chi-square goodness of fit test was used to assess the observed frequencies of each of the survey’s queries. In total, 382 participants completed the survey with an average age of 51.3 years (SD, 11.4). Around half of participants expressed to be lowly to very lowly familiarized with telemedicine technology (χ2(4) = 88.497, p = .000). Most of them considered to a high extent that telemedicine is effective in reducing costs of patient care in hospitals (32.5%; n=124; χ2(4) = 78.812, p = .000). Finally, 8 out 10 participants expressed that a framework should be created to prevent breaches of data confidentiality when using telemedicine (χ2(4) = 250.749, p = .000). In this study we found a considerable proportion of physicians reporting low familiarization with telemedicine despite being aware of the benefits it can bring to patient care. Breaches of data confidentially and the potential for malpractice were cited as main concerns in need of a framework to prevent them. Future studies are needed to address the perceived barriers of technology to ensure a safe and efficient use of telemedicine in the healthcare setting. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by “Comité de ética e Investigación en Seres Humanos” (CEISH), ethical review board, Kennedy Hospital, Guayaquil-Ecuador (#HCK-CEISH-18-0060). Additionally, as per the Declaration of Helsinki, written informed consent was obtained from all participants. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable The following supporting information can be downloaded at: [https://docs.google.com/document/d/1ctHGh4VMW\_zmbnTjiNnPfBH9EKJPMgKS/edit?usp=drive\_link&ouid=105604320198849901573&rtpof=true&sd=true][1] S1 Table: Percentages and frequencies of categories that indicate the extent to which participants asserted the influence of telemedicine on each of the topics covered by each domain. [1]: https://docs.google.com/document/d/1ctHGh4VMW_zmbnTjiNnPfBH9EKJPMgKS/edit?usp=drive_link&ouid=105604320198849901573&rtpof=true&sd=true