Introduction
Methods
Study population
-
Familiarity with telemedicine services
-
Age of at least 18 years
-
Previous admission to a health center or hospital
-
Provision of informed consent
Questionnaire development
Data collection
Variables
|
Variable type
|
Frequency
|
Percentage
|
---|---|---|---|
Sex
| Male | 304 | 24.8 |
Female | 922 | 75.2 | |
Age
| 18–27 | 661 | 53.9 |
28–37 | 370 | 30.2 | |
38–47 | 159 | 13.0 | |
48–57 | 29 | 2.4 | |
> 57 | 7 | 0.6 | |
Education level
| Diploma | 441 | 36 |
Associate degree | 103 | 8.4 | |
Bachelor | 480 | 39.2 | |
Master | 156 | 12.6 | |
PhD | 46 | 3.8 | |
Residence
| Metropolitan areas | 1105 | 90.1 |
Remote and rural areas | 121 | 9.9 | |
Disease type
| Oral and dental diseases | 359 | 29.3 |
Eye diseases | 291 | 23.8 | |
Skin and hair diseases | 281 | 22.9 | |
Digestive diseases | 254 | 20.7 | |
Otorhinolaryngology diseases | 190 | 10.5 | |
Gynecological diseases | 140 | 11.4 | |
Endocrine diseases | 121 | 9.9 | |
Psychological disorders | 101 | 8.2 | |
Musculoskeletal diseases | 95 | 7.7 | |
Cardiovascular diseases | 85 | 6.9 | |
Respiratory diseases | 61 | 5 | |
Cancers | 10 | 0.8 | |
Rheumatology diseases | 28 | 2.3 | |
Kidneys and urinary diseases | 73 | 6 | |
Genetic disorders | 18 | 1.5 | |
Infectious diseases | 7 | 0.6 | |
Birth Defects and disabilities | 6 | 0.5 | |
Rare diseases | 5 | 0.4 | |
Chemotherapy | 6 | 0.5 | |
Duration of the disease (Year)
| 1–10 | 1061 | 45.92 |
11–20 | 104 | 41.76 | |
> = 20 | 61 | 10.4 | |
Experience of using telemedicine
| Yes | 171 | 13.9 |
No | 1055 | 86.1 |
Data analysis
Ethical considerations
Results
Variables
|
Total frequency
|
In-person visit
|
Telemedicine visit
|
P
-value
| |
---|---|---|---|---|---|
Frequency (%)
|
Frequency (%)
| ||||
Sex
| Male | 304 | 207 (68.1) | 97 (31.9) | < 0.0001 |
Female | 922 | 658 (71.4) | 264 (28.6) | ||
Age
| 18–27 | 661 | 474 (71.7) | 187 (28.3) | 0.787 |
28–37 | 370 | 253 (68.4) | 117 (31.6) | ||
38–47 | 159 | 114 (71.7) | 45 (28.3) | ||
48–57 | 29 | 19 (65.5) | 10 (34.5) | ||
> 57 | 7 | 5(71.4) | 2 (28.6) | ||
Education level
| Diploma | 441 | 324 (73.5) | 117 (26.5) | < 0.0001 |
Associate degree | 103 | 70 (68.0) | 33 (32.0) | ||
Bachelor | 480 | 337 (70.2) | 143 (29.8) | ||
Master | 156 | 102 (65.4) | 54 (34.6) | ||
PhD | 46 | 14 (30.4) | 32 (69.6) | ||
Residence Type
| Metropolitan areas | 1105 | 772 (69.9) | 333 (30.1) | < 0.0001 |
Remote and rural areas | 121 | 93 (76.9) | 28 (23.1) | ||
Disease type
| Oral and dental diseases | 359 | 200 (55.71) | 159 (44.28) | < 0.0001 |
Eye diseases | 291 | 200 (68.72) | 91 (22.27) | ||
Skin and hair diseases | 281 | 130 (46.26) | 151 (53.73) | ||
Digestive diseases | 254 | 154 (60.62) | 100 (39.37) | ||
Otorhinolaryngology diseases | 190 | 110 (57.89) | 80 (42.10) | ||
Gynecological diseases | 140 | 109 (77.85) | 31 (22.14) | ||
Endocrine diseases | 121 | 115 (95.04) | 6 (4.95) | ||
Psychological disorders | 95 | 83 (87.36) | 12 (12.63) | ||
Musculoskeletal diseases | 101 | 45 (44.55) | 56 (55.44) | ||
Cardiovascular diseases | 85 | 65 (76.47) | 20 (23.52) | ||
Respiratory diseases | 61 | 32 (52.45) | 29 (47.54) | ||
Cancers | 10 | 10(100) | 0(0) | ||
Rheumatology diseases | 28 | 19 (67.85) | 9 (32.14) | ||
Kidneys and urinary diseases | 73 | 50 (68.49) | 13 (31.50) | ||
Genetic disorders | 18 | 12 (66.66) | 6 (33.33) | ||
Infectious diseases | 7 | 5 (71.42) | 2 (28.51) | ||
Birth Defects and disabilities | 6 | 2 (33.33) | 4 (66.66) | ||
Rare diseases | 5 | 4 (80) | 1 (20) | ||
Chemotherapy | 6 | 6 (100) | 0 (0) | ||
Duration of the disease
| 1–10 | 1061 | 746 (70.3) | 315 (29.7) | < 0.0001 |
11–20 | 104 | 77 (74.0) | 27 (26.0) | ||
> = 20 | 61 | 19 (31.1) | 42 (68.9) | ||
Experience of using telemedicine
| Yes | 171 | 70 (40.9) | 101 (59.1) | < 0.0001 |
No | 1055 | 746 (72.4) | 291 (27.6) |
Row
|
Advantages
|
In-person visit
|
Telemedicine visit
|
P
-value
|
---|---|---|---|---|
Mean (SD)
|
Mean (SD)
| |||
1. | Avoiding infectious diseases | 3.89(1.02) | 4.30(0.83) | < 0.0001 |
2. | Saving costs | 3.52(0.98) | 4.70(0.87) | < 0.0001 |
3. | Eliminate and overcome geographical distance barriers | 3.76(0.98) | 4.24(0.78) | 0/036 |
4. | Spending less time to receive medical services | 3.58(1.01) | 4.12(0.83) | < 0.0001 |
5. | Schedule the next visit | 3.38(1.15) | 3.99(0.76) | < 0.0001 |
6. | Easy electronic collection and storage of medical data and information | 3.32(1.02) | 3.91(0.85) | 0/045 |
7. | Convenient sharing of knowledge and information between therapists when faced with a rare disease | 3.27(1.03) | 3.88(0.94) | < 0.0001 |
8. | Reducing patient anxiety and stress | 3.19(1.09) | 4.07(0.80) | 0/014 |
9. | Less embarrassment and shame of the patient in providing information to the therapist | 3.18(1.53) | 4.02(0.94) | 0/011 |
10. | Easy to pay medical bills | 3.17(1.02) | 3.89(0.88) | < 0.0001 |
11. | Better patient-therapist interaction | 2.77(1. 04) | 3.89(0.88) | < 0.0001 |
12. | Maintaining confidentiality and privacy of information | 3.18(1.15) | 3.90(0.92) | < 0.0001 |
13. | Increasing the patient’s self-confidence in performing treatment processes | 3.09(1.05) | 3.92(0.87) | 0/043 |
14. | Easily perform self-care and self-management processes | 2.97(0. 98) | 3.88(0.83) | < 0.0001 |
15. | Easy exchange of information between the patient and the therapist | 2.90(1. 07) | 3.97(0.88) | 0/049 |
16. | Easy reporting of drug and treatment side effects to the physician | 2.37(0. 87) | 3.83(0.84) | < 0.0001 |
17. | Easy presentation of the patient’s treatment history to the therapist | 2.87(1. 05) | 3.93(0.85) | < 0.0001 |
18. | Better presentation of the patient’s current history to the therapist | 2.84(1. 07) | 3.94(0.86) | 0/03 |
19. | More patient peace of mind for treatment | 2.93(1. 13) | 3.81(0. 87) | 0/041 |
20. | Better and easier follow-up of treatment instructions | 2.87(1. 06) | 3.77(0. 87) | 0/042 |
21. | Better and easier use of health insurance | 2.92(1. 05) | 3.59(0.96) | 0/021 |
22. | Greater honesty of the patient in providing information to the therapist | 2.81(1.10) | 3.75(1.02) | < 0.0001 |
23. | Getting better treatment advice | 2.85(1.10) | 3.79(0.88) | 0/038 |
24. | Improving lifestyle | 2.65(1.13) | 3.73(0.82) | 0/02 |
25. | Easy follow-up of medical malpractices | 2.85(1. 13) | 3.58(0.99) | 0/049 |
26. | Giving more time to the therapist to treat the patient | 2.73(1.00) | 3.65(1.01) | < 0.0001 |
27. | Better interpretation of laboratory tests | 2.68(1. 09) | 3.65(0.90) | < 0.0001 |
28. | Professional commitment of the therapist to treat the patient | 2.66(1. 03) | 3.54(0.96) | < 0.0001 |
29. | Making better and more accurate treatment decisions by the therapist | 2.45(0.95) | 3.49(0.93) | < 0.0001 |
30. | Receive quality medical services | 2.47(0.93) | 3.49(0.94) | 0/01 |
31. | Greater medication adherence | 2.47(0.89) | 3.35(0.97) | 0/021 |
32. | Better and more accurate medicine prescription | 2.42(0.91) | 3.44(0.94) | 0/039 |
33. | Faster recovery of the patient | 2.37(0.87) | 3.33(0.95) | 0/034 |
34. | Reduction of medical errors | 2.33(1.01) | 3.31(1.00) | 0/033 |
35. | Better diagnosis of the disease | 2.19(0.94) | 3.25(1.08) | < 0.0001 |
36. | Quick diagnosis of the disease | 2.22(0.93) | 3.20(1.05) | < 0.0001 |
Reasons for choosing an in-person visit or telemedicine
Reasons for choosing an in-person visits
Main themes
|
Sub-themes
|
Number of quotes
|
---|---|---|
Physical examination
| Detailed and complete physical examination of the patient | 217 |
High quality examination tools in in-person visit | 10 | |
More accurate assessment of the patient | 8 | |
Reduction of medical errors by physical examination | 5 | |
Accurate decision-making by the physicians | 1 | |
More physician focus on the patient’s words | 1 | |
Physician paying more attention to the patient | 1 | |
Spending more time for the patient’s examination by the physician | 1 | |
Disease diagnosis
| More accurate diagnosis of the disease | 301 |
Reducing misdiagnoses | 68 | |
More accuracy of the physician in the examination | 30 | |
Faster diagnosis of the disease by the physician | 6 | |
Providing a better clinical history by the patient | 5 | |
Lack of use of telemedicine in diagnosing some diseases | 3 | |
More accurate understanding of the symptoms by the physician | 2 | |
Diagnosis of disease severity | 1 | |
Making treatment decisions faster | 1 | |
Reducing misconceptions | 1 | |
Provide more accurate, clearer and more honest explanations about the disease and its symptoms by the patient | 1 | |
Easy interpretation and analysis of the disease | 1 | |
Determining the exact location of the pain by the patient | 1 | |
Treatment
| More accurate and better treatment of the disease | 186 |
More confidence and trust in-person visits | 105 | |
Faster treatment | 35 | |
More adherence of the patient to the treatment | 18 | |
More commitment of the physician to treat the patients | 5 | |
Better and more complete exchange of patient information with the physician | 4 | |
Reducing medical errors and the risks of treatment | 3 | |
More motivation of the physician to treat the patients | 3 | |
Better understanding of how to perform post-treatment processes | 1 | |
Easier remembering of previous treatments done for the patient | 1 | |
Receiving medical services more easily from the nurses | 1 | |
Reducing treatment problems for the patients | 1 | |
High quality of treatment in in-person visits | 1 | |
Prescription and Medication
| Better prescription of medicines | 43 |
More accuracy of physician in prescribing medicines and fewer errors in prescriptions | 2 | |
Regular use of medicines | 1 | |
Fewer drug side effects | 1 | |
Face-to-face communication with the physician
| Direct, visual, comfortable and better communication between the patient and the physician | 84 |
Physician paying more attention to the patient | 33 | |
Patient’s clear response to the doctor’s questions | 10 | |
Closer communication between the patient and the physician | 20 | |
Providing better quality services | 12 | |
Providing a better clinical history by patient | 3 | |
Comfortable interaction of children with the physician | 2 | |
Not neglecting patient-provided clinical information to the physician | 1 | |
Better guidance of the patient in carrying out treatment processes | 1 | |
Psychological aspects
| Feeling better and more confident about the quick treatment of the disease | 12 |
More peace of mind for the patient during the treatment | 6 | |
Creating a positive feeling to continue further treatment | 5 | |
Patient’s mastery of speaking to provide a history to the physician | 1 | |
More understanding of the patient by the physician | 1 | |
Traditional and religious view of accepting in-person visits | ||
Increasing patients’ self-confidence | 1 | |
Habit of visiting the clinic in person | 1 | |
Insurance and reimbursement
| Being covered by insurance for drugs for certain diseases | 1 |
Use of insurance | 1 | |
Information technology infrastructure
| Lack of computer infrastructure and strong network for telemedicine | 21 |
No need for computer and digital knowledge and literacy | 17 | |
Constant Internet outages | 1 | |
Low bandwidth | 11 | |
Lack of culture to use technologies | 11 | |
No need for computers and other powerful communication equipment such as mobile phones | 4 | |
Slow internet speed | 1 | |
Lack of experience in using telemedicine | 1 | |
Security and privacy
| Maintaining patient privacy | 5 |
Maintaining confidentiality of information | 3 | |
Fearing of easy disclosure of information in telemedicine | 2 | |
Maintaining information security | 1 | |
Lack of clear rules in the field of electronic disclosure of patient information | 1 | |
Cyber fraud | 1 | |
Hacking and unauthorized access to medical record information | 1 | |
Fraud and abuse of patient data | 1 | |
Laboratory tests
| Necessity of conducting clinical tests in person | 1 |
Better interpretation of the results of clinical tests | 1 |
Physical examination
“I agree with the in-person visit because the examination is physical, and the physician can provide a more accurate diagnosis.” (Participant 200)
“I believe a more comprehensive examination is possible in-person, aiding the physician’s accurate decision-making.” (Participant 305)
Disease diagnosis
“I dislike telemedicine as the physician’s accurate diagnosis seems possible only in-person.” (Participant 105).
Treatment
“In my view, in-person visits are unmatched by telemedicine. I strongly believe they offer superior, more accurate, and effective treatment.” (Participant 505)
“I have more faith in my treatment process during in-person visits, expecting quicker and more effective care.” (Participant 321)
“Unlike telemedicine, I sense that the physician’s dedication to treating the patient is considerably greater during an in-person visit. This is why I never opt for telemedicine.” (Participant 71).
Prescription and medication
“In the clinic, when the patient visits in person, the physician can directly assess test results and the patient’s condition. This leads to more precise medication prescriptions.” (Participant 41)
“During in-person visits, I feel the physician allocates more time to me, resulting in better medication prescriptions that I consistently follow.” (Participant 320)
“The in-person physician’s cautious medication prescriptions lead to fewer drug side effects.” (Participant 901)
Face-to-face communication with the physician
“During in-person visits, I’m certain the physician attentively listens to what I say.” (Participant 12)
“I believe that more effective treatment occurs when there’s direct visual and verbal communication between the physician and the patient.” (Participant 1002)
“I believe direct patient-physician interaction in-person boosts physician accuracy and focus more than telemedicine. That’s why I exclusively visit clinics for treatment. For this reason, I choose to only seek treatment by physically visiting clinics.” (Participant 679)
Psychological aspects
“During an in-person office visit, I feel more inclined to pursue additional treatment.” (Participant 718)
“Personally, seeing a physician in person brings me a sense of peace that outweighs a faster recovery, as I trust their in-depth understanding of my condition leads to a more accurate diagnosis.” (Participant 347)
“I will have more self-confidence because I talk face-to-face with the physician during the in-person visit.” (Participant 417)
Insurance and reimbursement
“I have MS and require specific medications. Affording these drugs without insurance is unfeasible due to my financial situation, and I’m unsure if my insurance covers telemedicine visits and prescriptions.” (Participant 197)
“In-person visits offer more accurate clinical examinations, improved patient care from physicians, and notably, the ability for patients to utilize insurance.“ (Participant 521)
Information technology infrastructure
“Telemedicine infrastructure should be built in our country first, then we should use telemedicine, I think there is still no strong infrastructure.” (Participant 359)
“I live in a village and I am reluctant to use telemedicine due to the slow internet speed in my area.” (Participant 344)
“Due to my parents’ elderly status, using telemedicine is challenging for them as they lack computer and internet skills. Hence, in-person visits are more suitable for them.” (Participant 81)
“During an in-person visit, there’s no requirement to use devices like laptops or mobile phones for communication with the physician. Additionally, my economic situation does not allow me to afford such tools.” (Participant 651)
“I believe that a culture of using telemedicine has not yet fully developed, and if we intend to adopt it, we are likely to encounter numerous challenges.” (Participant 25)
Security and privacy
“Due to my unique medical condition, I choose not to use telemedicine as I am constantly concerned about information disclosure. I believe that sharing information is much more straightforward in telemedicine compared to an in-person visit.” (Participant 219)
“In my view, a telemedicine system might jeopardize patients’ privacy by potentially sharing their sensitive data with third parties for personal financial gains.” (Participant 44)
“In my opinion, the prevalence of cyber fraudsters who can readily exploit patients’ data is a significant concern, which is why I choose not to use telemedicine at all.” (Participant 49)
“In my opinion, there is a lot of possibility for fraud and abuse of patient data in telemedicine, which makes people less likely to go to this technology. Therefore, they prefer to use in-person visits.” (Participant 953)
Laboratory tests
“I believe that tests like mammography, pap smear, ultrasound, and eye pressure testing for glaucoma should be conducted in person.” (Participant 852)
Main themes
|
Sub-themes
|
Number of quotes
|
---|---|---|
Patient and provider safety
| Reduce the incidence of infectious diseases and prevent their further spread | 296 |
Protect service providers against infectious diseases | 2 | |
Initial assessment and triage of patients with symptoms of infectious diseases | 1 | |
Increase patient safety | 1 | |
Vaccination at national level | 1 | |
Physical examination
| Access to patients’ history | 1 |
Spending more time and time of the physician for the patient’s examination | 11 | |
Not forgetting the information that can be provided in describing the history by the patient | 2 | |
More honesty of the patient in providing information | 1 | |
Diagnosis
| Physician’s greater accuracy in diagnosing the disease and avoiding their mistakes during the diagnosis process | 4 |
Access to the patient’s clinical history | 1 | |
Physician’s access to reliable information | 1 | |
Reduction of life and financial complications | 1 | |
Treatment
| Easier, better and faster treatment | 21 |
Improvement of patient participation in treatment processes | 4 | |
Easy finding of answers to questions | 3 | |
Visiting and treating a larger number of patients | 3 | |
Managing and treating the elderly comfortably | 3 | |
Helping the patient in emergency situations | 2 | |
No need for in-person visits | 2 | |
Easy management and control of chronic diseases | 2 | |
Increasing individual independence | 2 | |
Allocating more time by the physician to the patient | 1 | |
Recording all treatment steps | 1 | |
Reviewing and accessing the patient’s electronic record | 1 | |
More energy of physicians to treat patients | 1 | |
More responsibility of physicians | 1 | |
Training on how to treatment processes for patients | 1 | |
Providing fast care services to patients | 1 | |
Improving self-care processes | 1 | |
Compensating for the lack of physicians in treatment centers | 1 | |
More accurate treatment recommendations | 1 | |
Spending more physician time to follow up the patient’s treatment processes | 1 | |
Medication prescription
| Better monitoring of patients’ health status by physician to prescribe medicine | 1 |
Better prescription of medicine for individuals with chronic diseases | 1 | |
Access to physicians
| Access to wider range of specialties | 45 |
Quick and easy access to physicians at any time and from any place | 11 | |
Cost management
| Reducing treatment costs | 210 |
Reduce consumption of personal protective equipment | 1 | |
Reduce fuel consumption | 1 | |
Simple payment of costs | 1 | |
Reduce costs related to office and paper processes | 1 | |
Reduce accounting errors | 1 | |
Increase the income of physicians and health organizations | 1 | |
Time management
| Saving time | 181 |
Control and manage time better | 2 | |
Reduce patient waiting time | 2 | |
Geographical distances
| Eliminating geographical distances | 9 |
Reducing the need for additional trips and the possibility of traveling to any medical center anywhere in the world | 5 | |
Receiving emergency care services quickly | 3 | |
Expanding the geographic range to receive healthcare services | 2 | |
Psychological aspects
| Comfortable interaction of shy and isolated individuals with the therapist | 19 |
Reducing tension and stress | 15 | |
More peace of mind for patients in treatment | 4 | |
Increasing patients’ self-confidence | 2 | |
Increasing patients’ motivation to continuing his treatment | 2 | |
Reducing social stigma | 1 | |
Reducing fear and stress caused by reducing time | 1 | |
Less stress of service providers | 1 | |
Faster recovery of patients with mental disorders | 1 | |
Electronic registration and management of patients’ information
| Saving the electronic information of the patients | 3 |
Access to clinical records of patients at any time and any place | 2 | |
Quickly retrieve the information | 1 | |
Reducing the use of paper | 1 | |
Don’t spend a lot of time by physicians to obtain the required information | 1 | |
Save audio and video information | 1 | |
Access to up-to-date information by physicians | 1 | |
Easy sharing of patient information with other physicians | 1 | |
Preservation of information against natural events | 1 | |
Transfer of patient information to medical centers | 1 | |
Insurance and reimbursements
| Easy receipt of bills from insurance companies | 1 |
Providing logical evidence against insurance companies’ claims | 1 | |
Healthy environment
| Reducing urban traffic | 5 |
Not destroying green spaces | 2 | |
Increasing the physical and mental health of patients by eliminating noise pollution | 2 | |
Reducing pollution | 1 | |
Interaction and communication
| Reducing the stress and anxiety of the patients | 5 |
Better and easier interaction with the therapist | 3 | |
Establishing private communication between the patient and the physician | 2 | |
Peer-to-peer support | 1 | |
Consulting physicians with each other | 1 | |
Information technology
| Creating a backup of medical records | 2 |
Reduce repetitive processes | 1 | |
Training self-care processes to patients | 1 | |
Allowing to patients to access their medical information | 1 | |
Security, privacy and legal issues
| Determination of authorized persons to use patient information | 1 |
Easy identification of persons who disclose information | 1 | |
Determination of access levels to medical records | 1 | |
Prevention of information losing | 1 | |
Reduction of unauthorized use of information | 1 | |
Easy follow-up of legal issues | 1 | |
Laboratory tests
| Storage and quick access to laboratory test results by patients | 1 |
Quick sending of laboratory test results to therapists | 1 | |
Better interpretation of test results | 1 | |
Reduction of in-person visits of patients to medical centers to perform laboratory tests | 1 | |
Remote monitoring
| Vital sign monitoring for control and management of patients | 5 |
Easy drug withdrawal for addicts | 2 | |
Reducing the exacerbation of the disease | 1 | |
Monitoring and controlling the health status of veterans | 1 | |
Providing easy services to disabled individuals | 1 | |
Easy care of babies and children | 2 | |
Providing telerehabilitation services to patients | 2 | |
Use of monitoring tools and sensors to monitor the condition of patients and save their lives | 1 | |
Admission and hospitalization
| Help individuals living in villages to easily visiting | 17 |
Easily determine appointment times | 7 | |
reducing the rate of hospital admissions and readmissions | 4 | |
reducing the crowding of medical centers and hospitals | 4 | |
Increasing the number of patients visited | 1 |
Patient and provider safety
“Currently, due to infectious diseases such as COVID-19, I prefer not to have an in-person visit and instead opt for telemedicine.” (Participant 230)
“I work in a hospital and believe that the primary advantage of telemedicine is its ability to minimize direct contact between providers and patients.” (Participant 765)
“A great feature of telemedicine is its ability to perform initial assessments and triage for patients with symptoms of infectious diseases like COVID-19. This allows for prompt identification and guidance towards suitable treatment.” (Participant 413)
“Now that COVID-19 has spread, I think one of the most important applications of telemedicine is national vaccination. Telemedicine can be used to encourage people to get vaccinated as soon as possible through video conferences or text reminder messages.” (Participant 310)
Physical examination
“I personally believe that I can more easily explain my medical history and concerns to the therapist through telemedicine.” (Participant 485)
“I have had the experience of using telemedicine once or twice. In my opinion, during telemedicine appointments, physicians devote more time to examining patients.” (Participant 1012)
“During in-person visits, long waits and rushed consultations due to high patient volume can stress patients and lead to missed important illness details.” (Participant 963)
“When using telemedicine, I find that I can provide the physician with a more honest presentation of my clinical information and medical history.” (Participant 1125)
Diagnosis
“I find telemedicine consultations to be better because I believe physicians are more accurate in diagnosing my condition.” (Participant 842)
“In my view, telemedicine leads to better diagnosis and management of diseases, resulting in reduced clinical and financial burdens for the patient.” (Participant 514)
Treatment
“I’m very fond of telemedicine because I believe it makes my treatment process easier and faster.” (Participant 574)
“I believe that in emergency situations, physicians can manage and control patients much more quickly online.” (Participant 1019)
For individuals with a chronic disease, telemedicine is highly beneficial as it enables them to enhance their lifestyle and manage their condition through convenient and easy communication with their physician.” (Participant 1001)
“As a disabled person still living with my family, when I fall ill, I need to visit the medical center accompanied by a family member. However, with telemedicine, I can readily undergo treatment without relying on anyone.” (Participant 219).
“Telemedicine enables me to easily manage self-care processes, treatments, and take better care of myself.” (Participant 917)
Medication prescription
“From my perspective, telemedicine holds value in prescribing medication for individuals dealing with chronic conditions. It facilitates convenient communication with physicians to obtain personalized prescriptions. Furthermore, it proves useful in addressing drug side effects through telemedicine consultations, providing guidance on proper usage and the management of emerging effects.” (Participant 444).
Access to physicians
“When I was diagnosed with Covid-19, I could easily communicate with my physician brother who lives in Canada and receive medical advice.” (Participant 1009)
“I live in a village and can’t go to the hospital or the hemophilia treatment center in the city every day for my treatment. With telemedicine, I can easily communicate with my physician anytime and anywhere.” (Participant 770)
Cost management
“Due to my limited economic situation, I prefer using telemedicine as I can’t afford to visit medical centers every day.” (Participant 1209)
“Another advantage of telemedicine is the reduction in fuel consumption, such as gasoline, as individuals do not need to visit the clinic in person.” (Participant 1204)
“I endorse telemedicine for its ability to markedly cut costs related to office and paper processes, postage, printing, and paper-based information storage.” (Participant 409)
Time management
Due to the widespread Covid-19 situation, minimizing medical center referrals is essential, saving patients from lengthy wait times. (Participant 883)
“I am confident that telemedicine allows me to better manage my time and plan my daily activities more effectively.” (Participant 706)
Geographical distances
“Telemedicine not only enables individuals with mental health conditions, who are particularly susceptible to self-harm and suicide, to consult a therapist or psychiatrist promptly day or night, but it also seamlessly extends healthcare services’ geographic reach to anywhere in the world.” (Participant 174)
“Telemedicine can effortlessly extend the geographic reach of healthcare services to anywhere in the world.” (Participant 967)
Psychological aspects
“I favor telemedicine for its convenience and peace of mind during treatment, offering me increased confidence and easy communication with the physician.” (Participant 97)
“ I believe telemedicine’s key benefit is seen in socially stigmatized conditions like HIV and addiction, where patients feel at ease with physicians, enabling open sharing of information.” (Participant 54).
“I believe telemedicine not only fosters improved physician and therapist ethics, encouraging patient commitment to treatment, but also aids isolated and shy individuals by alleviating shyness and creating a comfortable space for sharing information with therapists.” (Participant 710).
Electronic registration and management of patients’ information
“Telemedicine facilitates electronic exchange of patient information between patients and physicians, enabling the electronic storage and management of clinical data and information, consequently minimizing the requirement for paper usage.” (Participant 7)
“In my view, another significant advantage of telemedicine is its ability to effectively safeguard patient information against natural events like floods, earthquakes, and more.” (Participant 4)
Insurance and reimbursements
“In my opinion, telemedicine simplifies the process of providing legal evidence for insurance claims compared to in-person visits.” (Participant 367)
“ I believe that in telemedicine, insurance companies enable doctors and other therapists to bill for the healthcare services they offer, regardless of the patient’s or provider’s location.” (Participant 19)
Healthy environment
“I don’t like in-person visits because of my asthma. In polluted environments, my disease worsens, with in-person visits, travel between or within cities increases and the environment becomes more polluted. (Participant 10)”
“I love nature and green spaces. My top reason for choosing telemedicine is to lower pollution by minimizing in-person medical visits, which in turn helps preserve the environment.” (Participant 38).
“I appreciate telemedicine as it relieves me from city traffic fatigue. It helps reduce urban traffic congestion.” (Participant 1012)
“I believe car-related noise pollution is a major issue in urban areas, posing a threat to mental health, particularly for hospital patients. Through telemedicine, additional trips to hospitals and medical centers can be reduced and noise pollution can be prevented.” (Participant 1068)
Interaction and communications
“Telemedicine not only enables convenient communication between patients and physicians, preventing unnecessary time waste, but also alleviates the stress of in-person medical center visits, resulting in more relaxed interactions.” (Participant 988)
“ I get stressed when I want to go to medical centers in person and communicate with my physician, while with telemedicine I am not stressed at all.” (Participant 45)
Information technology
“Another advantage of telemedicine is its ease in delivering self-care training to patients through multimedia technologies following their treatment. (Participant 1)”
“Through telemedicine, numerous repetitive processes can be minimized, such as multiple visits to medical centers for medicine renewal. New medicines can be prescribed each time based on the patient’s current condition. (Participant 13)”
Security, privacy and legal issues
“I highly value my medical privacy and vehemently oppose unauthorized use of my information. Telemedicine can significantly reduce such unauthorized access and enable patients to determine who will have access to their information.” (Participant 27)
“When I visited medical centers in person several times, some of my information was lost, such as my test sheets. While in telemedicine, the possibility of losing patient information, especially the results of laboratory tests, is very low.” (Participant 209)
“Due to the advanced technologies used in telemedicine, it becomes easy to identify individuals disclosing patient information, and it also simplifies addressing legal matters for both patients and physicians.” (Participant 22)
Laboratory tests
“Telemedicine offers multiple advantages. It allows me to upload and store my lab test results on websites for easy access when needed by me or my physicians. Additionally, it reduces costs and distances while enabling swift transmission of laboratory test results to physicians.” (Participant 666).
“I believe that in telemedicine, physicians interpret the results of lab tests much more effectively. Unlike in-person visits, they aren’t dealing with a large population of patients, and medical centers are not as crowded.” (Participant 946).
Remote monitoring
“Telemedicine utilizes monitoring tools and sensors to track patients’ conditions and relay alerts to physicians, notifying them of health deterioration and emergencies.”(Participant 57)
“I am a chemical veteran, and I have to visit the physician’s office every week. Telemedicine could enable remote monitoring, alleviating the need for frequent visits.” (Participant 70)
“We have a disabled brother in the family who cannot speak or walk properly. Every month, we have to take him to medical centers for doctor’s monitoring. Telemedicine seems promising for providing medical care to disabled patients.” (Participant 1014)
“Through telemedicine, physicians can monitor patients in the ICU and monitor their vital signs, such as pulse rhythm, blood pressure, glucose levels, and more.” (Participant 1009)
“In my opinion, by using telemedicine, addicts can better quit their addiction, because physicians can monitor and control them more.” (Participant 1072)
Admission and hospitalization
“I live in the village, and it is very difficult for me to travel to the city every week for my physician to visit me, but with telemedicine it will be easier for me to be visited.” (Participant 104)
“I dislike crowded medical centers; I believe that by using telemedicine, I can easily schedule appointments without having to go to the hospital.” (Participant 1221)