CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Telemedicine involves the use of telecommunications and computer technology in the delivery of health services to enable provider-patient and provider-provider consultation across geographic boundaries. It encompasses several different forms of information transmission (voice, sound, video, still picture, text), communication technologies (standard telephone lines, coaxial cable, satellite, microwave, digital wireless, ISDN, Internet), and user interfaces (desktop computers, laptop computers, personal digital assistants, Fax machines, telephones, mobile phones, videophones, various stand alone systems and peripheries). These permit a range of activities, most prominent of which include: store-and-forward applications, which involve the asynchronous transmission of medical information, patient/provider communications and other data; live audiographic encounters, which combine sound with still pictures; and perhaps, most noteworthy, live two-way interactive video consultations. There are also several potential uses. This is reflected in the prevailing terminology, with “telemedicine” often being used to describe clinical, patient care applications, and “telehealth” being used more broadly to describe both clinical and non-clinical applications in the way of education, administration, and research.
Prior to adoption into routine use, any new technology must be ended up being better than the methodology that it is proposed to supplant, that is, it must be more successful or more financially savvy than the alternative(s). Telemedicine is no exemption to this standard. There is developing acknowledgment that telemedicine frameworks require appraisal and the continuous collection of significant information for authoritative purposes before they can be considered for routine use for a huge scope. Besides, appraisal of telemedicine applications is expected to help buying and arranging choices and furthermore to screen and adjust the utilization of the technology when it is set up (Hailey D, Jacobs P. 1997). Telemedicine is the utilization of communication and information technologies to give or bolster clinical consideration a good ways off. Telehealth is portrayed as the usage of electronic communication and information technologies to help huge separation clinical health care, patient and professional health related education, general health and health organization.
In terms of service delivery methods, telemedicine can be classified into three forms: store-and-forward, remote patient monitoring, and real-time interactive services (J. Hasan, 2012). Store-and forward telemedicine involves acquiring medical data (such as medical images and bio signals) and then transferring the data to a doctor or medical specialist across distance and time (Wanat et al., 2016). Remote monitoring is that the medical experts monitor a patient remotely by using wearable devices, digital video, or other devices. This method is mainly applied to manage chronic diseases, such as heart disease, diabetes mellitus, and asthma (Chakraborty, B. Gupta, and S. K. Ghosh, 2013). For the real-time interactive service, patients and doctors communicate through video conferencing (Drago, T. N.Winding, and N. Antypa, 2016). For the most part, patients need to go to the nearby telemedicine health centre for this service with the assistance of tele-experts. By giving simpler access to medical expertise, telemedicine can lessen the geographical variability of diagnosis, treatment, and clinical administration. The study led during 2009-2010 in remote areas of the Brazilian province of Minas Gerais shows that the teleconsultations can turn away 80.8% of referrals and 45.5% of transportation costs. Numerous different investigations likewise checked that telemedicine could significantly decrease the human services cost, abbreviate the waiting time, and improve the usage effectiveness of health resources (B. G. Sherwood, et al. 2018).
Advanced information and communication technologies enable patients to get health services through the website or mobile applications. This motivates an increasing number of hospitals to devote attention to telemedicine services. For instance, the division of neonatal medication of Mayo Clinic offers infant telemedicine consultations to 6 outpatient centers, and almost 33% of the babies could stay in the nearby emergency clinic (J. L. Tooth, et al. 2016). To give telemedicine services, the nonprofit hospital needs to confront an investment to recruit tele-specialists, and the system organizer needs to limit the total cost, which incorporates the hospital investment cost and patients' transportation cost and waiting cost. In this manner, regardless of whether the decrease of transportation cost and waiting cost can compensate for the investment turns into a significant issue for the system organizer.
In spite of the fact that telemedicine can avoid traveling and shorten the waiting time, the telemedicine service is certainly not a superior decision now and again. For patients with muddled illnesses, they cannot get relieved uniquely with the telemedicine services and still need retreatment from conventional offline outpatient. For instance, in general urological care, telemedicine can deter the in-person visits for almost 90% of patients, however just half of urological complaints could have been made do with telemedicine alone (B. G. Sherwood, et al. 2018). Notwithstanding, patients just realize the cure rate earlier likelihood of the telemedicine service. They do not know whether they can be cured or not before getting the telemedicine service. Hospitals can impact patients' choices by changing the online and offline service limit in the double channel service system. In this way, the market division of the telemedicine service and customary offline service is additionally changed. It is on this background that this study seeks to investigate the impact of telemedicine and online medical consultation on health care delivery in Nigeria by using Tremendoc as a case study.
1.2 Statement of the Problem
Lawful confusions are raising another warning. Laws and a set code of rules and morals should be applied before telemedicine can be utilized regularly in different capacities. This by itself may take some time. Services and how experts get paid for them will all should be settled as telemedicine turns into a more familiar practice. This can end up being a troublesome assurance. At that point we have clinical risk and over reliance on this telemedicine framework. Because of the risk involved with what is reliable vs unreliable information and over reliance or over utilization of telemedicine can without much of a stretch get out of control until more uniformed systems and methods are placed into play.
As should be obvious telemedicine is not yet completely worked out where it tends to be used continually or deftly. Be that as it may, it can possibly be a colossal advantage for the world and every one of its civic establishments. There is no contending that the contributions it can make have unlimited prospects anyway additional time and effort will be expected to sort out telemedicine for it to be unquestionably acknowledged.
1.3 Objectives of the Study
The main objective of this study is to examine the impact of telemedicine and online medical consultation on health care delivery in Nigeria by using Tremendoc as a case study. However, the specific objectives are:
i) To assess the effectiveness of telemedicine and online medical consultation on health care delivery in Nigeria
ii) To determine the various types of telemedicine available in Nigeria
iii) To understand the advantages of telemedicine as well as its disadvantages in the Nigerian society
1.4 Research Questions
This study shall seek to provide answers to the following questions:
i) To assess the effectiveness of telemedicine and online medical consultation on health care delivery in Nigeria
ii) To determine the various types of telemedicine available in Nigeria
iii) To understand the advantages of telemedicine as well as its disadvantages in the Nigerian society
1.5 Research Hypotheses
The following statements are considered to be the research hypotheses
i) There is no significant correlation between telemedicine and online medical consultation and health care delivery in Nigeria
ii) There is a significant influence of telemedicine on the Nigerian health care system
1.6 Significance of the Study
This study investigates the impact of telemedicine and online medical consultation on health care delivery in Nigeria and therefore will no doubt open the Nigerian health care sector to the impact of information and communication technology on the society and particularly to the health sector as it will help them to effectively and efficiently carryout their job in a without stress.
It will also help the government to look at the brighter side of ICT which has considerably helped the health practitioners to carry out their job without any delay. This study will also help the researchers by serving as a foundation for further study in this area.
1.7 Scope of the Study
This study on the impact of telemedicine and online medical consultation on health care delivery in Nigeria will be carried out at Tremendoc and therefore 100 workers of Tremendoc will be used as samples for this study.
1.8 Limitation of the study
The only major challenged encountered by the researcher was the attitude of the respondents. The researcher encountered the major challenge from the respondents on their typical reluctant attitude to fill the questionnaire or grant interview. In some cases, some respondents expect to be paid for the use of their time and knowledge; if otherwise, they were very reluctant in giving the required information. Some hoard information in keeping with the oath of secrecy. In spite of repeated assurance of confidentiality most of them fear the loss of their job and some were too busy to grant interview and fill the questionnaires correctly.
