The "Lazio ADVICE" telemedicine platform: First results of general practitioners' usage, facilitators and barriers in the Local Health Authority Roma 1

Abstract

Background: Telemedical approaches represent a valuable tool for the management of coronavirus disease 2019 patients, allowing daily clinical assessment, monitoring of vital parameters, remote visits, and prescription of treatment or hospitalization in case of clinical worsening. This cross-sectional study aims to evaluate the use, barriers and facilitators of the "Lazio ADVICE" telemedical platform, a regional system for remote assistance for coronavirus disease 2019 patients at home, according to General Practitioners and Family Pediatricians of the Local Health Authority Roma 1, during the coronavirus disease 2019 pandemic.

Methods: An interview-based survey was performed between December 2020 and January 2021. The survey investigated the demographic information of General Practitioner and Family Pediatricians, the knowledge of the platform, frequency of utilization, usefulness, strengths and weaknesses, and hypothesis of future implementation proposed.

Results: We interviewed 214 physicians and 89 (41.6%) were classified as users and 125 (58.4%) as non-users. Older age and working in District 1, 14 and 15 (vs. District 13) significantly reduced the probability of using the platform physician. Among the 89 users, 19 (21.3%) used the platform every day or even several times a day, 40 (44.9%) several times a week but less than one access per day, 30 (33.7%) used the platform several times a month up to one entry per week. Most of them (92.3%) consider the platform useful. Barriers were poor integration with software and work routine (76.4%), and usability issues (53.9%). Among the 125 non-users, 14 (11.2%) didn't know the existence of the platform, 60 (48.0%) never tried it and 51 (40.8%) tried to use it. Reported reasons for the interruption of use were not very user-friendly (45.1%), perceived useless (37.3%), non-optimal functioning (23.5%), and lack of time (19.6%).

Conclusion: The pandemic accelerated the implementation of telemedicine services around Lazio Region, starting a positive and continuous exchange of experiences, activities and best practices among physicians.

Keywords: Telemedicine; barriers; coronavirus disease 2019; facilitators; primary care.

Figure 1.

The organizational structure of the Local Health Authority (LHA) Roma 1 to manage the new telemedical platform “Lazio ADVICE/Lazio Doctor” made available by the Lazio Region.

Figure 2.

Frequency of platform use by general practitioners. Every day, even several times a day: Median of managed patient 1542 (Q1 909,75; Q3 1550,5). Several times a week, but less than one access per day: Median 1072 (Q1 775; Q3 1284). Several times a month, up to 1 access per week: Median 1031 (Q1 389; Q3 1421,5).