Power Gaps Among Stakeholders in Israel's Primary Care and the Role of Primary Care Physicians' Relative Power in Their Intention to Use Video-Consultations with Patients

Irit Chudner; Anat Drach-Zahavy; Hadass Goldblatt; Margalit Goldfracht; Khaled Karkabi

doi:10.1089/tmj.2018.0288

journal article Feb 01, 2020

Power Gaps Among Stakeholders in Israel's Primary Care and the Role of Primary Care Physicians' Relative Power in Their Intention to Use Video-Consultations with Patients

Irit Chudner

Anat Drach-Zahavy Hadass Goldblatt Margalit Goldfracht Khaled Karkabi

Telemedicine and e-Health Vol. 26 No. 2 pp. 190-204 · SAGE Publications

View at Publisher Save 10.1089/tmj.2018.0288

Abstract

Introduction:
Although some correlates of primary care physicians (PCPs) telemedicine adoption have been studied, little is known about whether the intention to use video-consultations (VCs) relates to how PCPs view their power, relative to other stakeholder groups in primary care. The aim of this study was (1) to describe PCPs', patients', and policy makers' (PMs) views of their power and (2) to explore how PCPs views of power are associated with their intention to use VC.

Methods:
A convergent parallel mixed-methods design was used. Interviews were conducted with five focus groups that comprised 42 patients; five focus groups with 52 PCPs; and 24 individual interviews with PMs. A total of 508 patients, 311 PCPs, and 141 PMs completed the questionnaire, assessing intention to use VC and stakeholders' relative power. The qualitative data were analyzed using the thematic method; survey data were analyzed using quantitative methods.

Results:

All stakeholder groups rated PCPs' power as significantly lower, relative to that of patients and managers. PCPs' intention to use telemedicine was found to be significantly related to perceived power gaps between them and patients (
r
= −0.24,
p
< 0.001) and between them and managers (
r
= −0.45,
p
< 0.001). Themes revealed in the analysis describing how PCPs' low power influences their intention to use VC were as follows: PCPs' low-impact telemedicine-related decisions, increased work overload, “big brother” control, and Health Maintenance Organization demands for telemedicine mandatory usage.

Conclusions:
To successfully adopt VC, efforts should be made to increase PCPs' relative power, by strengthening their involvement in decision-making procedures and by increasing PCPs' control over their work environment.

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Details

Published: Feb 01, 2020
Vol/Issue: 26(2)
Pages: 190-204
License: View

Authors

I

Irit Chudner

The Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel.

A

Anat Drach-Zahavy

Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.

H

Hadass Goldblatt

Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.

M

Margalit Goldfracht

The Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel.

K

Khaled Karkabi

The Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel.; Department of Family Medicine, Clalit Health Services, Haife, Israel.

Cite This Article

Irit Chudner, Anat Drach-Zahavy, Hadass Goldblatt, et al. (2020). Power Gaps Among Stakeholders in Israel's Primary Care and the Role of Primary Care Physicians' Relative Power in Their Intention to Use Video-Consultations with Patients. Telemedicine and e-Health, 26(2), 190-204. https://doi.org/10.1089/tmj.2018.0288

Power Gaps Among Stakeholders in Israel's Primary Care and the Role of Primary Care Physicians' Relative Power in Their Intention to Use Video-Consultations with Patients

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