Telemedicine implies that there is an exchange of information, without personal contact, between two physicians or between a physician and a patient. Thanks to telecommunications technologies telemedicine enables the provision of healthcare services or the exchange of healthcare information across geographic, temporal, social, and cultural barriers (Chau & Hu, 2004). Through telemedicine, healthcare centers can offer diverse specialty services to other centers, to other physicians, or directly to the patient, such as for example telecardiology, teledermatology, teleendoscopy, telemedicine, telemonitoring, telenursing, telepathology, teleradiology, or telesurgery (Tachakra, 2003). Telemedicine should not be confused with e-health (or teleHealth). Telemedicine only refers to the provision of medical services (Chau & Hu, 2004). E-health, on the other hand, refers both to medical services and to any other type of service, as long as it has something to do with health and employs information technology (Eysenbach, 2001; Rodger & Pendharkar, 2000). In this respect, e-health would also include healthcare educational activities, research in the health sciences, the handling of electronic files in the healthcare system, and any other use of information technologies in the healthcare system. Telemedicine requires a new type of worker: the healthcare teleworker. But unlike in other types of telework, the human factor is much more important for the success of projects in telemedicine. Nevertheless, physicians remain wary of adopting telemedicine. This work examines the sources of the resistance to incorporate telemedicine. It adopts a focus centering on the difficulties that human factors have in accepting the practice of telemedicine.
The various barriers to the implementation and development of telemedicine projects include patient acceptance (Eikelboom & Atlas, 2005; Hofmann-Wellenhof, Salmhofer, Binder, Okcu, et al., 2006; Turner, Thomas, & Gailiun, 2001; Wyman, 1994), government regulation (McGee, 2004; Schindler, 2005), the cost of the technology (Guy, 1997; McGee, 2004; Schindler, 2005), the absence of insurance coverage (Guy, 1997), technological barriers (Paul, Pearlson, & McDaniel, 1999), and social and cultural obstacles (Bangert & Doktor, 2002; Jarudi, 2000; Spil, Schuring, & Michel-Verkerke, 2004) among others. Nevertheless, there is consensus that the most important source of resistance comes from the failure to accept such systems by the healthcare workers, precisely the ones who will have to use them (Chau & Hu, 2002; Hu & Chau, 1999; Hu, Chau, Sheng, & Tam, 1999; Qavi, Corley, & Kay, 2001).