Questionnaire survey about barriers to telemedicine for patients with intractable neurological disorders

Telemedicine is not widely used in patients with intractable neurological disorders including neurodegenerative diseases even though its application was covered by national insurance in Japan. To clarify what patient factors should be overcome for telemedicine application, we surveyed outpatients with intractable neurological disorders using questionnaires in Tottori University Hospital, Tekeda General Hospital and Fukuoka University Hospitals. The survey showed that more than half of the telemedicine-beginners did not want to use telemedicine in the former two hospitals located in provincial cities (0.2 to 0.3 million population), but more than half would like to use it in the large hospital sited at one of the regional core cites (1.5 million population). Binomial logistic analysis of the beginners revealed that predictors for patients to choose "I do not want to use telemedicine" were "no experience using internet at home" and "need of a helper to use internet equipment for telemedicine at home". The odds ratios of the other factors such as the concerns about the cost or quality of outpatient medical practices were low. On the other hand, most of already telemedicine users wanted to continue telemedicine. The present study revealed that the quality of internet connection environment is the most critical factor for patients to use telemedicine. It must be requisite for wide use of telemedicine to establish a good internet connection environment at areas/home and to supply good equipment to the patients for the connection.