A Digital Governance Model to Optimize Telemedicine Services in a Peruvian Public Hospital: An Indicator-Based Assessment and Validation Through Expert Judgment

Background Telemedicine has expanded rapidly in public hospitals across Latin America, but its day-to-day management continues to lag behind its adoption. This study assessed perceptions of the telemedicine service at a public hospital in Lambayeque, Peru, and, on that basis, designed and validated a digital governance model. Methods In a quantitative, cross-sectional and descriptive-propositional design, 315 users of the telemedicine service were surveyed with a 15-indicator questionnaire covering three dimensions (accessibility and coverage, quality of care, and service management) on a five-point Likert scale. The psychometric properties of the instrument were verified and the resulting model was evaluated by three experts using Aiken’s V coefficient. Results Perceptions were almost unanimously intermediate (99.0% of participants at the intermediate level; 95% CI [97.2, 99.7]) and homogeneous: the three dimensions were statistically equivalent (TOST with margins of ±0.20, p ≤ .001), no indicator deviated from the neutral point after Holm’s correction, and the distribution of responses was symmetrical (50.1% favorable among non-neutral responses). Weaknesses were distributed throughout the sample: 88.6% of participants disagreed with three or more indicators, with the lowest means in operational process management, user satisfaction, professional coordination, patient safety and technical support. Psychometric validation was favorable (α = .75; KMO = .796; Bartlett, p = .050), supporting the aggregate interpretation of the diagnosis at the scale and dimension levels. The proposed model (three axes, nine lines of action and verifiable annual targets) obtained satisfactory validation through expert judgment (Aiken’s V = .86). Conclusions Perceptions of the telemedicine service are uniformly intermediate, with no discernible user segments and no statistically significant ranking among indicators. The descriptive ordering of the indicators nevertheless points to service governance, rather than technological infrastructure, as the area where corrective action is most needed, and the instrument showed adequate properties for supporting institutional diagnosis.