Volume 28, Issue 4 (3-2026)
jha 2026, 28(4): 70-84 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rahmani M, Ghafoorifard S, Soufi K, Fotoukian F, Asghari N, zeirani A. Feasibility study of telemedicine implementation in Saveh city healthcare centers: a cross-sectional study in 2023. jha 2026; 28 (4) :70-84
URL: http://jha.iums.ac.ir/article-1-4678-en.html
URL: http://jha.iums.ac.ir/article-1-4678-en.html
Meysam Rahmani1 
, Shadi Ghafoorifard2 , Kimia Soufi2 , Farnoush Fotoukian2 , Narges Asghari2 , Anahita Zeirani3
, Shadi Ghafoorifard2 , Kimia Soufi2 , Farnoush Fotoukian2 , Narges Asghari2 , Anahita Zeirani3
1- Health Information Technology Department, Saveh University of Medical Sciences, Saveh, Iran
2- Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran.
3- Health Information Technology Department, Saveh University of Medical Sciences, Saveh, Iran ,o.zeirani@gmail.com
2- Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran.
3- Health Information Technology Department, Saveh University of Medical Sciences, Saveh, Iran ,
Full-Text [PDF 951 kb]
(114 Downloads)
| Abstract (HTML) (249 Views)
Table 2. Staff awareness of the concept of telemedicine by occupational group
Table 3. Comparison of agreement with the concept of telemedicine technology among different staff groups
Full-Text: (55 Views)
Introduction
Telemedicine is utilized to deliver healthcare services in situations where there is temporal and/or spatial separation between the service provider and the recipient [1]. The successful implementation of telemedicine requires careful attention to essential infrastructure and critical success factors, such as high-speed Internet, up-to-date hardware and software, telecommunication systems for remote communication, and distance learning equipment [2]. Numerous studies have examined the status of infrastructure, physicians’ attitudes, and hospital management's perspectives on telemedicine. However, most research has been broad in scope and regionally limited [1,3,4]. Recent evidence indicates that despite the expansion of communication technology, the effective use of telemedicine in Iran remains limited and fragmented; less than 30% of health centers have active infrastructure, and most projects have been discontinued due to weak organizational culture and a lack of support from executive managers [5]. Additionally, there is a paucity of studies that comprehensively examine the roles of managerial factors and organizational culture alongside technical and economic factors in the adoption of telemedicine [6]. Moreover, the lack of insurance policies and sustainable financial support for telemedicine projects is a major obstacle to the development of virtual health services in most countries [7]. This gap between technological capacity and actual implementation highlights the need to examine the feasibility and implementation barriers of telemedicine at the urban health centers. Therefore, a detailed understanding of these challenges and opportunities at multiple levels can facilitate improved decision-making and strategic planning in the field of digital health technologies in Iran. Thus, this study is a feasibility assessment of telemedicine implementation across multiple dimensions in Saveh health centers.
Methods
This cross-sectional quantitative study was conducted in 2023 in selected healthcare centers in Saveh city, Iran. To ensure the accuracy and comprehensiveness of the methodological reporting, the STROBE checklist was utilized. The study was conducted over six months in the administrative, medical, and IT departments of urban health centers in Saveh city, which were selected based on the availability of specialized services, coverage of key stakeholders (managers, physicians, and IT experts), and the availability of minimum technical and communication infrastructure, such as LAN/WAN connectivity and active internet access. The study population consisted of 19 managers, 70 physicians, and 13 IT staff members at the selected centers. Given the limited size of the target population and the accessibility to all participants, no sampling was performed, and all eligible and willing individuals were included. This sample size was statistically sufficient for between group variance analyses (ANOVA). Data were collected using a researcher-developed questionnaire, designed based on the instruments from the studies by Mehraeen et al. [8] and Kiberu in Uganda [9], and tailored to the objectives of the present study. The questionnaire was prepared in three separate versions for the different groups (IT staff, managers, and physicians), with questions adapted according to the job scope and role of each group.
To ensure the quality of the instrument, its face and content validity were confirmed by five university faculty members in the fields of health information technology and telemedicine. For reliability assessment, a test-retest method was applied with a 10-day interval and the participation of nine individuals from the study population, yielding a Pearson correlation coefficient of 0.70. In addition, internal consistency was assessed by calculating Cronbach’s alpha coefficients for each questionnaire domain, all of which exceeded 0.70, indicating acceptable reliability of the instrument. The collected data were first entered into Microsoft Excel 2019 and subsequently transferred to SPSS version 24 for statistical analysis.
Results
Demographic information of participants: In this study, 102 individuals participated, comprising 70 physicians, 19 managers, and 13 IT staff. Most of physicians had less than ten years of work experience, while the majority of the managers had 10–20 years of experience. Most of the IT staff had less than ten years of work experience (Table 1).
Telemedicine is utilized to deliver healthcare services in situations where there is temporal and/or spatial separation between the service provider and the recipient [1]. The successful implementation of telemedicine requires careful attention to essential infrastructure and critical success factors, such as high-speed Internet, up-to-date hardware and software, telecommunication systems for remote communication, and distance learning equipment [2]. Numerous studies have examined the status of infrastructure, physicians’ attitudes, and hospital management's perspectives on telemedicine. However, most research has been broad in scope and regionally limited [1,3,4]. Recent evidence indicates that despite the expansion of communication technology, the effective use of telemedicine in Iran remains limited and fragmented; less than 30% of health centers have active infrastructure, and most projects have been discontinued due to weak organizational culture and a lack of support from executive managers [5]. Additionally, there is a paucity of studies that comprehensively examine the roles of managerial factors and organizational culture alongside technical and economic factors in the adoption of telemedicine [6]. Moreover, the lack of insurance policies and sustainable financial support for telemedicine projects is a major obstacle to the development of virtual health services in most countries [7]. This gap between technological capacity and actual implementation highlights the need to examine the feasibility and implementation barriers of telemedicine at the urban health centers. Therefore, a detailed understanding of these challenges and opportunities at multiple levels can facilitate improved decision-making and strategic planning in the field of digital health technologies in Iran. Thus, this study is a feasibility assessment of telemedicine implementation across multiple dimensions in Saveh health centers.
Methods
This cross-sectional quantitative study was conducted in 2023 in selected healthcare centers in Saveh city, Iran. To ensure the accuracy and comprehensiveness of the methodological reporting, the STROBE checklist was utilized. The study was conducted over six months in the administrative, medical, and IT departments of urban health centers in Saveh city, which were selected based on the availability of specialized services, coverage of key stakeholders (managers, physicians, and IT experts), and the availability of minimum technical and communication infrastructure, such as LAN/WAN connectivity and active internet access. The study population consisted of 19 managers, 70 physicians, and 13 IT staff members at the selected centers. Given the limited size of the target population and the accessibility to all participants, no sampling was performed, and all eligible and willing individuals were included. This sample size was statistically sufficient for between group variance analyses (ANOVA). Data were collected using a researcher-developed questionnaire, designed based on the instruments from the studies by Mehraeen et al. [8] and Kiberu in Uganda [9], and tailored to the objectives of the present study. The questionnaire was prepared in three separate versions for the different groups (IT staff, managers, and physicians), with questions adapted according to the job scope and role of each group.
To ensure the quality of the instrument, its face and content validity were confirmed by five university faculty members in the fields of health information technology and telemedicine. For reliability assessment, a test-retest method was applied with a 10-day interval and the participation of nine individuals from the study population, yielding a Pearson correlation coefficient of 0.70. In addition, internal consistency was assessed by calculating Cronbach’s alpha coefficients for each questionnaire domain, all of which exceeded 0.70, indicating acceptable reliability of the instrument. The collected data were first entered into Microsoft Excel 2019 and subsequently transferred to SPSS version 24 for statistical analysis.
Results
Demographic information of participants: In this study, 102 individuals participated, comprising 70 physicians, 19 managers, and 13 IT staff. Most of physicians had less than ten years of work experience, while the majority of the managers had 10–20 years of experience. Most of the IT staff had less than ten years of work experience (Table 1).
Table 1. Demographic characteristics of study participants
| Variable | Category | Physicians | Managers | IT staff |
| N(%) | N(%) | N(%) | ||
| Age | < 30 years | 2 (2.8) | 0 (0) | 5 (38.4) |
| 30–40 years | 25 (35.7) | 8 (42.1) | 6 (46.1) | |
| 40–50 years | 18 (25.7) | 8 (42.1) | 2 (15.3) | |
| Over 50 years | 25 (35.7) | 3 (15.7) | 0 (0) | |
| Gender | Male | 42 (60) | 12 (85.7) | 10 (76.9) |
| Female | 28 (40) | 2 (14.2) | 3 (23) | |
| Work experience | <10 years | 38 (54.2) | 4 (21) | 7 (63.6) |
| 10–20 years | 6 (8.5) | 11 (57.8) | 3 (27.2) | |
| 20–30 years | 19 (27.1) | 4 (21) | 1 (9) | |
| Over 30 years | 1 (1.4) | 0 (0) | 0 (0) | |
| No response | 6 (8.5) | 0 (0) | 0 (0) | |
| Total | 70 (100) | 19 (100) | 13 (100) | |
Staff awareness and attitudes toward telemedicine technology: Most physicians, managers, and IT personnel were aware of telemedicine, with IT staff demonstrating the highest prior experience and awareness. Specifically, 87.1% of physicians (n=61), 94.7% of managers (n=18), and 76.9% of IT experts (n=10) responded positively (Table 2).
Table 2. Staff awareness of the concept of telemedicine by occupational group
| Variable | Response/Category | Physicians | Managers | IT staff |
| N(%) | N(%) | N(%) | ||
| Awareness of the meaning of telemedicine | Yes | 61 (87.1) | 18 (94.7) | 10 (76.9) |
| No | 8 (11.4) | 1 (5.2) | 3 (23) | |
| No response | 1 (1.4) | 0 (0) | 0 (0) | |
| Experience using telemedicine | Yes | 42 (60) | 12 (63.1) | 10 (76.9) |
| No | 28 (40) | 7 (36.8) | 3 (23) | |
| Applications of telemedicine | Diagnosis | 40 (27.4) | 4 (16) | 5 (22.7) |
| Treatment | 32 (21.9) | 3 (12) | 3 (13.6) | |
| Prevention | 21 (14.3) | 4 (16) | 4 (18.1) | |
| E-learning | 15 (10.2) | 5 (20) | 5 (22.7) | |
| Knowledge sharing | 17 (11.6) | 4 (16) | 0 (0) | |
| E-consultation | 19 (13) | 4 (16) | 5 (22.7) | |
| Other | 2 (1.3) | 1 (4) | 0 (0) | |
| Interest in telemedicine | Yes | 36 (51.4) | 16 (84.2) | 10 (76.9) |
| No | 28 (40) | 1 (5.2) | 0 (0) | |
| No response | 6 (8.5) | 2 (10.5) | 3 (23) | |
| Total | 70 (100) | 19 (100) | 13 (100) | |
Attitudes toward the impact of telemedicine and its implementation: The overall attitude towards the effectiveness and implementation of telemedicine differed among the three groups. IT staff and managers, with mean scores above 3.7, had a more positive attitude towards the effectiveness and necessity of investing in telemedicine, whereas physicians, with a mean score of approximately 3.2, demonstrated a more cautious perspective. Based on the ANOVA (Table 3), there was statistically significant differences in agreement with telemedicine practices among physicians, managers, and IT personnel (P = 0.01, df = 2.99, F = 4.95). Furthermore, the comparison of perceived barriers between managers and physicians did not show a significant difference (P=0.20, F=1.66).
Table 3. Comparison of agreement with the concept of telemedicine technology among different staff groups
| Variable | Source of variance | Sum of squares | df | Mean square | F | P |
| Mean agreement scores with telemedicine across occupational groups (physicians, managers, IT staff) | Between groups | 33.59 | 2 | 16.79 | 4.59 | 0.01 |
| Within groups | 78.36 | 99 | 3.654 | – | – | |
| Total | 395.37 | 101 | – | – | – | |
| Mean perceived impact score of telemedicine on workflow across groups (physicians, managers, IT staff) | Between groups | 688.4 | 2 | 2.34 | 0.82 | 0.44 |
| Within groups | 282.33 | 99 | 852.2 | – | – | |
| Total | 287.02 | 101 | – | – | – | |
| Mean perceived barriers to telemedicine implementation (among physicians and managers) | Between groups | 87.92 | 1 | 87.92 | 1.666 | 0.20 |
| Within groups | 4592.19 | 87 | 52.78 | – | – | |
| Total | 4680.11 | 88 | – | – | – | |
| F shows the F-statistic value of the one-way analysis of variance (ANOVA) test. P is the probability value (P-value) corresponding to the F-statistic. |
||||||
Technical and communication infrastructure: Evaluation of healthcare centers regarding technical and communication infrastructure showed that most possessed the requisite basic technical infrastructure, including desktop computers (92.3%), internet access (92.3%), servers (69.2%), and telephones (69.2%). All the centers supported data and voice transfer across their networks, predominantly through LAN or a combination of LAN and WAN. Network security measures, including antivirus software and firewalls (92.3 percent each), were widely implemented. Most centers designated a network security officer (76.9%) and relied on external IT companies for security support (69.2%).
Administrative culture and organizational support: The findings indicated low levels of the presence of strategic planning and the regular provision of telemedicine services within centers (Mean=1.6 and 1.3 out of 3, respectively). Physician support was also rated as relatively weak (1.6 out of 3) (Figure 1).
Administrative culture and organizational support: The findings indicated low levels of the presence of strategic planning and the regular provision of telemedicine services within centers (Mean=1.6 and 1.3 out of 3, respectively). Physician support was also rated as relatively weak (1.6 out of 3) (Figure 1).
Physicians’ needs regarding telemedicine: Assessment of physicians’ referral practices and attitudes toward telemedicine showed that while 30% of centers reported more than 50 patient visits per day, most referrals involved 1 to 5 patients daily, primarily directed to general hospitals for specialized assessment and consultation. More than half of physicians believed telemedicine could decrease patient visits (55.7%) and relieve referral hospital congestion (81.4%). However, only 30% preferred telemedicine over traditional methods, and 74.3% viewed it as a potential threat. Physicians identified key requirements for effective telemedicine adoption, including comprehensive training (51.4%), fair compensation (42.9%), clear clinical guidelines (38.6%), and supportive policy frameworks (35.7%).
Barriers to telemedicine implementation: From the perspectives of physicians and managers, the major obstacles to telemedicine technology included insurance and payment concerns ( physicians: 4, managers: 4.1), licensing difficulties (physicians: 3.2, managers: 4), high upfront costs (physicians: 3.7, managers: 3.7), and the lack of training (physicians: 3.8, managers: 3.8), all scoring over 3.8 out of 5 for both groups.
Discussion
Overall awareness of telemedicine was high for all groups. However, the discrepancy between awareness and practical experience indicates a gap between theoretical knowledge and real world implementation at the provider level. These results are consistent with the study by Batsis et al. [10] in the United States, which reported although approximately 85% of physicians were familiar with telemedicine; only 58% used it regularly in their clinical practice. The findings showed that participants generally perceived telemedicine as beneficial in improving treatment processes and cost-effectiveness. At the national level, studies by Mehrolhassani [11] and Hosseini [5] have shown that although professionals’ awareness of the technical benefits of telemedicine is high, physicians’ attitudes are affected by a lack of training and practical experience. Overall, the findings indicate that attitudes towards telemedicine in Saveh are in line with the global trends.
The findings showed that most healthcare facilities had standard IT equipment. However, advanced tools such as videoconferencing equipment, and digital imaging systems were less frequently available. Compared to other studies, the identified infrastructure status is consistent with the results of Mehraeen et al. [8] who reported limited independent resource allocation, low communication speed, and dependence on government funding as key barriers. From an international perspective, studies by Scott and Mars [12] in South Africa and Kiberu et al. [9] in Uganda showed that limited bandwidth, low data storage capacity, and the lack of timely maintenance of equipment were common challenges in developing countries for implementing telemedicine. In a study conducted by Rahimi et al. [13] in Iran, evaluating the Electronic Health Record System (Sepas), the technical equipment domain received a moderate users rating.
From the managers’ perspectives, strategic and operational planning for telemedicine implementation was inadequate, as reflected by low mean scores for routine service provision and physician participation. In contrast, support from senior executives and boards of directors was noticeably stronger. These findings are consistent with research from other countries, which highlight the need for interdepartmental collaboration, favorable staff perceptions, and telemedicine structural support for sustainable telemedicine integration [10, 11]. Rahimloo et al. [14] also assessed the Integrated Health System (SIB) from users’ perspective and found that one of the lowest scores was related to human resource satisfaction with managerial and financial support.
The data indicate that physicians acknowledged the potential of telemedicine in improving patient access and reducing congestion in medical centers. Nematolahi and Abhari [4] found that insufficient familiarity with communication processes and how to work with telemedicine systems concerned Iranian physicians mainly, not technical aspects of the telemedicine. A systematic review by Mehrolhassani et al. [11] indicated that the most important barriers to the sustainable establishment of telemedicine in the country included the lack of clinical guidelines, the lack of adequate financial incentives for physicians, and weaknesses in the training and clinical performance evaluation systems. Overall, the data indicate that physicians in Saveh hold generally positive views regarding telemedicine benefits, however, three major barriers need to be addressed to ensure effective engagement: 1) insufficient specialized training; 2) lack of clear implementation guidelines; and 3) weak financial incentives.
The most important barriers identified by both physicians and managers included insurance and reimbursement policies and regulations, licensing issues, up-front costs, and inadequate training. These findings align with other studies conducted within the country [2,8,15], which highlight the importance of proactive insurance policies, and infrastructure and personnel investment. These findings are consistent with the framework of Scott and Mars [12] which highlights financial disincentives, inadequate training, and staff resistance as consequences of insufficiently integrated policies and institutional programs.
Limitations
This study has several limitations. The relatively small sample size may have limited statistical power of the study. Data were collected from self-report questionnaires, which may be subject to response bias. The cross-sectional design also did not allow for the exploration of temporal changes and causal relationships. The use of a researcher-devised questionnaire may also limit direct comparability with international studies.
Conclusion
This study provides a comprehensive assessment of awareness, attitudes, and barriers to telemedicine adoption in Saveh. Despite generally favorable awareness and attitudes, significant gaps in actual utilization persist due to infrastructure limitations, insurance and reimbursement problems, inadequate training, and resistance among certain groups. By addressing these limitations through strategic planning, sustained organizational support, and dedicated financial allocation, telemedicine has the potential to increase patient access to specialized care, reduce the workload of health centers, and improve efficiency and equity within the health system. Clear insurance policies, ongoing training of human resources and independent budget allocation are also needed. Future studies should employ larger, multi-center samples and mixed-method designs to improve generalizability and to more accurately evaluate the clinical and organizational impact of telemedicine, facilitating its sustainable integration into routine healthcare delivery and the improvement of treatment outcomes and the quality of health services in the country.
Declarations
Ethical considerations: This study was conducted under the ethics code (IR.SAVEHUMS.REC.1402.019) of the Biomedical Research Ethics Committee of Saveh University of Medical Sciences. Before the study began, written informed consent was obtained from all participants. Participants were explained that participation in the study was completely voluntary and that they could withdraw from further participation at any stage without any consequences. All participant identification information was considered confidential, and confidentiality was fully maintained throughout the data collection, analysis, and publication stages. Data were coded and used solely for research purposes, and results were reported in general terms without reference to individual information.
Funding: This study was supported by Saveh University of Medical Sciences, Iran, grant number IR.SAVEHUMS.REC.1402.019. The sponsor had no role in data collection, data analysis, or writing of the article.
Conflicts of interest: The authors declare no conflicts of interest.
Authors’ contribution: M.R.: Conceptualization, study design, methodology, supervision, data analysis, writing– review & editing, final approval. Sh.G.: Conceptualization, data curation, data analysis, writing original draft, final approval. K.S.: Conceptualization, data curation, data analysis, writing original draft, final approval. F.F.: Conceptualization, data curation, data analysis, writing original draft, final approval. N.A.: Conceptualization, data curation, data analysis, writing original draft, final approval. A.Z.: Conceptualization, supervision, final approval. All authors reviewed and approved the final version of the manuscript.
Consent for publication: Not applicable.
Data availability: The data used in this study have not been made public due to ethical considerations and to maintain the confidentiality of participant information. However, access to the data is possible upon reasonable request and through the corresponding author.
AI deceleration: The authors used Grammarly as an artificial intelligence–based tool solely for language editing and improvement of the English sections of the manuscript. All AI-assisted edits were carefully reviewed and approved by the authors. The authors take full responsibility for the content of the manuscript, and no artificial intelligence tools were used for content generation or authorship.
Acknowledgements: The authors express their sincere gratitude to all those who supported and collaborated in the implementation of this study. Their valuable efforts and cooperation are especially appreciated. This article is part of a research project entitled “Investigating the necessary infrastructure for the implementation of telemedicine in Saveh hospitals” which was approved by the Saveh Faculty of Medical Sciences in 1402, and with the code number IR.SAVEHUMS.REC.1402.019.
Barriers to telemedicine implementation: From the perspectives of physicians and managers, the major obstacles to telemedicine technology included insurance and payment concerns ( physicians: 4, managers: 4.1), licensing difficulties (physicians: 3.2, managers: 4), high upfront costs (physicians: 3.7, managers: 3.7), and the lack of training (physicians: 3.8, managers: 3.8), all scoring over 3.8 out of 5 for both groups.
Discussion
Overall awareness of telemedicine was high for all groups. However, the discrepancy between awareness and practical experience indicates a gap between theoretical knowledge and real world implementation at the provider level. These results are consistent with the study by Batsis et al. [10] in the United States, which reported although approximately 85% of physicians were familiar with telemedicine; only 58% used it regularly in their clinical practice. The findings showed that participants generally perceived telemedicine as beneficial in improving treatment processes and cost-effectiveness. At the national level, studies by Mehrolhassani [11] and Hosseini [5] have shown that although professionals’ awareness of the technical benefits of telemedicine is high, physicians’ attitudes are affected by a lack of training and practical experience. Overall, the findings indicate that attitudes towards telemedicine in Saveh are in line with the global trends.
The findings showed that most healthcare facilities had standard IT equipment. However, advanced tools such as videoconferencing equipment, and digital imaging systems were less frequently available. Compared to other studies, the identified infrastructure status is consistent with the results of Mehraeen et al. [8] who reported limited independent resource allocation, low communication speed, and dependence on government funding as key barriers. From an international perspective, studies by Scott and Mars [12] in South Africa and Kiberu et al. [9] in Uganda showed that limited bandwidth, low data storage capacity, and the lack of timely maintenance of equipment were common challenges in developing countries for implementing telemedicine. In a study conducted by Rahimi et al. [13] in Iran, evaluating the Electronic Health Record System (Sepas), the technical equipment domain received a moderate users rating.
From the managers’ perspectives, strategic and operational planning for telemedicine implementation was inadequate, as reflected by low mean scores for routine service provision and physician participation. In contrast, support from senior executives and boards of directors was noticeably stronger. These findings are consistent with research from other countries, which highlight the need for interdepartmental collaboration, favorable staff perceptions, and telemedicine structural support for sustainable telemedicine integration [10, 11]. Rahimloo et al. [14] also assessed the Integrated Health System (SIB) from users’ perspective and found that one of the lowest scores was related to human resource satisfaction with managerial and financial support.
The data indicate that physicians acknowledged the potential of telemedicine in improving patient access and reducing congestion in medical centers. Nematolahi and Abhari [4] found that insufficient familiarity with communication processes and how to work with telemedicine systems concerned Iranian physicians mainly, not technical aspects of the telemedicine. A systematic review by Mehrolhassani et al. [11] indicated that the most important barriers to the sustainable establishment of telemedicine in the country included the lack of clinical guidelines, the lack of adequate financial incentives for physicians, and weaknesses in the training and clinical performance evaluation systems. Overall, the data indicate that physicians in Saveh hold generally positive views regarding telemedicine benefits, however, three major barriers need to be addressed to ensure effective engagement: 1) insufficient specialized training; 2) lack of clear implementation guidelines; and 3) weak financial incentives.
The most important barriers identified by both physicians and managers included insurance and reimbursement policies and regulations, licensing issues, up-front costs, and inadequate training. These findings align with other studies conducted within the country [2,8,15], which highlight the importance of proactive insurance policies, and infrastructure and personnel investment. These findings are consistent with the framework of Scott and Mars [12] which highlights financial disincentives, inadequate training, and staff resistance as consequences of insufficiently integrated policies and institutional programs.
Limitations
This study has several limitations. The relatively small sample size may have limited statistical power of the study. Data were collected from self-report questionnaires, which may be subject to response bias. The cross-sectional design also did not allow for the exploration of temporal changes and causal relationships. The use of a researcher-devised questionnaire may also limit direct comparability with international studies.
Conclusion
This study provides a comprehensive assessment of awareness, attitudes, and barriers to telemedicine adoption in Saveh. Despite generally favorable awareness and attitudes, significant gaps in actual utilization persist due to infrastructure limitations, insurance and reimbursement problems, inadequate training, and resistance among certain groups. By addressing these limitations through strategic planning, sustained organizational support, and dedicated financial allocation, telemedicine has the potential to increase patient access to specialized care, reduce the workload of health centers, and improve efficiency and equity within the health system. Clear insurance policies, ongoing training of human resources and independent budget allocation are also needed. Future studies should employ larger, multi-center samples and mixed-method designs to improve generalizability and to more accurately evaluate the clinical and organizational impact of telemedicine, facilitating its sustainable integration into routine healthcare delivery and the improvement of treatment outcomes and the quality of health services in the country.
Declarations
Ethical considerations: This study was conducted under the ethics code (IR.SAVEHUMS.REC.1402.019) of the Biomedical Research Ethics Committee of Saveh University of Medical Sciences. Before the study began, written informed consent was obtained from all participants. Participants were explained that participation in the study was completely voluntary and that they could withdraw from further participation at any stage without any consequences. All participant identification information was considered confidential, and confidentiality was fully maintained throughout the data collection, analysis, and publication stages. Data were coded and used solely for research purposes, and results were reported in general terms without reference to individual information.
Funding: This study was supported by Saveh University of Medical Sciences, Iran, grant number IR.SAVEHUMS.REC.1402.019. The sponsor had no role in data collection, data analysis, or writing of the article.
Conflicts of interest: The authors declare no conflicts of interest.
Authors’ contribution: M.R.: Conceptualization, study design, methodology, supervision, data analysis, writing– review & editing, final approval. Sh.G.: Conceptualization, data curation, data analysis, writing original draft, final approval. K.S.: Conceptualization, data curation, data analysis, writing original draft, final approval. F.F.: Conceptualization, data curation, data analysis, writing original draft, final approval. N.A.: Conceptualization, data curation, data analysis, writing original draft, final approval. A.Z.: Conceptualization, supervision, final approval. All authors reviewed and approved the final version of the manuscript.
Consent for publication: Not applicable.
Data availability: The data used in this study have not been made public due to ethical considerations and to maintain the confidentiality of participant information. However, access to the data is possible upon reasonable request and through the corresponding author.
AI deceleration: The authors used Grammarly as an artificial intelligence–based tool solely for language editing and improvement of the English sections of the manuscript. All AI-assisted edits were carefully reviewed and approved by the authors. The authors take full responsibility for the content of the manuscript, and no artificial intelligence tools were used for content generation or authorship.
Acknowledgements: The authors express their sincere gratitude to all those who supported and collaborated in the implementation of this study. Their valuable efforts and cooperation are especially appreciated. This article is part of a research project entitled “Investigating the necessary infrastructure for the implementation of telemedicine in Saveh hospitals” which was approved by the Saveh Faculty of Medical Sciences in 1402, and with the code number IR.SAVEHUMS.REC.1402.019.
Type of Study: Research |
Subject:
Health Information Technology
Received: 2025/07/7 | Accepted: 2026/02/18 | Published: 2026/03/6
Received: 2025/07/7 | Accepted: 2026/02/18 | Published: 2026/03/6
supplement [PDF 475 KB] (22 Download)
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Site Keywords
Health, Administration, Scientific Article, Iran University of Medical Sciences,
