Background: Chronic diseases disproportionately affect minority and rural populations. Specialist access improves health outcomes in many chronic diseases but access to specialist care may be limited. Video telemedicine can expand access to specialists in rural locations. Introduction: The objective of this study was to understand patient and provider perspectives on the benefits, barriers, and best uses of video telemedicine in chronic disease specialty care in the setting of a well-established store-and-forward telehealth network with recent expansion of video telemedicine. Materials and Methods: Patients and providers were recruited from specialty clinics at the Alaska Native Medical Center. Semi-structured interviews were conducted after a brief survey. Interview questions focused on perceived benefits and barriers to use of video telemedicine for chronic disease specialty care, as well as the best uses of telemedicine and factors that improve the ease of use. Results: Participants considered the major benefit of telemedicine to be a reduction in travel and related costs. Telemedicine was considered by most participants as less appropriate for new conditions or for new patients. Limitations included the need to perform a physical examination or needing tests, procedures, or medications that cannot be performed in rural clinics. Discussion: This study describes the views of patients and providers who have experience with telemedicine. It did not evaluate the cost-effectiveness or impact on health outcomes, although further studies are planned. Conclusions: Patients and providers view video telemedicine as a reasonable addition to in-person visits for the management of chronic disease, although there are limitations.
Keywords: e-Health; extreme environments; telehealth; telemedicine.