Critical Factors that impact ICT Telemedicine utilisation in Germany

The objective of this research has been to identify which organisational factors facilitate or impede the sustainable adoption and integration of telemedicine solutions, from a stakeholder perspective. These factors should guide German health decision makers in their current IT-strategy. Literature documents the fragmented studies of successful telemedicine projects accompanied by unproven costs and benefits. The following research approach distinguishes from former research, as it tries to examine this multifaceted topic holistically and to find causes instead of investigating dedicated applications and symptoms. For this purpose the research included not only the analysis of all telemedicine solutions, but also its stakeholders, independent from their professional background and knowledge. Consequently two different research approaches were carried out. First the main factors that impact telemedicine in general were defined and evaluated through a factor analysis. Afterwards these factors were put in a structural equation model to visualise existing correlations and dependencies. Secondly these factors were drilled down in subsequent research to detect further underlying information. This challenging task was put into practise with a mixed methods approach aimed to cover relevant dimensions and items. The selected method included a multiple paradigm stance under the characteristic of the complementary strengths thesis. At the beginning quantitative research under the positivism-paradigm was undertaken to identify and cluster the major factors that influence the telemedicine perception of stakeholders. Here the ontological assumption was based on objectivity that was underlaid with a statistical factor analysis. Reality was seen as objective with no relationship or dependency between respondents and researcher.