GUIDELINES FOR IMPROVING THE EFFICIENCY OF TELEMEDICINE SERVICE DELIVERY IN PUBLIC HOSPITALS IN THAILAND

This research aimed (1) to analyze the factors influencing the development of the efficiency of telemedicine service delivery in public hospitals in Thailand and (2) to propose guidelines for improving the efficiency of telemedicine services in public hospitals in Thailand. This study employed a mixed methods approach combining quantitative and qualitative research. For the quantitative research, the sample consisted of 400 users of telemedicine services in public hospitals in Thailand. The sample size was determined using the criterion of 20 times the number of observed variables. Stratified sampling was applied, and questionnaires were used to collect the data. The data were analyzed using structural equation modeling (SEM). For the qualitative research, data were collected through in depth interviews with 10 key informants. These included officials from the Department of Medical Services, Ministry of Public Health, who are responsible for telemedicine services, and medical specialists providing telemedicine services in public hospitals. The qualitative data were analyzed using content analysis. The research findings revealed the following: (1) The structural equation model of the factors influencing the efficiency of telemedicine service delivery demonstrated validity and was consistent with the empirical data. All the model fit indices met the acceptable criteria, including Chi Square = 87.40, df = 74, χ²/df = 1.18, GFI = 0.98, AGFI = 0.94, NFI = 1.00, CFI = 1.00, RMSEA = 0.021, and RMR = 0.003. All causal variables in the model positively affect the efficiency of telemedicine service development. Together, these variables explained 97% of the variance in telemedicine service efficiency (R² = 0.97). (2) The guidelines for improving the efficiency of telemedicine services in public hospitals in Thailand include the following eight approaches: Proactive strategies: 1) Enhancing a comprehensive digital patient experience. 2) Developing the capacity of healthcare personnel and multidisciplinary teams in telemedicine. Corrective strategies: 1) Addressing service bottlenecks to reduce delays and system failures or unstable signals. 2) Improving the accuracy of information and the integration of electronic medical records. Preventive strategies: 1) Strengthening cybersecurity and personal data protection. 2) The suitability of patients and medical conditions should be screened before they enter the service system. Responsive strategies: 1) Establishing immediate patient assistance systems when service problems occur. 2) Developing contingency plans for crises and expanding emergency services through telemedicine.