Barriers and Opportunities for Telemedicine Volunteerism - A Case Study in India

Abstract Background The recent growth of telemedicine in middle and lower-middle-income countries was further propelled by the COVID-19 pandemic, birthing new models of telemedicine during this period. One such model was volunteer-based telemedicine networks. By leveraging existing infrastructure and resources to more efficiently allocate health personnel, this model allayed some of the burden placed on health systems by the pandemic. However, there is insufficient understanding about volunteer-based telemedicine models, especially on the human resources engagement on such networks. This study aims to understand the motivations and barriers to medical provider engagement with a volunteer telemedicine network during COVID-19, and the mechanisms that can potentially sustain volunteer provider engagement to address healthcare demands beyond the pandemic. Methods In-depth qualitative interviews were conducted with medical providers volunteering on a multi-state telemedicine network in India during the COVID-19 pandemic. Data were analyzed using thematic content analysis methods. Results Most providers reported being motivated to volunteer by a sense of duty to serve during the pandemic. Providers suggested organizational-level measures to make the process more efficient and facilitate a more rewarding provider-patient interaction. These included screening calls, gathering patient information prior to consultations, and allowing for follow-up calls with patients to close the loop on consultations. Many providers stated that non-financial incentives are enough to maintain providers’ volunteer engagement. However, providers expressed mixed feelings about financial incentives. Some stated that financial incentives are needed to maintain long-term provider engagement, while others stated that financial incentives would devalue the volunteer experience. Most providers highlighted that telemedicine can increase access to healthcare, especially to the rural and underserved, even after the pandemic. Providers also expressed an interest in continuing to volunteer with the network if the need arose again. Conclusion Our study findings suggest that medical providers are highly intrinsically motivated to volunteer during large healthcare emergencies and beyond to address the healthcare needs of the underserved. Following the recommendations presented in the study, telemedicine networks can more successfully engage and maintain volunteer providers. Volunteer-based telemedicine networks have the potential to bridge shortages of health personnel in resource-constrained settings both in times of crises and beyond.