Assessment of the attitude of students of Burdenko Voronezh State Medical University to the use of telemedicine technologies as a modern direction of medical counseling

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Relevance. In our ever-evolving world, the application and improvement of information technology is a critical issue. The digitalization of health services became most discussed during the COVID-19 pandemic. It was the transition to telemedicine (TM) that was seen as a possible way to modernize the counseling of the population on COVID-19 prevention and diagnosis.
A large part of people's lives is associated with the use of various gadgets, and with the increase in the pace of life and urbanization, more and more urban populations are preferentially choosing to communicate with specialists of various specialties online, physicians being no exception. This way of consulting saves time for traveling, allows you to get the opinion of a specialist from another city, and is especially comfortable for people with disabilities. In addition, telemedicine is an important area for doctors of various specialties. Thus, specialists can hold consiliums and share experience with colleagues, have an opportunity to consult patients from other regions.
However, with the emergence of opportunities for the implementation of telemedicine activities, more and more often there are questions regarding the awareness of doctors and patients about Article 36, paragraph 2 of the Federal Law N323 "On the Fundamentals of Health Protection of Citizens in the Russian Federation", which regulates the specifics of medical care provided through the use of telemedicine technologies.

The aim of the study is to investigate the awareness of medical school students about the use of telemedicine technologies and to assess their attitudes towards the modern direction of medical counseling.
Materials and methods of the study. In order to realize the set goal, 94 students of N.N. Burdenko VSMU were surveyed. Representatives of 3 faculties were chosen for the study: medical, pediatric, dental. Since doctors-graduates of these faculties most often have to consult patients on prevention, diagnosis and treatment of diseases at offline or online appointments.
As a result of the study, 32 students of the Faculty of Medicine, 28 students of the Faculty of Pediatrics and 34 students of the Faculty of Dentistry were interviewed.

Initially, the respondents were asked a question related to the direct definition of the concept of "telemedicine". It turned out that 51.1% of respondents believe that telemedicine is the main and leading direction of IT development in healthcare and that no global healthcare tasks can be solved without the use of telemedicine technologies. However, 46.8% decided that telemedicine is an important, but not the only direction, which should not be developed to the detriment of other equally important tasks in modern medicine. Only 2.1% of students came to the conclusion that telemedicine is an artificially inflated direction, its expected effects compared to the real possibilities are very exaggerated.
Next, the students had to reflect their personal opinion about the cases when telemedicine technologies should be used. According to Article 36.2 of the Federal Law-N323 p.2: Consultations of the patient or his legal representative by a medical worker with the use of telemedicine technologies are carried out in order to: 1) prevention, collection, analysis of the patient's complaints and anamnesis data, evaluation of the effectiveness of therapeutic and diagnostic measures, medical monitoring of the patient's health; 2) making a decision on the need for a face-to-face appointment (examination, consultation). The majority of students agree with the goals of providing care using telemedicine technologies, but 8.5% are convinced that it is necessary to consider the possibility of obtaining prescriptions for medicines by the patient.
The respondents could make multiple choices and in the end the results were as follows: 74.5% of students chose 2 possible reasons for online consultation: 1) The need to consult a specialist from another city. 2) In case of disability of the patient, when he/she cannot visit a medical institution on his/her own; 36,2%- In any case convenient for the patient; equally 14,9%: 1) In any case convenient for the doctor. 2) During the doctor's vacation, at his/her request; 6.4% of the respondents thought that TM should be resorted to when the doctor does not want to conduct offline consultations.
Then the interviewees were asked to give one answer to the question: "In what case did you choose or recommend to choose (acquaintances, relatives) to consult a doctor online?". And then the answers were distributed as follows: 36.2% thought that remote consultation is the most appropriate if it is not possible to come to see a doctor in person; 25.5% chose the option - the need for urgent consultation; 21.3% decided that online consultation is possible only after a face-to-face appointment with a specialist; 17% - the need to get a "second opinion".
In this regard, it was necessary to find out whether the interviewees or their relatives or acquaintances had applied for online consultations with a specialist. It turned out that 73.9% did not have such an experience; 15.2% did not apply personally and have no information about possible applications of their relatives or acquaintances to telemedicine consultations and only 10.9% of respondents were personally or indirectly related to online consultations. At the same time, 66% of students believe that they would consult a doctor remotely if they received good feedback about the service from a close circle of people; 61.7% would choose such an option if they needed to consult a highly qualified specialist; 48.9% if the price was affordable; 44.7% if they were sure that their personal data would be transferred safely; 40.4% if there was a comfortable platform for online consultations and there were no technical failures at the remote reception.
Among the existing disadvantages of TM, 68,1% of the respondents identified the lack of confidence of the population in absentee counseling; 48,9% consider the risk of "leakage" of personal data as significant; 44,7% of students identified such disadvantages as the "habit" of the population to consult face-to-face and the lack of full coverage of the Internet throughout the country; 42,6% - the lack of specialists ready to conduct online consultations.

Conclusions. As a result of the conducted sociological survey we can conclude that the majority of the surveyed medical students (97.9%) evaluate telemedicine technologies as a necessary direction for the development of medicine in the Russian Federation. The participants of the survey consider the objectives of online consultations in FZ-N323 to be true, but still 8.5% are convinced that there is a need to supplement the current law in the form of the possibility for patients to receive prescriptions for medicines. Despite the fact that the respondents are aware of telemedicine technologies, only 10.9% of them have applied for remote medical consultation in person or know about such experience from relatives or acquaintances. According to the survey data, it is possible to increase the level of application of telemedicine with the elimination of such significant disadvantages of this direction as distrust of the population to extramural counseling, the probability of "leakage" of personal data, the lack of full coverage of the Internet throughout the country, the shortage of specialists ready to conduct online consultations.

Conclusion. Thus, on the part of the medical community, ways of solving the problems highlighted as a result of the questionnaire survey of students of the
medical university students: 1) preventive talks with patients in medical institutions, at enterprises, in educational institutions about the possibility of using telemedicine technologies; 2) counseling of medical specialists and students of medical universities on the application of telemedicine in their practice. This will help popularize remote medical consultation and open new opportunities to optimize the provision of highly qualified medical care to the population.

 

About the authors

Victoria Dmitrievna Polyakova

Voronezh State Medical University named after N. N. Burdenko

Author for correspondence.
Email: lyalinavika1201@gmail.com
ORCID iD: 0009-0001-3465-7735
Russian Federation, 394036, Russia, Voronezh, st. Studencheskaya, 10

Nadezhda Aleksandrovna Schcetinina

Voronezh State Medical University named after N. N. Burdenko

Email: n.a.schetinina@vrngmu.ru
ORCID iD: 0000-0001-8881-2019

Assistant of the Department of Health Care Management

Russian Federation, 394036, Russia, Voronezh, st. Studencheskaya, 10

Ekaterina Alekseevna Chernykh

Voronezh State Medical University named after N. N. Burdenko

Email: e.a.cherhyh@vrngmu.ru
ORCID iD: 0000-0002-5741-0444

Assistant of the Department of Health Care Management

Russian Federation, 394036, Russia, Voronezh, st. Studencheskaya, 10

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