From Readiness Assessment to Co-Design: A Cross-Sectional, Living Lab-Informed Study of Telemedicine Implementation in Albania

Background/Objectives: Telemedicine has substantial potential to improve access and continuity of care, but implementation depends on professional, organizational, technological, and governance readiness. This cross-sectional study examined healthcare professionals’ perceptions of telemedicine implementation in Albania as an exploratory needs-assessment phase informed by Living Lab principles. Methods: An online survey was completed by 1213 healthcare professionals. The study used a questionnaire developed for this project; its multi-item domains are therefore treated as exploratory rather than established constructs. Descriptive statistics, exploratory factor analysis, Spearman correlations, and multivariable linear and logistic regression were used. Two supplementary open-ended questions were analyzed using content-oriented thematic coding and integrated with the structured survey findings to identify preliminary priorities for later participatory co-design. Results: High future willingness to use telemedicine was reported by 67.4% of participants. Continuous training (84.7%), adaptation of traditional healthcare delivery (65.8%), limited digital skills (64.7%), and lack of clear protocols/guidelines (61.5%) were frequently endorsed implementation issues. Perceived usefulness showed the strongest adjusted statistical association with future willingness in the linear model (B = 0.665, 95% CI 0.602–0.727, p < 0.001) and logistic sensitivity model (OR = 5.41, 95% CI 4.32–6.79, p < 0.001). Professional confidence was positively associated with willingness, whereas workflow and relational barriers were negatively associated. Conclusions: The findings describe the perceptions of this non-probability sample and should not be interpreted as national estimates of telemedicine readiness. They provide exploratory evidence that may inform subsequent stakeholder consultation, instrument validation, and participatory Living Lab activities focused on training, workflow integration, infrastructure, governance, and patient engagement.