Perspectives of frontline healthcare workers on telemedicine implementation in hard-to-reach areas of Rajasthan: A longitudinal study
Ramesh K. Huda, Rahul S. Chowhan, Sumit Kalra, Ramesh K. Sangwan, Mukti Khetan, Harish Agarwal
A
BSTRACT
Context:
Telemedicine can reduce healthcare burden in hard-to-reach areas by providing teleconsultations and e-prescriptions. Understanding frontline healthcare workers’ (FLHWs) experiences is essential for evaluating implementation and informing scalable strategies.
Aims:
To explore FLHWs’ experiences, perceived benefits, and challenges in delivering telemedicine services in Balotra district, Rajasthan.
Settings and Design:
Five villages in Balotra district, Rajasthan, were included in a longitudinal study involving seven FLHWs (two doctors, five nurses) actively providing telemedicine services.
Methods and Materials:
Over 10 months (November 2024 to September 2025), FLHWs completed monthly structured Google Forms. Nurses answered six open- and six closed-ended questions; doctors answered seven open-ended and six closed-ended questions. Data captured experiences, benefits, challenges, and suggestions for improvement.
Statistical Analysis Used:
Closed-ended responses were analyzed descriptively using frequency percentages. Open-ended responses underwent thematic analysis, with code contribution calculated for each theme.
Results:
Nurses initially rated experiences as “Good” (100%), with 60% upgrading to “Very Good” or “Excellent” by Month 6. Benefits included doorstep care (up to 80%) and reduced patient travel/costs (60%). Doctors highlighted improved access, continuity, and efficiency (80–100%). Key challenges included network disruptions (80–100%) and female patient hesitancy (40% of nurses), with limitations of physical examinations and patient data management (50%). Both groups emphasized the need for reliable portals, stronger connectivity, gender-sensitive staffing, and expanded diagnostic tools.
Conclusions:
FLHWs perceived telemedicine as a promising approach to improving access, reducing travel and cost burdens, and supporting continuity of care. Sustained implementation requires strengthened infrastructure and integration with existing health systems.