Digital transformation and rural healthcare disparities: A mixed-methods approach in India

Healthcare disparity is a major issue for Universal Health Coverage (UHC) faced by countries across the globe. It results in hardship for people living in rural areas who need healthcare services, ultimately impeding their right to health. A key digital transformation component, 'Telemedicine,' has the potential to reduce this healthcare disparity by offering virtual consultation, diagnosis, and treatment, thus leading to better healthcare access. However, research and practice on telemedicine adoption in rural healthcare systems (RHS) is nascent. The present study addresses this issue by examining the barriers to telemedicine adoption and mitigation strategies through a mixed-method study of India's RHS. In the first phase, the Grey Decision Making Trial and Evaluation Laboratory (Grey-DEMATEL) method is used, which identifies seventeen barriers that impede telemedicine adoption in RHS and unearths the causal relationship between them. In the second phase, a qualitative approach is used, which helps propose barrier mitigation strategies under three heads: Patient Acceptance, Physician Buy-in, and Policy Support, referred to as the "3P framework". A total of 10 strategies are proposed under this 3P framework to strengthen the RHS. The study results provide valuable insights to policymakers and decision-makers working towards healthcare digital transformation, UHC, and improving RHS.