TeleHealth Final Manuscript

RUNNING HEAD: A PHENOMENOLOGICAL STUDY ON THE PRACTICALITY OF
TELEHEALTH AMIDST COVID-19 PANDEMIC

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A Phenomenological Study on the Practicality of TeleHealth
amidst COVID-19 Pandemic
Completed on: June 25, 2022
Basilio, Kaycee B.
Gacillos, Resurrection P.
Garcia, Faith Lijana B.
Magtoto, John Brett O.
Manaloto, David Jeshurun M.
Mayrina, Alonzo D.
Pagaduan, Miles Gabriel A.
Pineda, Sophia Wina R.
Tulio, Jaslyn M.
Researchers
Angeles City Science High School
Senior High School

A PHENOMENOLOGICAL STUDY ON THE PRACTICALITY OF TELEHEALTH
AMIDST COVID-19 PANDEMIC
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Abstract
With over 3.67 million COVID-19 cases in the Philippines, lockdowns and community
quarantines have been implemented to minimize the transmission of the virus. To address
the inability to conduct standard consultations, healthcare providers used TeleHealth (TH) to
deliver healthcare services to their patients. This allowed more individuals to benefit from
quality health services while potentially cutting healthcare costs. Unfortunately, previous
research focused on the utilization of TH in economically advanced metropolitan areas, thus
leaving less populated places at a disadvantage. Hence, this study utilized semi-structured
interviews and phenomenological research design to identify and evaluate the perceptions
and lived experiences of middle-aged adults regarding the existing TH services in Angeles
City, Pampanga, the factors that constitute their satisfaction, and to determine the aspects of
TH that they deem important. Generally, the results showed that (a) participants described
TH as convenient, useful, and practical as they were greatly satisfied with its functionality;
(b) technological hurdles and the lack of physical examination significantly impacted their
satisfaction; and (c) TH is more practical for consulting minor illnesses. Taking these into
account, the researchers concluded that the supposed downsides of TH will gradually
decrease as more futuristic developments emerge. The findings of this study are
fundamental to the delivery of TH services in other nonmetropolitan areas.
Keywords: TeleHealth, COVID-19, phenomenology, healthcare services, consultations,
perceptions, practicality
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Introduction
Background of the Study
With more than 454 million confirmed cases and 6 million deaths globally, the
COVID-19 outbreak has produced a myriad of issues in various sectors of society (Johns
Hopkins University, 2022). In the global pulse survey conducted by the World Health
Organization (WHO) (2022), over 90% of countries surveyed reported ongoing disruptions
in their health services. For this reason, health institutions across the world are taking
intensive measures to mitigate its deadly effects on people. Since the onset of the pandemic
in the Philippines, approximately 3.67 million cases have been reported with roughly 57,000
people dead (Statista, 2022). Among these people, the majority were adults aged 18-60
wherein the rate of death is observed to be higher. As stated by the Centers for Disease
Control and Prevention (CDC) (2020), older adults are more likely to get infected by the
COVID-19 virus which conveys that they are prone to hospitalization, intensive care, or
ventilators.
Due to the rapid transmission of the virus, the Philippines sustained impactful
problems in delivering its healthcare services. In fact, half of the population resides in rural
areas, where there are sometimes unqualified medical doctors and ill-equipped facilities
with broken medical equipment. Moreover, a number of healthcare facilities are only found
in metropolitan areas, placing rural areas at a higher risk (Arsdale, n.d.). This urged the
government to employ technology to address the ongoing crisis.

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According to He, Zhang, and Li (2021), information systems and information
technology, both of which are components of TeleHealth, contribute a significant role in
healthcare services, emergency/crisis responses, clinical decision support, and risk
management. By definition, TeleHealth refers to the application of technological strategies
to deliver healthcare services. This includes the usage of cameras, computers, video
conferences, the internet, and whatnot (Center for Connected Health Policy [CCHP], 2021).
It is imperative to know that TeleHealth is an umbrella term that encompasses
certain fields such as TeleDermatology, which is defined as the delivery of dermatologic
services and clinical information at a distance; TeleTherapy, which involves speech,
occupational therapy, or mental health sessions; and TeleRehabilitation, which focuses on
examination, diagnosis, and treatment using clinical rehabilitation services (Eedy &
Wootton, 2001; Prvu & Resnik, 2020; Villines, 2020). It has been added by the WHO (2017)
that although TeleMedicine is often used interchangeably with TeleHealth, it refers to
services delivered by physicians only.
It is stated by eVisit (2020), a virtual care platform used by various healthcare
organizations, that TeleHealth first arose in communities in the early 1960s, with it being
primarily used in medical emergencies. This emphasizes the importance of TeleHealth in
today's healthcare, as the lack of effective treatments and social distancing made it difficult
for patients and doctors to engage.
As studied by CCHP (2021), TeleHealth has four key components in delivering its
services. One of these is live video conferencing which uses audiovisual
telecommunications technology. This form of service is also referred to as "real-time," and it

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is used to substitute in-person sessions when they are not available. Another distinct
component is Store-and-Forward, more commonly referred to as Asynchronous TeleHealth.
This service records clinically important digital samples such as X-rays, MRIs, patient data,
and videos without requiring the patient and attending physician to be present (Deshpande et
al., 2009). Seeing how it entails digital samples, this service primarily aids in diagnostics
and medical consultations (CCHP, 2021). Aside from the given components, Remote Patient
Monitoring (RPM) is also an emerging research field due to the advantages it brings.
Malasinghe, Ramzan, and Dahal (2019) said that RPM is essentially monitoring patients
outside hospital conditions via technological means. The medical data collected is sent to a
provider in a different location for use in care and related support. This service allows
continuous observation of patients, significantly reducing readmission rates since both the
patient and attending physician interact with the system independently (Pandian et al.,
2007). Lastly, mobile health is an extensive element of technology-assisted health care.
According to Istepanian et al. (2007), it is the utilization of mobile communications and
network technologies. These are dedicated application software or applications that are
downloaded into devices such as smartphones and tablet computers. Along with its newness
in the industry, laws governing the usage of this technology are still being formulated
(CCHP, 2021).
In the context of a pandemic, TeleHealth serves a vital role in lessening the health
risks present. Along with the growth of internet access, telehealth allows more people to
benefit from health services while potentially lowering healthcare expenses. (United States
Senate Committee on Finance, 2015). This particularly benefits individuals living in rural
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and nonmetropolitan areas where money is scarce and healthcare services are limited. To
support this claim, Marcin et al. (2015) discovered that TeleHealth is seen as a practical and
cost-effective technique for providing high-quality, cost-effective care. An 11% decrease in
costs and more than tripled ROI for investors were observed (American Hospital
Association, 2015). It is also said that remote care and diagnosis through TeleHealth assist
both patients and the health care system in less-developed economies by minimizing the
distance traveled for specialized care and the associated expenses, time, and stress (Tracy et
al., 2008). WHO (2009) also emphasized that the accessibility of this technology may
encourage rural doctors to stay in practice offering greater professional support and
opportunities for continuing study.
Although several physicians expressed their favorable outlook on the
implementation of TeleHealth amid the pandemic, they specified opportunities to enhance it,
improving patient care. It has been noted that certain groups of vulnerable patients were
unable to manage telemedicine encounters or did not have the necessary technology (Gomez
et al., 2020). Several have mentioned challenges concerning the quality of provider-patient
interactions, including decreased clinical data for evaluation, a decline in patient privacy,
and the rise of distractions in patients' home spaces (Uscher-Pines et al., 2020).
On the contrary, improved population health management was observed due to
greater convenience. Physicians stated that telemedicine visits extended patient counseling
hours and provided opportunities for proper medication reconciliations (McConnochie et al.,
2009; Gomez et al., 2020). Most adults expressed a generally high satisfaction regarding the
usage of TeleHealth mainly for its practicality while staying safe (Choi et al., 2021). A study
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by Malani et al. (2020) stated that interest in telehealth visits rose from 55% in May 2019 to
63% in June 2020.
Seeing the benefits of TeleHealth, the provincial government of Pampanga started
offering its services to enable patients to contact medical specialists virtually (Del Rosario,
2019). Meanwhile, Carmelo Lazatin Jr., the mayor of Angeles City, Pampanga, established a
telemedicine hotline on January 4, 2022, that Angelenos can use for free 24/7 via phone
calls and Messenger. With teleconsultation, the clinic doctor has the potential to collaborate
closely with a pharmacist to manage the patient's medication requests (Cayabyab, 2022).
To ensure the smooth and accurate flow of data, the Medium-Term Information and
Communication Technology Harmonization Initiative (MITHI), spearheaded by the
Department of Budget and Management (DBM), Department of Science and Technology
(DOST), and the National Economic Development Authority (NEDA), is guided by the
Philippine eGovernment Master Plan of linking government data centers and databases to
create a secure network for government information systems and harmonize information
technology systems, programs, and projects in the public sector (DOH, 2014).
Justification
TeleHealth utilization and services have become an increasingly crucial part of the
global healthcare systems, especially now that a pandemic is still raging on and social
distancing and lockdowns are still enforced, coupled with the fact that there are no reliable
and effective treatments yet. On top of that, it is common knowledge that as people get
older, they become more vulnerable to disease and illnesses (CDC, 2020). That being said,
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Eboña et al. (2021) discovered that adults residing in Metro Manila, Philippines expressed
generally high satisfaction with TeleHealth because of its accessibility and efficacy. Given
that the delivery of TeleHealth is more observed in metropolitan areas, the researchers aim
to discover if the same kind of satisfaction is experienced in nonmetropolitan areas. Hence,
with this in mind, the participants of this study will be middle-aged adults residing in
Angeles City, Pampanga, Philippines.
Research Questions
This research study aims to analyze the practicality of TeleHealth as a public health
measure in today’s healthcare through the lived experiences of patients. Therefore, this
study will focus on these main points:
● How may TeleHealth be described by middle-aged adults?
● How does TeleHealth affect local healthcare systems in nonmetropolitan areas?
● What aspects of TeleHealth can other healthcare systems adopt?
● What problems do the users encounter that limit their usage of TeleHealth?
Research Objectives
The research objectives listed below are a summary of what the researchers hope to
achieve by collecting data and gathering information. This will allow the researchers to
focus their attention on the key variables, which will guide them throughout the entire study
process. The following are the study's objectives:
● To critically analyze the use of TeleHealth services;

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● To investigate the direct and indirect effects on patients and healthcare
administration;
● To identify the information of TeleHealth's practicality and provide
recommendations regarding the concerns of discovery; and
● To evaluate the main efficacy of TeleHealth services that apply technologies and
strategies for delivering healthcare over long distances.
Scope and Delimitation
This study will mainly cover the practicality of TeleHealth amid the COVID-19
pandemic. It will be limited to middle-aged adults ranging from ages 35 to 55 living in
Angeles City, Pampanga. We, the researchers, will also be considering the participants’
computer literacy to ensure that the data collected is significant. To protect the participants’
privacy, all personal information will be kept strictly confidential under the Data Privacy
Act of 2012. The collected data will be only used to complete the study.
The researchers aim to determine the perceived practicality of TeleHealth during the
pandemic based on how convenient it is for the participants; whether the quality of its
services is consistent; how user-friendly it is to participants with or without prior knowledge
of TeleHealth; and whether it is cost-effective. Therefore, this study will only seek the
perceived advantages and disadvantages of TeleHealth that will be provided by the
participants.
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Other areas of Telehealth such as TeleTherapy, TeleRehabilitation, and
TeleDermatology will be included as well. If applicable, this study will assess the
satisfaction of patients with the other fields of TeleHealth stated.
Benefits and Beneficiaries
Primarily, this study aims to improve the overall quality of the TeleHealth system in
nonmetropolitan areas through the participants’ lived experiences. This will be beneficial
since the increased use of TeleHealth is observed today. Additionally, this study will
directly benefit the following:
Local health systems will predominantly be the ones to benefit from the findings of
this study. Since the municipality of Angeles only launched its TeleHealth services recently,
they can use the data gathered to improve the implementation of services for the citizens.
Moreover, neighboring municipalities may gain insight into how to improve their system
using this study.
As a result of improved delivery, efficacy, and overall implementation, patients
using TeleHealth services during the pandemic will mainly be the population that will
greatly benefit. Since the findings of this study will take into account the personal insights
of some patients, better satisfaction will be observed in future studies that aim to replicate
this research.
Additionally, doctors and physicians alike will be more inclined to stay in practice,
especially this time when face-to-face interactions are limited. Using the insights of this
study, they will be able to offer greater professional support and better clinical workflow
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efficiency. Moreover, they can use the participants’ shared experiences to determine the
advantages and disadvantages of this health measure and how they can improve it.
Lastly, the researchers conducting this study will benefit from the extensive
knowledge gained. Similarly, researchers in the same field will benefit from the data
gathered if they will conduct a study comparable to this.
Literature Review
In the study conducted by Morgan et al. (2014), it was stated that patient
satisfaction is a fundamental determinant of the quality of care and a factor to consider to
continuously improve a healthcare system. With the advancement of technology in today’s
healthcare, TeleHealth (TH) emerged as an alternative to conventional medical
appointments, especially in the context of a pandemic (Eboña et al., 2021). It was
emphasized by Noknoy et al. (2020) that for TH to be effective and alleviate satisfaction, it
must be appropriately integrated with the existing health service.
Based on the study by Hirko et al. (2020), the rapid adoption of TH systems in rural
regions in response to the COVID-19 epidemic has enormous promise for reducing rural
health inequities. But given the significant infrastructural development and training, health
systems in rural areas should adopt a thorough strategy to ensure the viability of TH
programs after the COVID-19 pandemic. To acknowledge this, Andrews et al. (2020)
undertook a study to look at current evidence on patient and healthcare provider satisfaction
with the use of TH during the outbreak. With it in mind, the researchers devised a PICOT
question: "What is the satisfaction (O) of patients and providers (P) with the use of
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telehealth or telemedicine (I) during the COVID-19 pandemic? (T)". Based on 18
international articles, patients and healthcare providers expressed high levels of satisfaction
with the utilization of TH. It is imperative to note, however, that their extensive research
was primarily focused on highly industrialized countries such as Italy, France, and China.
To support this, a study by Drerup et al. (2020) evaluated the perspectives of
patients from March 2020 to May 2020 using nine commonly used satisfaction metrics.
They found that 65 surveyed patients who experienced virtual appointments had similar
feedback on seven of nine satisfaction metrics compared to the 36 people who attended
face-to-face visits. However, 20% of the patients expressed that the technology should be
improved, specifically better internet connection and video quality. Similar to the study of
Iyer et al. (2021), patients and physicians alike were pleased with the delivery of TH
because of its accessibility while staying safe.
Perception-wise, frontline health professionals who treated adults during the
pandemic seem to have been strongly in favor of prolonging TH use beyond the virus
outbreak, according to the research made by Goldberg et al. (2021). Many studies imply that
it benefited healthcare during the outbreak and that it should be used for public safety
(Monaghesh & Hajizadeh, 2020; Somsiri et al., 2020). However, they mentioned that
sustainability would be contingent on implementing measures to address access disparities
and reimbursement concerns. This was inferred since the researchers used a conceptual
framework called Quadruple Aim to conduct semi-structured interviews, employing
purposive sampling approaches with 48 participants who cared for older adult patients
during the outbreak. The study found that using TH to treat older adults has several
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advantages, including reducing deferred care and increasing timely care, increasing
physician efficiency, improving communication with patients and care providers, reducing
patient travel burdens, and facilitating health outreach and education.
Concerns about insufficient or uncertain reimbursement were identified as the top
barriers to TH use among providers in New York City during the pandemic (Chang et al.,
2021). As a result, this contributed to suboptimal implementation, use, and outcomes of TH
(Payán et al., 2022). Because of this, it is important for policymakers to be aware of the
impact of having temporary policies in place on the sustainability and long-term use of TH.
As said by Ong et al. (2021), aspects of in-person treatment must be optimized for
remote care as TH emerges as a public health measure. They discovered that some patients
refused to self-advocate during virtual appointments because of poor eye contact and audio
interference. Because of this, Békés and Doorn (2020) stressed that healthcare providers
may find it difficult to build rapport and express empathy due to the unavailability of
physical presence. To support this, Sabesan et al. (2014) revealed that the most effective
communication involves physical presence. During a TH consultation, the dynamics alter in
several ways since the patients and the specialist are in separate rooms. As a result, it is only
reasonable that recurring concerns regarding the doctor-patient relationship and rapport
would arise when clinical services are delivered via virtual meetings.
The Philippines only started to prioritize the shift to TH once it had suffered the
severe impacts of the pandemic to reduce the transmission of the virus. To determine how
the public can optimally benefit from TH, a prior study by Pasco (2016) revealed that
performance expectancy, effort expectancy, social influence, attitude, and facilitating

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conditions were among the seventeen questions that reflected the important domains or
variables that determine user acceptance of new technology. Among these, the most
important factor that compelled the intention to use TH was the social influence, which
accounted for 54.8 percent of the variance in the decision to use telemedicine when
combined with the other factors studied. The insufficiency of current telecommunication
infrastructure, the requirement for specialists to be available at all times to answer referrals,
and the retention of e-mail and SMS for voluntary referrals were among the major findings
that arose from the group discussions the researcher made with the participants.
An additional study by Cantos et al. (2021) used a descriptive strategy in
conjunction with a quantitative research design in their study. This was useful in
determining the perceived degree of satisfaction of Filipino patients with Teleconsultation as
a means of healthcare delivery, which was the study's purpose. This study included 360
participants who received Teleconsultation and were between the ages of 20 and 50 years
old and residing in Metro Manila. For data analysis, the researchers employed the Statistical
Package for Social Sciences (SPSS) and the Structural Equation Model was used to
determine the effect of the given parameters on the level of satisfaction among patients.
Additionally, the link between the components was investigated using correlation analysis
and multiple linear regression. Generally, the patients were pleased with the service they
received since their calls were taken promptly. However, they were dissatisfied because
obtaining a referral was difficult and they saw that healthcare staff were untrustworthy with
patient information and were unresponsive to clients. For this reason, the researchers
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emphasized that staff and physician attitudes should be well-maintained and standardized
for patients to be as satisfied as possible with the service.
Tackling the legal side of TH, Patdu et al. (2016) said that although the patient gives
the physician permission for the domain expert to consult with them and access their
medical data, there is usually no direct communication between the patient and the domain
expert. This raises the question of whether a patient's legal agreement with the physicians is
sufficient to initiate a physician-patient relationship between the patient and the domain
expert working solely with the data provided. It was also stated in the article that both
personal and health information about the patient is strictly confidential and should be kept
private only to the physician and the domain expert. However, because TH is primarily
conducted via the internet, the data may be vulnerable to hacks or cyberattacks.
Despite this drawback, Macariola et al. (2021) studied that during a pandemic, TH
provides people with convenience, security, and a safer healthcare option. In fact, nations
can improve healthcare provision, raise worker productivity, and ultimately improve
economic performance by investing in TH (Raghupathi & Raghupathi, 2020). To hasten the
development and implementation in the Philippines, the researchers advised that local
government units get involved in TH training for healthcare practitioners and public
information efforts. Moreover, collaboration with the national government can aid in the
implementation process and fill in any gaps that may occur.
Given these details, TH aims to contribute convenience with a safe and viable
platform that helps to present potential high-quality care for the patient and the provider
(Zuñiga, 2020). However, the process of using TH has its faults, such as technical
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difficulties within its extent. The development and spread of TH services that require
live-video connections between patients and providers might be attributed to a lack of
connectivity, where the recurring dropped calls and delays in video feeds can cause sessions
to be disrupted and patients to be unsatisfied with their service (Spargo, 2015). Additionally,
the researchers want to establish the importance of assessing the phenomenological aspect
of health systems by considering the patients' outlook and suggestions. Patient satisfaction is
an essential factor of patients' perspective behavioral intention and is an important measure
of healthcare quality since it provides information on the provider's performance in
achieving clients' expectations (Xesfingi & Vozikis, 2016). The purpose of this research is to
primarily evaluate patient satisfaction and to investigate the association between this and
healthcare service quality.
Methodology
Research Design
The researchers employed a qualitative design for this study because of its inherent
simplicity, adaptability, and utility in various healthcare situations (Doyle et al. 2020). This
allowed us, the researchers, to obtain rich data that aided us in understanding the perceived
practicality of TH (Kim et al. 2017).
Specifically, the researchers used a Phenomenological approach as this aims to
uncover and describe a phenomenon’s universal essence. This approach is what made
phenomenological research a suitable design for this study, as it sought to investigate how
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participants perceive not only the benefits of TH amid the pandemic but also its usefulness
in the current and future healthcare system (Wilson, 2015).
Locale of the Study
The study was virtually conducted in Angeles City, Pampanga starting from May
2022 to June 2022 during the second semester of the academic year 2021-2022. No data was
collected before or after this time frame.
Research Participants and Informants/Consultants
Eight (8) Filipino adults aged 35-55 years old using TH amid the pandemic were
the participants of this study. The informants were licensed physicians who utilized TH. All
concerned people in the study lived in Angeles City, Pampanga.
The chosen participants' perspectives, viewpoints, and satisfaction with the
practicality of TH were the basis of this study. With their participation, the researchers
assessed the perceived practicality of TH during the pandemic based on how convenient,
user-friendly, and cost-efficient it is to the aforementioned participants. The informant was a
physician that knew how to use TH so the researchers had a concept of how it worked in
that specific city. With the expertise and knowledge offered by the professional, the
proponents accurately noted the credibility of the acquired data which substantially
benefited the study.

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The researchers utilized purposive sampling. In qualitative research, this is
commonly employed to identify and select relevant data samples connected to the topic of
interest. It is chosen based on the characteristics of the population and the study's objectives.
As previously indicated, this sampling design was appropriate for the study because
the required participants possessed particular qualities for the proponents to conduct the
study. Using the implemented sampling design, the researchers addressed older Angeleños
who have been using TH and investigated their lived experiences extensively.
Research Instrument
The research instrument used in this study was a semi-structured interview. This
type of instrument was useful in finding out the experiences, opinions, and concerns of
participants and informants regarding TH. Furthermore, this type was specifically chosen so
the researchers can have a guided conversation with the participants (Moran, 2022). All
participants were virtually interviewed via Zoom, Google Meet, or Facebook Messenger.
The following questions were asked while interviewing the following people:
The participants;
1. What are your thoughts about TeleHealth or the delivery of clinical practices
virtually?
2. How long have you been using TeleHealth?
3. What are your reasons for using TeleHealth?
4. Do you find TeleHealth practical?

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5. How did your attending physician guide you when you consulted them? Were
their instructions clear and helpful?
6. How would you compare TeleHealth to traditional face-to-face consultation?
7. Are you satisfied with the services of TeleHealth? Why or why not?
8. What problems have you encountered when using TeleHealth?
9. What are your suggestions for improving the use of TeleHealth?
10. Will you continue using TeleHealth after the pandemic? Why or why not
The informant/s;
1. What are your thoughts about TeleHealth?
2. How would you describe the importance of TeleHealth in local health
systems during the pandemic?
3. Based on your experiences, do you prefer TeleHealth or face-to-face
consultations? Why?
4. What do you think are the advantages and disadvantages of TeleHealth?
5. Based on your experiences, how can TeleHealth be more effective?
6. Given the restriction of the virtual setup, how do you ensure or guarantee that
your patients receive the correct diagnoses?
7. Would you encourage your patients to push through online consultations? If
so, why?
Additional questions may have been asked by the researchers depending on the
answer of the participant to have a more in-depth understanding of their statements.

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Data Collection Procedure
The researchers gathered information through a virtual interview with the relevant
participants which consisted of middle-aged adults with experience in utilizing TH, and
informants, which consisted of licensed doctors or other medical practitioners who practice
their profession via TH. These participants and informants were limited to residents of
Angeles City, Pampanga, where the data collection was administered from May to June
2022.
The data collected from the participants and informants were recorded and
transcribed. The records and transcripts served as raw and organized data that the
researchers analyzed and interpreted for the outcome of the study.
Ethics of Research
As Israel and Hay (2006) put it, ethical behavior aids in the protection of people,
communities, and environments, as well as increasing the possibility for global good.
Hence, the researchers strived to conduct the study by the ethical standards of research. To
maintain professionalism between the researchers and participants in conducting the study,
the ethical principles that are most essential to observe are as follows: honesty, objectivity,
confidentiality, carefulness, competence, respect for intellectual property, and social
responsibility. The complete data and results of the study, including the methods and
procedures employed in data-gathering were reported truthfully and transparently; the
researchers did not falsify and fabricate any data. Moreover, bias in all possible aspects of
the research was avoided – bias in experimental design, data analysis and interpretation, and
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the peer-review process was not tolerated. In addition, all the gathered data in conducting
the study was kept strictly confidential and was only used by the researchers for academic
purposes to ensure confidentiality in line with the Data Privacy Act of 2012. Furthermore, it
was crucial attaining carefulness in keeping accurate records of all research investigation
processes as the researchers aimed to successfully present high-quality knowledge to the
public. Lastly, the researchers met the needs and conditions of the participants.
Results
Themes
Through a series of interviews, it was found that there are four main themes; (1)
users’ perception of TeleHealth (TH), (2) comparison between TH and face-to-face
consultations, (3) issues encountered on TH, and (4) perceived improvements for TH.
The first theme from the interviews is that TH is proven to be convenient, practical,
safe, and time-efficient, especially now that the pandemic has ravaged the world, and
medical services have become harder to access; a very similar result to the study conducted
by Choi et al. (2021) where adults found TH as a safe and convenient alternative to access
medical care. Moreover, according to the interviewees, most of them started utilizing TH at
the onset of the COVID-19 pandemic. This has been further acknowledged through a study
conducted by Bestsenny et al. (2021) wherein patients started to use TH from February to
April 2022, when the pandemic started and lockdowns and quarantines were very stringent.
As for the physicians in the patients’ perspective, they were thorough, comprehensive, and
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proficient. This indicates that patients were satisfied with the TH they used in regard to the
doctors they were consulting from. This is parallel to what Donelan et al. (2019) researched
about wherein they found out that more than 90% of the patients were satisfied with the
telemedical services they received from physicians.
The second theme is about the comparison of TH and traditional face-to-face
consultations. According to the answers from the participants, TH is a more convenient and
secure way to consult with physicians during the pandemic. This is further recognized by
the study of Gajarawala and Pelkowski in 2021. Despite this, TH has limitations, especially
ones regarding the fact that most major illnesses require physical examinations and
practically limiting TH to minor illnesses. Another issue with TH is the technical side, as it
is very vulnerable to difficulties, information breaches, and regulatory restrictions. All of
these point toward the fact that TH is conditional based on different factors. Moreover,
physicians themselves prefer face-to-face consultations. This is based on the premise that
physical examination is the most important thing to consider when giving diagnoses. This
was also seen in a study by Moore et al. (2016) where physicians preferred face-to-face
because of TH’s relatively young age.
The third theme from the set of interviews is all about the problems that come along
with using TH. Although very advantageous and convenient, it cannot escape from flaws
and limitations. Most of the problems faced when using TH are rooted down to
technological issues such as slow connections and delayed responses. In one study by
Gomez et al. (2020), there were even patients which did not possess the right type of
technology to fully utilize TH. Although these aforementioned problems are about the
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technical side, the human aspect of TH, particularly the physician and the patient, are also
factors to consider in identifying problems. When giving diagnoses, doctors rely only upon
what the patient said, which can sometimes be inaccurate or wrong. This is why it was
stressed by the consultants in the interview that it is very important for patients to be
self-aware, as doctors’ diagnoses are patient-dependent. Doctors cannot efficiently give out
comprehensive diagnoses as consultations are done online. (Gajarawala and Pelkowski,
2021)
The fourth and final theme is all about the recommendations from the interviewees,
both from the perspective of the patients (participants) and physicians
(informants/consultants). From the participants’ point of view, they recommended
improvements in communication and the technological aspect. As mentioned earlier in the
third theme, several technological issues come up when utilizing TH. Therefore, an
improvement in this aspect is reasonable. Although not stated directly by the interviewees,
using video telemedicine (Faucett, 2017) as an alternative to “see” the patients’ conditions
is one of the possible improvements in using TH since most physicians nowadays use TH
through textual or audio telemedicine. This way, communication when utilizing TH will be
improved. As for the physicians, they must be knowledgeable enough to adapt what they
already know in in-person consultations to online ones.
In addition to the participants’ suggestions, the consultants had varying
recommendations. One included educating the patients on using TH; how to use it. what its
limitations are, and helping patients overall improve their computer literacy. This way,
according to the interviewees, TH could be more effective. Moreover, accessibility is a very

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huge factor as studied by White et al. (2022) since patients encountered problems in
booking appointments. Additionally, physicians suggested thoroughness in asking questions
to increase the accuracy of their diagnoses. However, they also mentioned that TH was still
patient-dependent, as they can only formulate their diagnoses based on what patients say.
This is further argued by a study by Haleem et al. (2021), wherein it was recommended that
patients should require their physicians to ask them more questions about their medical
history to give a more in-depth analysis of the patients’ conditions. It was also encouraged
for patients to submit their medical documents instead of typing them to avoid mistakes.
All in all, both patients (participants) and physicians (informants/consultants)
consider TH as a very convenient, practical, and safe alternative for medical consultations.
Both have identified positive and negative sides to utilizing TH. As a result, both
acknowledge its significance and help, while also considering its flaws and limitations.
While both have their preferences in choosing between TH or face-to-face consultations,
both have admitted that they will use whichever considering numerous factors, especially
regarding the illness itself and the legal limitations enforced by the government.
Lessons Learned
The researchers discovered that all participants started using TeleHealth (TH) at the
onset of the pandemic as medical face-to-face consultations were difficult to receive during
the current situation. Many considered TH to be practical because of how convenient and
time-efficient it is compared to standard consultations. The services provided by physicians
through the use of TH by delivering professional and thorough diagnoses brought

25
satisfaction to the patients. The researchers learned that many people found TH as a
practical way to get one's diagnosis with its use of technology as a means of communicating
which promoted safety during the pandemic.
Along the way, the researchers also discovered that TH has limitations despite being
a convenient and secure alternative consultation during the pandemic. The majority of issues
encountered when using TH are due to technical issues such as slow connections and
delayed responses. Major illnesses that necessitate physical examinations are what restricted
TH to only minor concerns. TH also has technical vulnerabilities, such as information
breaches and regulatory restrictions, in addition to limitations. Doctors relied solely on what
the patient said which can be inaccurate in stating a patient's diagnosis. The researchers
determined that since consultations were conducted online, doctors were unable to provide
comprehensive diagnoses promptly. For this reason, face-to-face consultations were
preferred by physicians who believed that physical examination is the most important factor
to consider when making diagnoses.
Findings
This qualitative research explored the practicality of TeleHealth (TH) as a public
health measure in today’s healthcare through the lived experiences of patients amidst the
pandemic. In addition, the study sought to investigate the participants’ satisfaction and
perception and the main efficacy of using TeleHealth services over long distances. The
proponents interpreted the implications of the data with gathered information from varying
26
people who possess expertise in the field of TH. From the answers of eight participants and
three informants, the researchers derived the findings of the study.
Based on the data collected, TeleHealth was mostly described as convenient, useful,
and practical. The participants were greatly satisfied with its functionality as a tool that is
affordable and beneficial. This is in line with the study of Polinski et al. (2015), which states
that convenience and perceived quality of care are important aspects in considering
participants’ satisfaction with TH. The gathered information claimed that TH can be utilized
as an alternative for face-to-face consultations. According to the participants, during the
pandemic, they started using TH services to avoid contracting diseases and endangering
their well-being. However, the study by Dorsey and Topol (2016), mentioned that TH
cannot facilitate physical examinations properly unlike consultations done face-to-face,
since the presence of a trained physician is needed. One participant said that the
professionals were really helpful when giving out diagnoses and they guided them to the
best of their knowledge. After providing clear results and videos to the doctor, they asked a
series of questions and gave prescriptions that indicated their expertise in the said matter.
Despite the said issue, the participants of this study found TH a necessity during this
outbreak.
Evidence suggested that employing TH in rural areas when distributing and
facilitating healthcare services assisted the healthcare systems’ attempt to enhance the
quality of rural healthcare. In such cases, the participants and informants stated that the
process was quick, the instructions were clear, and the health assistance was also addressed.
With a safe, convenient, and helpful option, the results showed an improving source of
27
health population management regarding the general effects of TH on local healthcare
systems in nonmetropolitan areas. Since the pandemic remained and isolation security
measures were still in effect, and there were still no dependable and practical medications,
which caused TH to become a more significant means of ensuring healthcare. Given these
views, applications and programs have become an increasingly essential aspect to both
consultants and physicians that will primarily benefit from enhanced delivery, efficacy, and
overall implementation usage of TH.
Each individual had a different stand on TH being effective. Although five
participants stated they had not experienced any issues and problems yet, three shared their
opinions. Technological hurdles were found to be one of the major factors that contributed
to problems and issues encountered considering that the study was conducted in a rural area.
One participant shared their experience when faced with technological hurdles including
data connectivity and one consultant expressed that one of the disadvantages of using TH is
its need for a stable internet connection. Along with that problem, two participants
encountered physician errors such as the availability of the doctor and misdiagnosis. They
stated that the quality of images depends on the phone which may result in misdiagnosis.
Because of this, participants suggested that physicians can diagnose better through video
and not just by using images. Moreover, the slow and late replies of the doctors make the
participants question their availability and credibility in making diagnoses.
Professionals responsible for developing, maintaining, and handling information and
communications services faced a continuously changing array of hardware and software
alternatives that are not specialized to healthcare users. Consultants, on the other hand, are
28
in control and are expected to provide particular information, follow-up questions, and
documents related to their medical history. Given this view, the researchers have developed
recommendations that are based on the participants and informants for TH service
adaptation which included better communication and information accuracy to consider
regulations to expand and maintain telehealth access, and expanding technological
improvements to fulfill the needs of rural areas. As a result, both recognized its signiﬁcance
and usefulness while also taking into account its disadvantages and difficulties. This
gathered information would eventually help in the advancement of TH in future studies.
Discussion
Conclusion
With the advancement of technology, TeleHealth (TH) has been more utilized for
many reasons. At the onset of the pandemic, people who needed to consult a physician were
forced to either endure the illness with self-induced medications or do it online in various
telecommunication ways, which is TH in different forms. As the pandemic took a while to
subside, with fluctuations in the restrictions, people had been used to consulting with
physicians in this manner. This is the reason why the researchers decided to investigate this
matter.
After extensive research, interviews, analyses, and interpretations, the researchers
found out that among the patients, particularly those who are middle-aged adults, the
majority of them perceived TH as convenient, useful, and helpful. They described it as a

29
useful alternative to traditional consultations as it saved time and energy and it minimized
the risk of contracting the virus. Although most of them had good comments about TH, they
still expressed their concerns regarding the various troubles they faced when using it as well
as its limitations. But overall, TH has been a great help for them.
In general, TH is a very convenient and efficient way of delivering as well as
receiving medical consultations. However, as with every good thing in the world, TH also
has its downsides. These include problems with connectivity, misdiagnosis due to the
absence of physical examinations, and the inaccuracy of the examinations. Another problem
that appeared was the lack of the technology to fully utilize TH, especially for those who are
in rural or nonmetropolitan areas. However, it was found that employing TH in such areas
greatly improved their quality of healthcare.
Overall, TH has both positive and negative characteristics, and according to one's
viewpoint, either the positive or negative parts will be emphasized. As the pandemic starts
to subside, there will be less need for TH to be used. Despite this, it was discovered that
most prefer consulting virtually for minor illnesses. As more futuristic innovations emerge,
the perceived drawbacks of TH will gradually disappear.
Recommendations
Given that the scope of this study is restricted to the healthcare systems of Angeles
City, Pampanga, researchers who will conduct future studies can address the same research
problems in different locations. Although the main objectives of this study have been
successfully accomplished, further research is needed in order to fill in gaps that this study
30
has not been able to cover due to limitations that relate to the location as well as the sample
size. For this reason, the researchers recommend widening the age range of the participants
to obtain a more diverse population which will substantiate the research questions.
Moreover, increasing the number of participants will allow the researchers to have a more
sufficient source of data. In line with this, the researchers would like to suggest asking more
specific queries in regard to the participants’ satisfaction to recognize the underlying
phenomenon behind their responses. Lastly, re-assessing similar studies in a different
context can gain more findings and developments, thus it can open new research
possibilities that concern the field of TH. When these recommendations are properly
implemented, TH can be fully maximized which will result in better health population
management.
31
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Assessing the impact of socio-economic and healthcare provision factors. BMC
Health Serv Res 16, 94. https://doi.org/10.1186/s12913-016-1327-4
Yen, Y., Tsai, Y., Su, V.Y., Chan, S., Yu, W., Ho, H., Hou, C., Chen, C., Woung, L. & Huang,
S. (2020). Use and Cost-Effectiveness of a Telehealth Service at a Centralized
COVID-19 Quarantine Center in Taiwan: Cohort Study. J Med Internet Res
2020;22(12):e22703
Young, L. B., Foster, L., Silander, A., & Wakefield, B. J. (2011). Home Telehealth: Patient
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https://doi.org/10.3928/00989134-20110706-02
43
Appendices
Appendix A
Letters
Image 1. Request Letter for Interview to Mrs. Ruth M. Buan

44
Image 2. Request Letter for Interview to Mrs. Crissa Mae Manalastas

45
Image 3. Request Letter for Interview to Mrs. Eirene Eudia M. Manaloto

46
Image 4. Request Letter for Interview to Mrs. Mary Ann Bundalian-Gomez

47
Image 5. Request Letter for Interview to Mr. Jay-R Ortega

48
Image 6. Request Letter for Interview to Mr. Reimon Cedric P. Mayrina

49
Image 7. Request Letter for Interview to Mrs. Nanette D. Mayrina

50
Image 8. Request Letter for Interview to Mrs. Rhoda M. Espiritu

51
Image 9. Request Letter for Interview to Mr. Nino Angeles

52
Image 10. Request Letter for Interview to Mrs. Relene Angeles

53
Image 11. Request Letter for Interview to Mr. Victor D. Ramos

54
Image 12. Letter to Principal

55
Appendix B
Transcript and Codes
Participants:
Question 1: What are your thoughts about TeleHealth or the delivery of clinical practices
virtually?
Verbatim Translation Initial Codes Final Codes Themes
(1.1) Being able to (1.1) Consulting C1: Convenient Conditionally In the study of
consult to a with a physician with convenient Polinski et al.
physician online, online, especially nonphysical (2015),
especially with with concerns that examinations convenience
concerns that do do not require and perceived
not require physical quality of care
physical examination is are important
examination is very convenient. aspects in
very convenient. considering
their
(2.1) At some (2.1) At some C2: Useful Practical
satisfaction
point, TeleHealth point, TeleHealth
with TH.
is useful is useful C3: Convenient
During the
nowadays. You nowadays. You scheduling
pandemic, its
can make a can make a
56
schedule with your schedule with convenience is
doctor your doctor greatly
conveniently. conveniently. emphasized
since physical
(3.1) Being able to (3.1) Being able C1: Convenient Conditionally
interactions are
consult to a to consult with a with convenient
limited.
physician online physician online, nonphysical
However,
especially with especially with examinations
similar to the
concerns that do concerns that do
study of Dorsey
not require not require
and Topol
physical physical
(2016), TH is
examination is examination is
found to be
very convenient. very convenient.
limited to
minor purposes
(4.1) Based on my (4.1) Based on my C4: Good Proficiency of only. It cannot
experience, it was experience, it was doctor facilitate
relatively okay. relatively okay. C5: Address physical
The doctor was The doctor was concerns examinations
thorough in thorough in thoroughly properly since
addressing my addressing my the presence of
concern. concern. a trained
57
physician is
needed. For this

(5.1) Convenient (5.1) Convenient C6: Convenient Minor
reason,
and good for minor and good for purposes
improvements
purposes like daily minor purposes C4: Good
should be done
health checkups. like daily health
to address this
checkups.
concern.
(6.1) Ahh okay (6.1) It’s okay and C7: Okay Necessity Despite the said
siya, atsaka it’s also required issue, the
required talaga yun for me because I C8: participants of
kasi nga got sick so I have Requirement this study find
nagkasakit ako so to consult the TH a necessity
kailangan ko na doctor online. during this
kahit online lang pandemic.
maka-kapag
consult ako sa
doctor, hindi ba?
(7.1) I would say (7.1) I would say C9: Helpful Evolving
it’s very helpful. I it’s very helpful. I medical
think if we’re think if we’re C10: Check service
going to allow going to allow physicians’

58
people to learn people to learn credibility
more about more about
TeleHealth, they TeleHealth, they C11:
don’t have to don’t have to Improvements
cram. When it cram. When it
comes to the comes to the
delivery of the delivery of the
practices, we practices, we
should still check should still check
the credibility of the credibility of
the people the people
answering our answering our
questions. Again, questions. Again,
nothing beats nothing beats
meeting face to meeting face to
face, for us to be face, for us to be
able to be able to be
diagnosed well by diagnosed well by
the people who are the people who
in this field. are in this field.
Basically, it’s Basically, it’s

59
helpful for me but helpful for me but
there are there are
improvements to improvements to
be done. be done.
(8.1) I-minimize (8.1) It minimizes C12: Convenience
de ing face-to-face, face-to-face. It’s Minimizes
ahh.. Itang also convenient face-to-face
convenience na having the
ning maka-store la patients’ data C13: Storing
reng patients data stored online. patients’ data
online. So meaning Meaning, it’s not online
online la, ala na required to keep conveniently
rin, e na rin require paper trails. Also,
itang mag-keep it’s convenient to C14: Not
kang paper trails. book required to
So ita, appointments in keep paper
convenience. Itang the comfort of trails
convenience as your home.
well ketang C15:
pamag-book, Appointments
appointment at the at home

60
comforts of your
home.
Question 2: How long have you been using TeleHealth?
(1.2) Since the (1.2) Since the C16: Start of More than 2 In a study
pandemic pandemic. the pandemic years conducted by
Bestsennyy et
(2.2) I used (2.2) I used C17: During the Throughout
al. (2021),
TeleHealth during Telehealth in late pandemic lockdowns
most patients
Pandemic days, 2019 where it was and
started utilizing
late 2019, and I during the start of quarantine
TeleHealth
stopped when the pandemic. I inspections
from February
walk-in patients stopped using it
2020 to April
are available. as soon as walk-in
2020, when
appointments
lockdowns and
were available.
quarantine
(3.2) Since the (3.2) Since the C16: Start of Over 2 years protocols were
pandemic pandemic. the pandemic strictly
enforced.
61
(4.2) Not long. I (4.2) Not long. I C18: Once Only once
only used it once. only used it once.
(5.2) Since the (5.2) Since the C16: Start of Over 2 years
pandemic pandemic. the pandemic
(6.2) Actually mag (6.2) I've been C16: Start of Nearly 3
3 years na siya. actually using it the pandemic years
for almost 3
years.
(7.2) Before the (7.2) Before the C19: Before and 3 years
pandemic, not that pandemic, I didn't during the
much. I’ve been use telehealth that pandemic
using Telehealth much since I've
since the pandemic only used it since
started since we the pandemic
can’t go out, all of started and when
us. So, I think it was the time we
almost three years couldn't all go
ago since I’ve been outside. So, I
using this think it's been 3
consistently. years since I've

62
been using
telehealth.
(8.2) Ahhh… 3 (8.2) I have been C20: 6 months 6 months
months, since mig using it for 6
launch ya keng months.
company. O 6 a
mu na
Question 3: What are your reasons for using TeleHealth?
(1.3) (1.3) I use C6: Convenient Alternative Referring to
Convenience, TeleHealth since it the study
safety is convenient and C21: Safe conducted by
a safer option. Choi et al.
(2021), most
(2.3) I did use (2.3) I did use C8: Necessity
adults find the
TeleHealth when I TeleHealth when I Requirement
use of
encountered encountered
TeleHealth
problems with my problems with my C21: Safe
consultations
hearing because hearing because
as a safe and
63
all hospitals are all hospitals are convenient
required to do so required to do so alternative for
for safety for safety accessing
measures. measures. health care
under
(3.3) (3.3) I use C6: Alternative
COVID-19
Convenience, TeleHealth since it Convenience
social or
safety. is convenient and
physical
a safer option. C21: Safe
distancing
(4.3) Convenience (4.3) Convenience C6: Convenience guidelines.
Convenience Due to
TeleHealth’s
(5.3) (5.3) Since it is C21: Safe Accessibility
practicality
Convenience, convenient, safer,
and guaranteed
safety, cheaper and cheaper C22: Cheap
safety in
(6.3) Because it (6.3) Because C9: Helpful Personal
regards to
helps me. TeleHealth helps circumstances
delivering
me.
medical
(7.3) Very easy, (7.3) It is very C22: Easy Advantageous services
convenience, easy, convenient, amidst the
practicality. That’s and practical. C6: pandemic, the

64
it. That’s it. Convenience needs and
satisfaction of
C23: Practical most adults are
attained.
(8.3) At saka (8.3) It’s required C8: Requirement
Moreover, it
number one in our company so Requirement
has become a
required ya king it’s not possible to
necessity to
company, so ena go to the clinic.
consider TH as
rin pwedi ing We should use the
a solution and
munta ka keng app given to us.
an innovative
clinic. Dapat ahh,
method to
itang app.
provide
medical care
while
lessening the
risk of
exposure to
COVID-19 in
order to ensure
the well-being
of patients and
65
healthcare
workers
(Bokolo, 2020)
. Hence, this
continues
patients to
receive
adequate care
through the
benefits of TH.
Question 4: Do you find TeleHealth practical? Why or why not?
(1.4) Yes, it saves (1.4) Yes, as it C24: Saves Practical In the study of
time, effort, and is saves time and time Sabesan et al.
very convenient. effort. It is also (2013), the
very convenient. C25: Saves practicality
effort regarding TH
depicts how it
66
C6: Convenient may possibly
conserve
(2.4) For me, (2.4) TeleHealth is C26: Own time Time-efficient
advantages
TeleHealth is practical because
with the
practical. Why? you can go to your
consumers
You can go to your doctor on your
and health
doctor on your own time and ask
physicians,
own time, and ask the doctor how
and also the
the doctor how much the expenses
time and cost
much the expenses need to be paid.
by
need to be paid.
minimizing
(3.4) Yes, it saves (3.4)Yes, as it C24: Saves Practical out-of-pocket
time, effort and is saves time and time receipts. In
very convenient. effort. It is also addition to
very convenient. C25: Saves this, Agboola
effort et al. (2014),
stated that the

C6: Convenient growing
interest in TH
(4.4) Yes, but only (4.4) Yes, if the C27: Addressed May vary
services
If the concern can concern can be virtually according to
develops such
be addressed addressed circumstances
67
virtually. “No, if it virtually. No, if it C28: Physical privilege that
is imperative that is imperative that examination attempts to
the doctor the doctor provide wide
examines you examines you support with
personally. personally. the current
healthcare
delivery
(5.4) Since I have (5.4) Since I have C29 : Possible Accessibility
issues, which
a friend who is a a friend who is a medications
requires and
doctor, I can easily doctor, I can
examines the
ask her about easily ask her C30: Given
deployment,
possible about possible symptoms
adoption, and
medications given medications given
engagement
the symptoms I the symptoms I C23: Practical
obstacles that
have. So, yes, it is have. So, yes, it is
measures the
practical. practical.
outcome
(6.4) Oo, practical (6.4) Yes, it’s C9: Helpful Practical formative
siya kasi marami practical because assessments
siyang it helps many in building
natutulungan sa people with the TH
illnesses. system’s
68
mga taong may leading
sakit objectives.
(7.4) Well it is (7.4) It’s practical C23: Practical Functionality
practical for me for me because I
because I don’t don’t have to C31: Used in
have to commute, commute going to emergencies
ride a taxi or a the hospital. I will
jeep, or a tricycle only spend on
going to the mobile data. Also,
hospital. Yeah, it’s TeleHealth can be
practical, load used in
lang naman emergencies
gagastusin. Also, I because you could
think using actually save a
Telehealth person’s life. In
consultation not case of
just in the topic or emergency, we
the context of have to call 911 or
pandemic, kapag anyone that knows
may emergency, first aid.
kapag
69
nag-TeleHealth
consultation ka,
you could actually
survive a person’s
life. In case of
emergency, we
have to call 911 or
any available
doctor that you
know, anyone that
you know who
knows first aid.
And you can help
the person who’s
in need.
(8.4) Yes, same (8.4) Yes, for the C6: Convenient Substitute
reasons. same reason that it
is a convenient C21: Safe
and safer option.

70
Question 5: How did your attending physician guide you when you consulted them? Were
their instructions clear and helpful?
(1.5) After (1.5) After C32: Clear Comprehensive In a study
providing clear providing clear videos ness conducted by
photos and/or and/or videos (to Donelan et al.
videos (to the dermatologist) C33: (2019), they
dermatologists) and lab results (to Prescription found out that
and lab results (to specialty doctors), most patients
specialty doctors), they asked a series (92.9%) said
they asked a series of questions and that their
of questions and gave a clinician
gave prescription. prescription. explained
things in a way
(2.5) The doctors (2.5) The doctors C9: Helpful Thoroughness
that was easy to
on this matter on this matter
understand
were really were really
while 92.5%
helpful, and they helpful, and they
said that their
guide you to the guide you to the
clinician
best of theiri best of their
listened
knowledge. knowledge.
carefully to
71
(3.5) After (3.5) After C32: Clear Comprehensive them. This
providing clear providing clear videos ness suggests that
photos and/or and/or videos (to initial
videos (to the dermatologist) C33: experiences for
dermatologists) and lab results (to Prescriptions patients and
and lab results (to specialty doctors), clinicians were
specialty doctors), they asked a series positive and
they asked a series of questions and that, for most
of questions and gave prescriptions. encounters,
gave prescription. these virtual
video visits are
just as clinically
(4.5) In my case, (4.5) In my case, C34: Proficiency of
effective and
yes. She seemed to yes. She seemed Appropriate doctor
less expensive
have asked the to have asked the questions
for both patient
right questions for right questions for
and provider
me to explain my me to explain my
compared with
symptoms symptoms
in-person visits.
properly. properly.
(5.5) She asked (5.5) She asked C35: Clarity of Proficiency of
me to take pictures me to take instructions doctor

72
and explain my pictures and
symptoms. explain my
Afterwards, she symptoms.
explained what Afterwards, she
diseases or explained what
sicknesses I might diseases or
have. Yes, their sicknesses I might
instructions were have. Yes, their
clear. instructions were
clear.
(6.5) Yes, of (6.5) Yes, C36: Monthly Recurrent
course. Yun na Absolutely. I get
nga, kasi ako, ih consulted by my C37: Lifetime
c-consult ko sa doctor then they'd term
doctor yung ano, examine me for 3
tapos yung to 4 months. The
gagawin ng doctor medical check-up
ko sakin, ih papa is a lifetime term
laboratory niya since I was
ako every 3 or 4 operated.

73
months. Lifetime
nadin ang medical
check up na yan,
dahil nga operado
na ako.
(7.5) Sa (7.5) Yes, they C35: Clarity of Intelligible
experience ko yes, were clear about instructions
they were clear the instructions
about the given to us when C38:
instructions that we had COVID Supervision
they have given us and I have friends
when we had the who are doctors
COVID. Yes, we and they really
had the COVID, guided us on what
and I have friends to do since we’re
who are doctors not
and then they knowledgeable
really guided us about the situation
what to do since so we have to trust
we’re not them what to do
knowledgeable and what the

74
about the situation medicines are.
so we have to trust Also, they helped
them what to do, us calm down
what are the during that
medicines, what situation since we
are the things that were rattled. They
we can’t do and said, “This is
we can do. And curable, guys.
also, I think ano, Don’t worry too
they helped us to much about it.”
be calm in that Overall, their
situation because instructions were
again, sometimes very helpful and
it’s mind battle. clear.
Yeah, I would say.
So if your body is
weak, and your
mind is also weak,
yeah, nothing is
going to happen.
So yeah, they
75
helped us to look
at the situation in a
calm way, in a
way that is, “This
is curable, guys.
Don’t worry too
much about it.” So
yeah, their
instructions are
helpful and clear,
yeah, definitely.
(8.5) How did? (8.5) The guiding C39: Quick Expeditious
uhh.. It was easy process was easy process
kasi atin neng since my previous
record eh. record was stored C40: Medical
Maka-store ing online so when I history
record ku online requested
na available kaya. medicine, my
So anyang manyad doctor knew my
kung medicine, history and what
balu na nung nanu dosage to give.

76
itang history, nung Also, if you want
nanu itang dosage another physician
a bibye na. Yeah, to guide you, it’s
ayni pa pala, even possible since they
if you ahh… want may access your
another physician medical record.
na lumawe keka
pwedi mu rin kasi
pin akit ne itang
history.
Question 6: How would you compare TeleHealth to traditional face-to-face consultation?
(1.6) Telehealth is (1.6) Telehealth is C6: Conditional TeleHealth has
convenient. But convenient. But Convenient been proven to
for concerns that any concerns that be a more
require physical require physical C28: Physical convenient and
examination, face examination, face examination secure way to
to face to face consult with the
doctor
77
consultation is consultation is still especially with
still best. the best option. the current
pandemic. With
(2.6) TeleHealth (2.6) Telehealth is C6: Better
its flexible
saves you some a great way to save Convenient
scheduling, it
time because you time and effort
also makes
can make an since it's easy to C41: Less
things easier for
appointment with book appointments hassle
patients.
your doctor with your doctor
However,
depending on your and is perfect for
several
schedule while people who has
limitations of
face-to-face busy schedules,
TH include the
consultation while face to face
inability to
requires patients consultations
undertake full
to fall in line and requires you to
physical
wait for their turn. queue in line and
examinations,
wait for your turn.
the possibility
(3.6) Telehealth is (3.6) Telehealth is C6: Conditional of technical
convenient. But convenient. But Convenient difficulties,
for concerns that any concerns that security
require physical require physical breaches, and
78
examination, face examination, C28: Physical regulatory
to face face-to-face examination restrictions,
consultation is consultation is still making TH a
still best. the best option. conditional
method of
consulting one's
(4.6) If conducted (4.6) If conducted C42: Conditional
health concerns
effectively, I think effectively, I think Persuasive
(Gajarawala &
telehealth is a telehealth is a
Pelkowski,
powerful means to powerful means to C43: Not
2021).
encourage more encourage more effective in all
people to do people to do cases
consultations. consultations.
However, I don’t However, I don’t
think it is think it is effective
effective in all in all cases as there
cases as there are are instances
instances when when one has to
one has to personally see a
personally see a doctor for
doctor for consultation,
consultation
79
especially when a especially when a
child is involved. child is involved.
(5.6) Telehealth is (5.6) Telehealth is C6: Preference
more convenient more convenient Convenient
compared to than face to face
face-to-face consultation. C44: Prefer
consultation. However, I would face- to-face
However, I would still prefer face to
still prefer face consultation
face-to-face because I feel
consultations more assured when
because I feel a diagnosis is
more assured that presented to me in
I received the a face-to-face.
correct diagnosis.
(6.6) Kasi yung (6.6) Let's say I C45: Appropriate
consultation felt something bad Immediate according to
through online, in my body like concerns circumstances
let’s say kapag dizziness or
nakakaramdam muscle pain. In an

80
ako ng hindi online C46: On-time
maganda sa consultation, I can prescriptions
katawan ko, just ask about what
kagaya ng kailan I'm worrying about C28: Physical
lang ay nahihilo and the doctor examination
ako or minsan would just give me
masakit at a prescription and
nagkakaroon ako make me buy the
ng muscle pain, na medicine.
dahil nga sa Meanwhile in
gamot na face-to-face
prino-provide sa consultation, it's
akin ng doctor. better since they
Ang face-to-face would check your
mas maganda kasi heart rate and they
kukuhanan ka can get a better
niya ng blood look on your
pressure, tapos ih physical health. In
c-check niya yung short, they could
heartbeat mo, examine you easily
tapos titignan niya

81
ang physical in a face-to-face
health appearance diagnosis.
mo ganun. In
short, mas
madaling ma
examine pag face
to face.
(7.6) Telehealth is (7.6) Telehealth C47: Useful Inadequate
you know... consultations are for minor
Telehealth useful for minor illnesses
consultation is illnesses, but
good when it nothing beats C48: Other
comes to minor face-to-face vitals
sicknesses, but consultations for unobtainable
nothing beats face major illnesses through TH
to face because it only
consultation when became more
it comes to major relevant almost
sicknesses three years ago,
because again implying that there
this...this was are still some areas

82
birth almost 3 that need to be
years ago lang so improved.
there are other Professionals can't
things pa na you see other
know, needs to be symptoms while
improved right? talking on the
So umm...because phone because
there are other they can only hear
symptoms that your voice. They
they can't see and won't be able to
they're talking to determine your
you at the phone, weight, height, or
they can only hear the state of your
your voice but internal organs,
they can't which are all
umm...they can't necessary for
see your face, they conducting blood
can't see your and X-ray exams.
body, they can't Face-to-face
know your consultation is
weight, your
83
height so what's needed for
happening with situations like this.
your you
know…internal
organs, your
lungs, with your..
yeah. They can't
do an examination
of blood
examination, an
X-ray so there are
things like that
when you have to
do face to face
consultation. So
for me, weigh it.
Do you wanna do
a minor
consultation? Do
it Telehealth but if
you're feeling
84
something that is
major, do it face
to face.
(8.6) How would I (8.6) TeleHealth C49: Very Equally
compare? Night and face-to-face different from exclusive
and day 'di ba. It’s consultations are each other
very different. very different from
each other.
Question 7: Are you satisfied with the services of TeleHealth? Why or why not?
(1.7) Yes. So far, (1.7) Yes. So far C50: Provides Affirmative According to a
the doctors that the doctors that teleconsultatio study by Young
provided provided n et al. (2011),
teleconsultation teleconsultation interviews
have been helpful have been helpful generally
with my needs and with my needs and supported
were able to assist were able to assist patients' high
me with my me with my survey ratings,
concerns. concerns. but they also

85
(2.7) In my (2.7) In my C51: revealed some
experience, I am experience, I am Treatment issues that the
satisfied with it satisfied with it survey failed to
because it helped because it helped notice. Access,
me cure my me cure my education or
hearing problems hearing problems instruction, and
during the during the monitoring or
lockdown. lockdown. tracking were
the most
(3.7) Yes. So far, (3.7) Yes. So far C52: Health
important
the doctors that the doctors that assistance
program
provided provided
functions for
teleconsultation teleconsultation
patients.
have been helpful have been helpful
Patients, on the
with my needs and with my needs and
other hand,
were able to assist were able to assist
were frustrated
me with my me with my
by equipment
concerns. concerns.
issues as well
as the
(4.7) With that (4.7) With that C53: Correct inaccessibility
single experience, single experience, diagnosis and slow
86
yes. I think the yes. I think the response of the
doctor was able to doctor was able to care
diagnose the diagnose the coordinator.
problem correctly. problem correctly.
(5.7) Yes, I am (5.7) Yes, I am C6:
satisfied because satisfied because Convenient
of how convenient of how convenient
it is. Although not it is. Although not C54: Virtual
many doctors offer many doctors offer medical
virtual services, I virtual services, I services
am glad with the am glad with the
current services. current services.
(6.7) Yes, I’m (6.7) Yes, I’m C55: Satisfied
satisfied. Pero pag satisfied. However,
serious at hindi when the problem C56:
maganda at is serious and I felt Conditional
biglaan talaga a sudden pain, I
yung have to consult my

87
nararamdaman doctor physically
mo, doon so I can report all
kailangan my symptoms
ipa-consult lahat properly.
ng nararamdaman
mo sa doctor
physically.
(7.7) Am I (7.7) Yes, so far, C54: Virtual
satisfied? yeah so everything has medical
far, so good. Yes, I gone well. I’m not services
am satisfied with sure until when
that. Umm...but this pandemic will
again I don't last and what are
know...until when, the other variants
this pandemic? as well as their
And also what are effects. But just
the other you talking about the
know...what are pandemic, I am
the other variants satisfied with the
that will come out TeleHealth
or the effects of services that our

88
those. Pero just movement
talking about the provides. We have
pandemic, I'm so our own
far yeah... umm TeleHealth and we
satisfied with the have doctors in the
services of movement.
Telehealth that
the..that our
movement is
giving us because
our movement has
our own
Telehealth - we
have our own
Telehealth,
Teleconsultation
and we have
doctors in the
movement, they're
ones being asked
about the situation

89
of the members of
our organisation
and even the
subministers in
our yeah...in the
church, that's it.
(8.7) So far, so (8.7) Yes, my C23: Practical
good because it is experience with it
practical. is going well so
far, and I would
say it's because it
is very practical.
Question 8: What problems have you encountered when using TeleHealth?
(1.8) None so far. (1.8) So far I have C57: No issues None In the study of
no issues in yet Gomez et al.
regards to (2020), some
telehealth. participants did
not possess the

90
(2.8) I haven’t (2.8) I haven’t appropriate
encountered any encountered any technology to
problems when problems when utilize
using TeleHealth. using TeleHealth. TeleHealth
properly. Some
(3.8) None so far. (3.8) So far I have
of these
no issues in
drawbacks
regards to
include slow
telehealth.
internet or data
(4.8) None (4.8) None connectivity
and physicians’
(5.8) The quality (5.8) The quality C58: Physicians’
delayed
of pictures of images depends Misdiagnosis errors
response.
depends on the on the phone
Similar to this
phone which may which may result C59:
study, some
result to to misdiagnosis. Physician’s
participants
misdiagnosis. My My physician also delayed
believe that TH
physician also replies slowly response
is prone to
replies slowly sometimes
misdiagnosis
sometimes because because they treat
due to the loss
they treat patients patients in
in hospitals. hospitals.
91
(6.8) Wala naman (6.8) I didn't C57: No issues None of physical
ako na-encounter encounter any presence.
kasi ginagamit ko issues since i just
lang talaga siya use telehealth if i
pag may don't feel well in
nararamdaman my body.
ako.
(7.8) Number 1, (7.8) First is the C60: Technological
availability of the availability of call Preoccupied hurdles
receivers. Yung iba recipients. Some physicians
hindi sumasagot, people won't
maybe marami answer, maybe C61:
masyadong calls. they are Technology
Number 2, preoccupied with
technology. I think other calls. Second C62:
they can do a is technology. I Credibility
better diagnosis if think, they can do
it’s through video a better diagnosis
and not just voice. if it's through
Number 3, I think video and not just
is the credibility of voice. Third in my

92
those receiving the opinion is the
calls because credibility of call
we’re not sure if receivers since
they are actually we're not sure if
the licensed doctor they are actually a
and if they gave licensed doctor
the correct and if they will
medicine. provide the correct
Basically, it’s medicine. To sum
availability, it up it's the
technology, and availability,
credibility. technology, and
credibility.
(8.8) Kayi (8.8) Data C63: Data Technological
uhmm… data connectivity. If connectivity hurdle
connectivity. Wa your data is weak,
nung medyu maina you might get
ka mag-drop ka. disconnected since
Kasi dependent ya TeleHealth is
king [internet]. dependent on
Wa, actually ali mu connectivity. Also,

93
rin eh kasi the availability of
masanting ta a physician may
[internet]. Isipan also be a problem
ku nung pweding for other people.
mika prublema However, I did not
den. Plus of course encounter those
nung atin kang personally.
preferred physician
kaybat akit mo
retang slots
available. Ita
medyu hassle mu
rin for other people
siguru.
Question 9: What are your suggestions for improving the use of TeleHealth?
(1.9) None so far. I (1.9) None so C64: Proper In the study of
think the success of far. I think the Physician’s communication Kvedar (2012),
a telehealth success of a thoroughness improving

94
consultation telehealth TeleHealth may
depends on the consultation C65: use electronic
thoroughness of the depends on the Assessment communication
doctor and the thoroughness of s to
ability of the patient the doctor and communicate
to provide specific the ability of medical
information needed the patient to information
for the doctor to provide specific from one
assess the patient. information location to
needed for the another in order
doctor to assess to enhance a
the patient. patient's clinical
health. TH
(2.9) Additional (2.9) Additional C66: Additional Manpower
services enable
manpower, so they manpower, so manpower
customers to
can help more they can help
have access to
people who need to more people
health
use TeleHealth who need to use
education and
rather than TeleHealth
self-manageme
face-to-face rather than
nt assistance
consultation. face-to-face
over the
consultation.
95
(3.9) None so far. I (3.9) None so C64: Proper internet, using
think the success of far. I think the Physician’s communication their home PCs
a telehealth success of a thoroughness or wireless
consultation telehealth devices.
depends on the consultation C65: According to
thoroughness of the depends on the Assessment Faucett (2017),
doctor and the thoroughness of more
ability of the patient the doctor and professionals
to provide specific the ability of are using video
information needed the patient to telemedicine to
for the doctor to provide specific see patients
assess the patient. information from afar. As a
needed for the result,
doctor to assess physicians who
the patient. are generally
educated for
(4.9) I suppose there (4.9) I suppose C67:Better Appointment
in-person visits
are better ways to there are better appointment methods
must learn to
schedule an ways to methods
transmit health
appointment. schedule an
facts as well as
appointment.
nonverbal
96
(5.9) Some doctors (5.9) I don’t C67: Better affective signals
are difficult to book appointment to patients via a
contact so I don’t appointments methods digital medium.
book appointments sometimes Additionally,
sometimes so I because some appointment
would suggest doctors are methods are
better appointment difficult to suggested to be
methods. Aside contact so I improved for
from that, there is would suggest better patient
none. better satisfaction.
appointment
methods. Other
than that, there
is none.
(6.9) For me, you (6.9) For me, C68: Listen Proper
should know and you should attentively communication
listen carefully to know and listen
your doctor. And carefully to
also communicate your doctor.
properly. And also

97
communicate
properly.
(7.9) Wala, same (7.9) Better C69: Technological
with number 8, availability, Availability improvements
availability, technology, and
technology and credibility C61:
credibility. because these Technology
were my
problems when C62: Credibility
using
TeleHealth.
(8.9) Simpler (8.9) I’d C70: Simpler Simpler UI
interface na even suggest a interface
the… deng e simpler
masyadung techy interface so that
ela magkasakit. even those who
Kasi itang kekami are not
balamu first ya rin computer
milyari eku medyu literate may use
biyasa. TeleHealth. In
98
my case, I had a
hard time
initially because
of the interface.
Question 10: Will you continue using TeleHealth after the pandemic? Why or why not?
(1.10) Yes, I will (1.10) Yes, I will C6: Convenient Practical Based on the
continue using continue using findings of the
telehealth for telehealth for C24: Saves study of Powell
concerns that do concerns that do time et al. (2017),
not need physical not require a the majority of
exam because it is physical C25: Saves patients
convenient- saves examination effort expressed
time and effort. It since it is interest in
is also generally convenient and C21: Safe continuing to
safe especially now saves time and use virtual
that COVID is still effort. It's also consultations
a threat. generally safe, as an
especially now alternative to

99
that COVID is face-to-face
still a threat. consultations.
Aside from
(2.10) Yes, because (2.10) Yes, since C2: Useful
convenience
it is useful for me. it has been useful
and decreased
to me.
costs, the
(3.10) Yes, I will (3.10) Yes, I will C6: Convenient significant
continue using continue using benefits cited
telehealth for telehealth for C24: Saves were
concerns that do concerns that do time efficiency,
not need physical not require a communication
exam because it is physical C25: Saves , privacy, and
convenient- saves examination effort comfort.
time and effort. It since it is Considering
is also generally convenient and C21: Safe the patients’
safe especially now saves time and varying reasons
that COVID is still effort. It's also and situations
a threat. generally safe, as to their
especially now interest in
that COVID is future virtual
still a threat. consultations,
100
(4.10) depends, (4.10) It depends, C56: Conditional some actually
but if possible, yes. but if possible, Conditional preferred it due
yes. to necessity,
while the need

(5.10) Yes, for (5.10) Yes, but C6: Convenient
to meet in
minor purposes only for minor
person for a
only like checkups. purposes such as C24: Saves
required
It is convenient, checkups. It is time
physical
saves time, and is convenient, saves
examination
cheaper. time, and it is C22: Cheap
might affect the
cheaper.
decision-makin
(6.10) Yes, kasi ito Yes, since this is C71: Lifetime Necessity g of others.
nga lifetime a lifetime treatment
treatment na ito treatment.
sakin, so ayun,
habang buhay na
ito.
(7.10) I’ll still use (7.10) I’ll still C6: Convenient Practical
Telehealth amidst use Telehealth
the pandemic since amidst the C2: Useful

101
it’s convenient, pandemic since C23: Practical
usable, and it’s convenient,
practical. usable, and
practical.
(8.10) Yes, feeling (8.10) Yes, I C72: Preferably May vary
ku pin ena ku actually would online according to
bisang mibalik dati. prefer all my consultations circumstances
But of course, I consultations to
still have to go to be online. But of C28: Physical
my physical course, I still examination
examinations if have to go to my
ever. physical
examinations if
ever.
Consultants:
Question 1: What is TeleHealth?
(1.1) I think that (1.1) I think that C73: Great tool Physicians’ According to
TeleHealth is a TeleHealth has tool Lambert et al.

102
great tool for us been a great help (2020), it is
physicians in the to us physicians stated that the
face of a pandemic. especially in the healthcare
midst of the system and its
pandemic. services have
been
substantially
(2.1) TeleHealth is (2.1) Telehealth C54: Virtual Virtual
affected by the
in simple terms, the is the delivery of medical services medical
impact of the
delivery of medical medical service practice
COVID-19
services virtually. virtually.
pandemic and
(3.1) TeleHealth, I (3.1) TeleHealth, C54: Virtual current
would say, is a I would say, is a medical services worldwide
form of health form of health occurrences,
assistance virtually assistance contributing to
provided for a virtually extensive
patient whenever a provided for a surgical
physical set up is patient whenever difficulties. For
not possible or a physical set up that reason,
cannot be done in a is not possible or Tuckson et al.
time being. cannot be done (2017), said
103
in a time being. that TH has
suggested a
unique and
capable
platform to
serve the needs
of underserved
communities in
rural parts as
software and
devices
developed more
access, data
becomes more
integrated, and
where patients
and healthcare
providers are
able to generate
and engage
with much
104
more
documentation.
Given this
view, TH can
be used to
provide
supplements
and improve
care quality that
entails anything
from having
physicians
manage and
visit patients
efficiently in all
health services
given via
technology.
Question 2: How would you describe the importance of TeleHealth in local health systems
during the pandemic?

105
(1.2) Telehealth has (1.2) Telehealth C74: Has taken Essential According to
taken the place of has taken the the place of Koonin et al.
face to face consult place of face-to-face (2002),
using different face-to-face consultation TeleHealth
platforms. consultation might offer
Telehealth has been using different C75: Beneficial various
beneficial for us platforms. benefits for
physicians as this is Telehealth has C21: Safe public and
a way to drastically been beneficial individual
lessen the risks of for us physicians health during
contracting COVID. as this is a way the COVID-19
to drastically pandemic.
lessen the risks When many
of contracting outpatient
COVID. offices were
closed or had
limited
(2.2) TeleHealth (2.2) Telehealth C76:
working hours
was and still is was and Indispensable
in late March
indispensable in the continues to be
2020, remote
106
pandemic. During indispensable in C6: Convenient screening and
the lockdowns, the pandemic. management
telemedicine was Telemedicine C9: Helpful of people who
provided to patients was provided to needed clinical
who were unable or patients who C21: Safe treatment for
unwilling to leave were unable or COVID-19
their unwilling to and other
homes. It also leave their diseases may
helped most of our homes during have expanded
medical providers to the lockdowns. access to care.
do rounds for our It also helped The increasing
patients most of our availability of
admitted for Mild medical TH services
Covid. There was providers in may have also
less risk of doing rounds for minimized
transmission. our patients with disease
mild COVID. exposure for
There was a staff and
lower risk of patients,
transmission. preserved
limited
(3.2) Telehealth has (3.2) Telehealth C77: Great
107
been of great value, has been of great value supplies of
especially during value, personal
the time when the especially during C52: Health protective
Covid-19 pandemic the time when assistance equipment, and
hit. It has been a the Covid-19 reduced the
channel through pandemic hit. It number of
which health has been a patients who
assistance such as channel through visited
consultation, initial which health facilities.
assessment, and assistance such
primary aid has as consultation,
been provided for initial
patients. assessment, and
primary aid has
been provided
for patients.
Question 3: Based on your experiences, do you prefer TeleHealth or face-to-face
consultations? Why?

108
(1.3) I prefer (1.3) I prefer C44: Prefer Face-to-face According to
face-to-face face-to-face face-to-face the study of
consultation over consultation Moore et al
TeleHealth as 90% over TeleHealth (2016), it was
of diagnosis is as 90% of pointed out
based on physical diagnosis is that
examination. based on physicians
physical prefer
examination. face-to-face
consultations
(2.3) Face-to-face (2.3) C78:
rather than
consults are Face-to-face Irreplaceable
virtual ones
irreplaceable. consults are
since it is
Telemedicine irreplaceable. C28: Physical
fairly new.
provides a Telemedicine examination
Because of its
convenient provides a
technological
alternative but convenient
nature, only
physical alternative but
people who
examination is still physical
are
of utmost examination is
knowledgeabl
importance along still of utmost
e enough with
with medical importance
109
history. along with technology
medical can maximize
history. TH.
Physicians
also noted that

(3.3) I would not (3.3) I wouldn't C79: Both are May vary
having
say that I prefer one say that I prefer essential according to
face-to-face
over the other kind one over the circumstance
consultation is
of consultation other kind of s
crucial as full
because both are consultation
physical
essential, depending because both are
examinations
on what every essential, of
play a big part
situation would call course
in one's
for. depending on
check-up.
the situation that
would call for.
Question 4: What do you think are the advantages and disadvantages of TeleHealth?
(1.4) Advantages: (1.4) Its C21: Safe Organized Some
Less contact and advantages are disadvantages

110
less contamination, less contact and C80: No Medical error of TeleHealth,
no problem with less logistical according to
logistics, more contamination, problems Gajarawala &
convenient no problem with Pelkowski
Disadvantages: logistics, and its C6: Convenient (2021),
Less personal, more more include the
likely to convenient. C58: inability to
misdiagnose, not Meanwhile, its Misdiagnosis perform
everyone can access disadvantages comprehensiv
it because of lack of are the C81: Lack of e physical
technology. following: it is technology examinations,
less personal, technical
misdiagnosis is difficulties,
more likely, and security
not everyone has breaches, and
access to it regulatory
because of lack barriers. Some
of technology. critics of TH
argue that
(2.4) Advantages: (2.4) Its C6: Convenient Practical
online
Ease of use, advantages are
interactions
convenience, less ease of use, C22: Cheap Lack of
111
overhead expenses convenience, guidance are impersonal
Disadvantages: and less C82: Lack of and dangerous
Lack of physical overhead physical exam because the
exam, needs expenses. virtual
working gadgets Meanwhile, its C83: Requires provider lacks
and stable internet. disadvantages suitable the benefit of
are lack of technology a complete
physical exam history and
and it needs physical
working gadgets examination to
and stable aid diagnosis
internet and treatment.
connection. TH and
telemedicine
(3.4) Telehealth (3.4) Telehealth C21: Safe Inadequate
may offer
minimizes physical reduces physical
benefits such
interaction b/w interaction
as preventing
patient and between the
the spread of
physician. This now patient and the
COVID-19,
limits any possible physician. This
reducing
and unnecessary now limits any
healthcare
spread of any possible and
112
infection. However, unnecessary costs, and
not all kinds of spread of any ensuring that
treatment and infection. patients
medical services However, receive
can be provided Telehealth appropriate
through Telehealth. cannot provide care (Safdari
Many kinds of all kinds of et al., 2021).
health care services treatment and
would require medical
physical interaction. services. Many
kinds of health
services would
require physical
interaction.
Question 5: Based on your experiences, how can TeleHealth be more effective?
(1.5) TeleHealth (1.5) TeleHealth C84: Awareness Knowledge The study by
could be more could be more on Telehealth White et al.
effective if more effective if more (2022) found

113
people were people were TeleHealth
educated on its educated on its limitations that
use. use. resulted in the
delivery of
(2.5) Make it (2.5) I would say C85: Accessibility
healthcare
accessible for the is to make it Socioeconomic
when
economic classes accessible for the accessibility
participants
D and E. Most of economic classes
encountered
my patients from D and E. Most of
difficulties
Bayanihan my patients from
with booking
E-Konsulta Bayanihan
processes slow
enjoyed the E-Konsulta
internet
convenience of enjoyed the
connection, as
Telemedicine convenience of
well as poor
because most of Telemedicine
patient
them didn’t have because most of
computer
the means for them didn’t have
literacy. The
travel. the means for
researchers
travel.
also said that
(3.5) TeleHealth is (3.5) TeleHealth C86: Prioritization various
very effective. I is very effective. Exclusivity barriers to
114
cannot think of I cannot think of interacting via
anything at the anything at the C87: Safety TH were
moment on what moment on what measures discovered,
more can be done. more can be such as the
But I think, as done. But I significant
much as it is very think, as much as time necessary
helpful and it is very helpful for
convenient, it has and convenient, professionals,
its limitations too. it has its often
While we fight our limitations too. administrative
way to continue While we fight staff, to plan
providing health our way to sessions at
care physically continue both hospitals
(face to face set providing health and general
up) I believe we care physically practitioners'
should keep (face-to-face set offices, which
Telehealth to cater up), I believe we needs
patients that do not should keep understanding
necessarily have to Telehealth to and awareness
be present in the cater patients of the TH
doctor’s office, that do not modes.

115
minimizing necessarily have Furthermore,
exposure and to be present in Monaghesh
contact that the doctor’s and Hajizadeh
prevent office, (2020) claimed
unnecessary spread minimizing in their study
of any illness. exposure and that there are
contact that numerous
prevent advantages to
unnecessary employing TH,
spread of any particularly in
illness. non-emergenc
y care and
circumstances
when services
may not
involve direct
patient-provide
r engagement,
such as
delivering
psychological
116
assistance.
Non-emergenc
y care
decreases the
use of
resources in
health centers
or hospitals
and enhances
healthcare
access while
mitigating the
chance of
direct
transmission
of infectious
diseases from
person to
person.
Question 6: Given the restriction of the virtual setup, how do you ensure or guarantee that
your patients receive the correct diagnoses?

117
(1.6) We guarantee (1.6) We C88: Thoroughnes Based on the
correct diagnosis guarantee a Diagnostic tests s study of
for the first time correct diagnosis Haleem et al.
that we interview the first time we C89: (2021), during
online, so that we interview online, Follow-ups TeleHealth
tend to order more so that we tend to discussions,
diagnostic tests in order more C90: patients should
lieu of the physical diagnostic tests Check-ups concentrate on
exam, so that we instead of a patient
meet more physical exam, self-reports
frequently online, we meet more and require
and follow-ups and frequently online, clinicians to
check-ups are and follow-ups ask additional
observed. and check-ups questions in
are observed. order to obtain
a thorough
(2.6) Through the (2.6) Through the C91: Patient’s Patient-depe
medical
participation of the participation of participation ndent
history.
patient him/herself. the patient
Treatment may
We can only depend him/herself. We C40: Medical
be
118
so much on can only depend history compromised
medical history so much on if a patient
without the medical history C88: fails to report a
advantage of a without the Diagnostic tests key symptom
physical exam. advantage of a that should
Diagnostic work-up physical exam. have been
could also be of Diagnostic noticed during
help. work-up in-person care.
could also be of Poor
help. communicatio
n makes it
(3.6) We can only (3.6) We can only C91: Patient’s Patient-depe
impossible to
make our judgment make our participation ndent
deliver
and diagnosis from judgment and
dependable
the information the diagnosis from C40: Medical
treatment.
patient provides at the information history
Patients must
the given time. We the patient
submit their
can only assume, provides at the
medical
while still making given time. We
history,
sure that the patient can only assume,
verification
is properly educated while still
documents,
and informed, making sure that
119
giving professional the patient is medical
advice based on the properly reports, and
provided patient educated and previous
medical history. informed, giving prescriptions
When deemed professional rather than
necessary, patients advice based on typing them. A
will be referred to a the provided proper
nearest medical patient medical function that
facility. history. When enables the
deemed physician to
necessary, construct an
patients will be urgent
referred to a treatment plan
nearest medical is the patient
facility. interface
which shows a
summary of
the patient's
physical and
personal
records,
120
supporting the
doctor in
coming to a
decision.
Question 7: Would you encourage your patients to push through online consultations? If so,
why?
(1.7) No, I do not (1.7) No, I don't C92: Physical Face-to-face According to
advise online advise online interaction the study of
consultation consultation, Moore et al.
because I believe because I believe (2017), most
that human that human physicians
interaction is better, interaction is prefer
with preventive better, with face-to-face
measures to fight preventive and consultations
Covid. We are safety measures since they
better with seeing against cannot fully
patients in person COVID-19. We practice their
rather than online. are better with profession

121
seeing patients virtually. In
in person rather addition,
than online. physicians
mainly use TH
(2.7) Yes, if the (2.7) Yes, if the C93: Conditional
nowadays to
patient’s case is not patient’s case is Urgency-depen
mitigate the
urgent, not needing not urgent and dent
spread of
extensive physical does not need an
infectious
exam, only extensive C87:
diseases
for follow-ups on physical exam. It Follow-ups
(Johns
chronic stable is also
Hopkins
conditions, and can recommended
Medicines,
be managed via for
2022).
telehealth. follow-ups on
their chronic
stable
conditions.
(3.7) Yes, I would (3.7) Yes, I C94: Conditional
highly encourage would highly Functionality
TeleHealth to encourage
122
maximize its full TeleHealth to C56:
potential. But again, maximize its full Conditional
when necessary, potential. But
patients will still be again, when
referred to a health necessary,
facility as patients will still
Telehealth has its be referred to a
limitations. health facility as
Telehealth has its
limitations.
Appendix C
Clustering of Codes
CLUSTERING
Perception on TeleHealth Comparison between TeleHealth and
Face-to-face Consultations
C1: Convenient with nonphysical C12: Minimizes face-to-face
examinations C14: Not required to keep paper trails
C2: Useful C24: Saves time
C3: Convenient scheduling C25: Saves effort

123
C4: Good C26: Own time
C6: Convenient C27: Addressed virtually
C7: Okay C28: Physical examination
C8: Requirement C29: Possible medications
C9: Helpful C30: Given symptoms
C13: Storing patients’ data online C31: Used in emergencies
conveniently C41: Less hassle
C15: Appointments at home C44: Prefer face-to-face
C16: Start of the pandemic C45: Immediate concerns
C17: During the pandemic C46: On-time prescriptions
C18: Once C47: Useful for minor illnesses
C19: Before and during the pandemic C48: Other vitals unobtainable through TH
C20: 6 months C49: Very different from each other
C21: Safe C74: Has taken the place of face-to-face
C22: Cheap consultation
C23: Practical C78: Irreplaceable
C37: Lifetime term C79: Both are essential
C39: Quick process C93: Urgency-dependent
C42: Persuasive
C50: Provides teleconsultation
C51: Treatment
124
C52: Health assistance
C53: Correct diagnosis
C54: Virtual medical services
C55: Satisfied
C56: Conditional
C71: Lifetime treatment
C72: Preferably online consultations
C73: Great tool
C75: Beneficial
C76: Indispensable
C77: Great value
C94: Functionality
Issues encountered on TeleHealth Perceived Improvements for TeleHealth
C43: Not effective in all cases C5: Address concerns thoroughly
C57: No issues yet C10: Check physicians’ credibility
C58: Misdiagnosis C11: Improvements
C59: Physician’s delayed response C32: Clear videos
C60: Preoccupied physicians C33: Prescription
C61: Technology C34: Appropriate questions
C62: Credibility C35: Clarity of instructions

125
C63: Data connectivity C36: Monthly
C80: No logistical problems C38: Supervision
C81: Lack of technology C40: Medical history
C82: Lack of physical exam C64: Physician’s thoroughness
C83: Requires suitable technology C65: Assessment
C92: Physical interaction C66: Additional manpower
C67: Better appointment methods
C68: Listen attentively
C69: Availability
C70: Simpler interface
C84: Awareness
C85: Socioeconomic accessibility
C86: Exclusivity
C87: Safety measures
C88: Diagnostic tests
C89: Follow-ups
C90: Check-ups
C91: Patient’s participation
Appendix D
Pictures/Screenshots
126
Image 13. Interview with Mrs. Rhoda Espiritu
Image 14. Interview with Mrs. Relene Angeles

127
Image 15. Interview with Dr. Eirene Eudia Manaloto

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RUNNING HEAD: A PHENOMENOLOGICAL STUDY ON THE PRACTICALITY OF

TELEHEALTH AMIDST COVID-19 PANDEMIC

A Phenomenological Study on the Practicality of TeleHealth

amidst COVID-19 Pandemic

Completed on: June 25, 2022

Garcia, Faith Lijana B.

Magtoto, John Brett O.

Manaloto, David Jeshurun M.

Pagaduan, Miles Gabriel A.

Pineda, Sophia Wina R.

Angeles City Science High School

Senior High School

research focused on the utilization of TH in economically advanced metropolitan areas, thus

fundamental to the delivery of TH services in other nonmetropolitan areas.

Keywords: TeleHealth, COVID-19, phenomenology, healthcare services, consultations,

Background of the Study

government to employ technology to address the ongoing crisis.

technology, both of which are components of TeleHealth, contribute a significant role in

healthcare services, emergency/crisis responses, clinical decision support, and risk

management. By definition, TeleHealth refers to the application of technological strategies

It is imperative to know that TeleHealth is an umbrella term that encompasses

certain fields such as TeleDermatology, which is defined as the delivery of dermatologic

services and clinical information at a distance; TeleTherapy, which involves speech,

occupational therapy, or mental health sessions; and TeleRehabilitation, which focuses on

that although TeleMedicine is often used interchangeably with TeleHealth, it refers to

services delivered by physicians only.

It is stated by eVisit (2020), a virtual care platform used by various healthcare

primarily used in medical emergencies. This emphasizes the importance of TeleHealth in

for patients and doctors to engage.

services. One of these is live video conferencing which uses audiovisual

telecommunications technology. This form of service is also referred to as "real-time," and it

component is Store-and-Forward, more commonly referred to as Asynchronous TeleHealth.

2007). Lastly, mobile health is an extensive element of technology-assisted health care.

According to Istepanian et al. (2007), it is the utilization of mobile communications and

cost-effective technique for providing high-quality, cost-effective care. An 11% decrease in

opportunities for continuing study.

Although several physicians expressed their favorable outlook on the

On the contrary, improved population health management was observed due to

63% in June 2020.

Seeing the benefits of TeleHealth, the provincial government of Pampanga started

Communication Technology Harmonization Initiative (MITHI), spearheaded by the

Department of Budget and Management (DBM), Department of Science and Technology

to discover if the same kind of satisfaction is experienced in nonmetropolitan areas. Hence,

Angeles City, Pampanga, Philippines.

study will focus on these main points:

● How may TeleHealth be described by middle-aged adults?

● How does TeleHealth affect local healthcare systems in nonmetropolitan areas?

● What aspects of TeleHealth can other healthcare systems adopt?

process. The following are the study's objectives:

● To critically analyze the use of TeleHealth services;

● To identify the information of TeleHealth's practicality and provide

recommendations regarding the concerns of discovery; and

strategies for delivering healthcare over long distances.

Scope and Delimitation

pandemic. It will be limited to middle-aged adults ranging from ages 35 to 55 living in

services is consistent; how user-friendly it is to participants with or without prior knowledge

perceived advantages and disadvantages of TeleHealth that will be provided by the

satisfaction of patients with the other fields of TeleHealth stated.

Benefits and Beneficiaries

directly benefit the following: