Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people

BACKGROUND: Among indigenous populations in remote locations who are at increased risk for chronic diseases such as diabetes, telemedicine has the potential to improve access to health care services and thus may reduce adverse health outcomes. Yet few studies are available on how best to use telemedicine technology in reducing ethnic and racial health care disparities. OBJECTIVE: We examined perspectives of patients and providers in 2 indigenous populations in Alaska and Hawai'i about the use of telemedicine in primary care chronic disease management. DESIGN: Six focus groups with patients and providers at 2 sites (3 in Alaska and 3 in Hawai'i). RESULTS: Three broad themes were common to both sites: (a) benefits and barriers of using telemedicine; (b) building patient–provider relationships; and (c) elements of an acceptable telemedicine primary care encounter. Two key elements were endorsed by both patients and providers as important for an effective telemedicine encounter: (a) the initial patient–provider interaction should be face-to-face; and (b) patients must see the same provider on follow-up visits. CONCLUSION: The use of telemedicine in chronic disease management has potential to improve patient care in remote indigenous populations and may supplement patient–provider relationships.