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[pt] A teleconsulta, como ferramenta tecnológica, pode gerar maior acessibilidade a serviços de saúde de qualidade, além de servir para lidar com os desafios de recursos na indústria da saúde. Pode também ser particularmente relevante durante a pandemia de COVID-19, com o distanciamento social que demanda novas soluções tecnológicas para a oferta de serviços de qualidade com contato pessoal reduzido. Este trabalho propõe um modelo integrativo de aceitação de tecnologia para avaliar os fatores determinantes da adoção de teleconsulta pelos pacientes, alinhando construtos de caráter cognitivo e comportamental, oriundos do modelo de aceitação de tecnologia, com outros construtos de natureza distintas: (i) prontidão tecnológica, representando o fator de natureza tecnológica do modelo; e (ii) confiança e autoeficácia, representando construtos relacionados com aspectos específicos e relevantes na adoção de tecnologias em serviços de saúde. Para testar e validar o modelo conceitual proposto, foi utilizada a modelagem de equações estruturais com dados dos questionários de 415 consumidores. Os resultados obtidos indicam relações significativas entre os construtos avaliados, com particular relevância nos efeitos da utilidade percebida, antecedida pela confiança e prontidão tecnológica, sobre atitude e intenção de uso da teleconsulta. O uso deste modelo integrativo, com seis potenciais antecedentes, possibilitou explicar 67,7 por cento da variância da intenção comportamental de uso dos respondentes. Os achados também sugerem que o contexto pandêmico associado com o Covid-19 possa influenciar o comportamento dos pacientes quanto à intenção de uso da teleconsulta. Desta forma, os resultados obtidos fornecem avanços no debate da aceitação de tecnologia nos serviços de saúde, ao propor um modelo integrativo e potencialmente inédito de avaliação das intenções de uso, sobre a ótica dos pacientes. Também servem como potenciais fontes orientadoras para organizações de saúde e reguladores públicos, na formatação de estratégias para o futuro da teleconsulta no Brasil no período posterior à pandemia de COVID-19. / [en] Teleconsultation can be a strategic technological tool for patients to access quality healthcare while dealing with resource challenges within health industry. It can be particularly relevant during and after the COVID-19 pandemic, when the social distancing world had to scramble for new technological solutions to offer quality healthcare services with reduced personal contact. Our research proposes an integrative technology acceptance model to evaluate the drivers of teleconsultation adoption by patients, aligning cognitive and behavioral constructs from the technology acceptance model with other drivers associated with distinct natures, such as: (i) technology readiness, a factor with technological characteristics; and (ii) trust, and self-efficacy, constructs strongly associated and relevant to the acceptance of technologies in health-related services. To test and validate the proposed conceptual model, this study applied structural equations modeling based on survey’s data from a sample of 415 consumers. Results indicate significant relationships between the assessed constructs, with particular relevance on the effects of perceived usefulness, anteceded by trust and technology readiness, on attitude and intention to use teleconsultation. The model was able to explain 67.7 percent of respondents behavioral intention in adopting teleconsultation. Our findings also suggested the potential impact of the pandemic context (Covid-19) on the respondents answers and behaviors. Our findings support the debate on technology acceptance by providing an integrative and potentially new model for assessing patients intention of adopting new health-related technologies. In addition, results provide helpful insights for health organizations and regulators in their future strategies and debates on the teleconsultation introduction in Brazil in the period post-Covid-19 pandemic.

Contexte. La pandémie de la COVID19 (maladie à coronavirus) a entrainé une réorganisation rapide des services de santé en mars 2020, au Québec et dans le monde. La télésanté, qui ouvre de larges perspectives pour faciliter l’accès aux services de santé, a gagné en popularité durant cette période. Les systèmes de soins de différents pays ont mis sur pied des solutions de télésanté ; plus particulièrement des programmes de téléconsultation afin de maîtriser l’afflux des patients dans les centres de soins de première ligne, de gérer le nombre de lits disponibles et de limiter les contacts pour éviter la propagation du virus. Plusieurs travaux actuels décrivent le potentiel d’utilisation de la téléconsultation dans le contexte de la COVID-19 dans les soins médicaux et infirmiers, mais très peu dans les autres types de soins dispensés par d’autres professionnels de la santé. Objectifs. Cette étude vise à apporter des connaissances sur l’utilisation et la perception des professionnels de la DSM, ayant utilisé la consultation à distance durant la pandémie de la COVID-19 au Québec. Notamment à travers les facteurs qui ont influencé son utilisation. Nous ferons ressortir aussi les avantages et contraintes perçus de cette modalité de prestation de soins. Méthodologie. Le devis mobilisé pour atteindre cet objectif est une étude de cas qualitative descriptive, exploratoire et rétrospective. Cette recherche est basée sur l’analyse de 16 entrevues individuelles semi-structurées réalisées auprès de personnes affiliées à la direction des services professionnels d’un centre hospitalier universitaire au Québec. Ces entrevues ont été réalisées avec les professionnels qui ont recouru à la téléconsultation durant la crise de la COVID-19. Elles ont fait l’objet d’une analyse de contenu à l’aide du logiciel QDA Miner 5 selon une approche thématique émergente. Résultats. Au terme de cette étude, l’analyse des résultats montre une évolution de la perception des professionnels de la téléconsultation pendant la pandémie de COVID-19 et une nette augmentation de son utilisation. Les répondants ont partagé divers avantages perçus et améliorations à apporter. Les principaux bénéfices perçus concernaient l’amélioration de la continuité des soins, une meilleure observance du traitement par les patients et la personnalisation des soins par l’accès au milieu de vie des personnes. Les obstacles les plus importants étaient le réseau internet et l’augmentation de la charge de travail. Un modèle hybride de prestation de soins est en train d’émerger. Conclusion. L’expérience des répondants par rapport à la téléconsultation s’avère particulièrement positive, et ce, malgré les contraintes mineures rencontrées en contexte de pandémie de COVID-19. Ces résultats permettront d’élaborer des stratégies pouvant les aider dans leur pratique au-delà du contexte de COVID-19. / Background. The COVID 19 (coronavirus disease) pandemic led to a rapid reorganization of health services in March 2020. Telehealth, which opens great prospects for facilitating access to health services, gained in popularity during this period. Healthcare systems in different countries have developed telehealth solutions; more specifically, teleconsultation programs to control the influx of patients into primary care centers, manage the number of available beds and limit contacts to prevent the spread of the virus. Several current studies describe the potential for the use of teleconsultation in the context of COVID-19 in medical and nursing care, but very little in other types of care. Objective. This study aims to provide knowledge on the use and perception of DSM professionals, having used remote consultation during the COVID-19 pandemic in Quebec. In particular through the factors that influenced its use as well as the perceived advantages and constraints. Methods. The design used to achieve this objective is a descriptive, exploratory, and retrospective qualitative case study. This research is based on the analysis of 16 semi-structured individual interviews conducted with people affiliated with the professional services department of a university hospital in Quebec. These interviews were conducted with professionals who used teleconsultation during the COVID-19 crisis. They were subjected to content analysis using QDA Miner 5 software using an emerging thematic approach. Result. The results show that the main perceived benefits focused on improving the continuity of care, better adherence to treatment by patients, and personalization of care by having access to people’s living environment. The biggest barriers were the Internet and the increased workload. Conclusion. The experience of respondents with teleconsultation is particularly positive, despite the minor opposites encountered in the context of the COVID-19 pandemic. These results will make it possible to develop strategies that can help them in their practice beyond the context of COVID-19.