Boruta-driven analysis of telehealth amalgamation across healthcare stratifications with diffuse-dual-channel and tiered-gatekeeper systems

This study aimed to evaluate the adaptation and effectiveness of telemedicine with the diffuse-dual-channel system (DDS) and tiered-gatekeeper system (TGS) across different tiers of the healthcare system on technical-organizational-environmental (TOE) framework. The telemedicine services were extended as Tiered-gatekeeper system (TGS) by Primary and Secondary Healthcare (PSHC) and Diffuse-dual-channel system (DDS) by King Edward Medical University (KEMU) in 2020 benefiting 2605 and 21,905 patients, respectively. This cross-sectional survey is based on a structured questionnaire conducted on 172 healthcare practitioners (HCP) from KEMU and 76 from PSHC selected by purposive sampling and analysis is conducted through descriptive analysis and the Boruta features selection method. The diffuse-dual-channel system is found to be flexible, easy to implement, and impactful due to innate compatibility with prevailing healthcare practices, however, it is a parallel effort to the existing healthcare system. The tiered-gatekeeping system is found to be complex in adaptation initially, but is more organized, deeply integrated, accountable and channelizes the flow of patients, resultantly aiding the preservation of resources.