Fish Allison, George Sheba, Terrien Elizabeth, Eccles Alicia, Baker Richard, Ogunyemi Omolola
Center for Biomedical Informatics, Charles Drew University of Medicine and Science, Los Angeles, California, USA.
AMIA Annu Symp Proc. 2011;2011:417-26. Epub 2011 Oct 22.
Telemedicine holds great promise for increased access to specialty care services for safety net clinic patients. However, the adoption of these technologies is not a seamless transition for clinicians working in resource-poor settings. Previous research has analyzed workflow issues that arise in primary care settings when adopting telehealth tools but has not examined the unique workflow challenges facing specialists who provide assessments to safety net clinics. Findings are presented from a case study that employed qualitative methodologies as part of an assessment of a teleretinal screening program in Los Angeles urban safety net clinics. The program utilizes external ophthalmologists to perform retinal readings. The case study provides insights into how difficulties that arise in reader workflow are resolved and identifies unique factors requiring consideration when highly trained specialists perform teleretinal readings. The discussion outlines important issues to address when developing telehealth workflow protocols for the safety net, specifically, and their broader applicability in telemedicine.
远程医疗有望为安全网诊所的患者提供更多获得专科护理服务的机会。然而，对于在资源匮乏环境中工作的临床医生来说，采用这些技术并非是一个无缝的转变。先前的研究分析了在初级保健环境中采用远程医疗工具时出现的工作流程问题，但尚未研究为安全网诊所提供评估的专科医生所面临的独特工作流程挑战。本文呈现了一项案例研究的结果，该研究采用定性方法，作为对洛杉矶城市安全网诊所远程视网膜筛查项目评估的一部分。该项目利用外部眼科医生进行视网膜读数。该案例研究深入探讨了如何解决读者工作流程中出现的困难，并确定了训练有素的专科医生进行远程视网膜读数时需要考虑的独特因素。讨论概述了在为安全网制定远程医疗工作流程协议时需要解决的重要问题，特别是其在远程医疗中的更广泛适用性。
