Biomedical and Health Informatics, School of Medicine, University of Washington, Seattle, WA 98195, USA.
Telemed J E Health. 2013 Apr;19(4):235-40. doi: 10.1089/tmj.2012.0185. Epub 2013 Mar 18.
This study aims to examine the technical quality of videoconferencing used in hospice to engage caregivers as "virtual" members of interdisciplinary team meetings and their impressions of telehealth. Furthermore, it aims to compare the quality of plain old telephone service (POTS) and Web-based videoconferencing and provide recommendations for assessing video quality for telehealth group interactions.
Data were obtained from an ongoing randomized clinical trial exploring Web-based videoconferencing and a completed prospective study of POTS-based videoconferencing in hospice. For the assessment of the technical quality, an observation form was used. Exit interviews with caregivers assessed impressions with the use of telehealth. A retrospective analysis of video-recorded team meetings was conducted rating attributes essential for the quality of videoconferencing (e.g., video artifacts, sharpness).
In total, 200 hospice team meetings were analyzed, including 114 video-recorded team meetings using Web-based videoconferencing and 86 meetings using POTS videophones. A direct comparison between the two modalities indicates the superiority of Web-based video in image quality but less so in audio quality. Transcripts of 19 caregiver interviews were analyzed. Caregivers found the use of videoconferencing to be a positive experience and a useful and essential tool to communicating with the hospice team.
This study highlights the potential of telehealth to improve communication in hospice and the need for new tools that capture the quality of video-mediated communication among multiple stakeholders and strategies to improve the ongoing documentation of telehealth group sessions' technical quality.
本研究旨在考察临终关怀中使用视频会议将护理人员作为跨学科团队会议“虚拟”成员的技术质量及其对远程医疗的印象。此外，还旨在比较普通老式电话服务（POTS）和基于 Web 的视频会议的质量，并为远程医疗团体互动的视频质量评估提供建议。
数据来自正在进行的探索基于 Web 的视频会议的随机临床试验和已完成的基于 POTS 的视频会议在临终关怀中的前瞻性研究。为了评估技术质量，使用了观察表。对护理人员进行的离职访谈评估了使用远程医疗的印象。对团队会议的视频记录进行了回顾性分析，对视频会议质量至关重要的属性进行了评分（例如，视频伪影、清晰度）。
共分析了 200 次临终关怀团队会议，其中包括 114 次使用基于 Web 的视频会议的视频记录团队会议和 86 次使用 POTS 可视电话的会议。两种模式之间的直接比较表明，基于 Web 的视频在图像质量方面具有优势，但在音频质量方面优势较小。分析了 19 次 caregiver访谈的记录。护理人员认为使用视频会议是一种积极的体验，是与临终关怀团队沟通的有用且必不可少的工具。
本研究强调了远程医疗在改善临终关怀中的沟通的潜力，以及需要新的工具来捕捉多方利益相关者之间的视频介导的沟通质量，以及提高远程医疗团体会议技术质量的持续记录的策略。
