Department of Community and Behavioral Health, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado 80045, USA.
Telemed J E Health. 2013 Jun;19(6):433-7. doi: 10.1089/tmj.2013.0068. Epub 2013 Apr 16.
Many providers are hesitant to use telemental health technologies. When providers are queried, various barriers are presented, such as the clinician's skepticism about the effectiveness of telemental health (TMH), viewing telehealth technologies as inconvenient, or reporting difficulties with medical reimbursement. Provider support for TMH is critical to its diffusion because clinicians often serve as the initial gatekeepers to telehealth implementation and program success. In this article, we address provider concerns in three broad domains: (1) personal barriers, (2) clinical workflow and technology barriers, and (3) licensure, credentialing, and reimbursement barriers. We found evidence that, although many barriers have been discussed in the literature for years, advancements in TMH have rapidly reduced obstacles for its use. Improvements include extensive opportunities for training, a growing evidence base supporting positive TMH outcomes, and transformations in technologies that improve provider convenience and transmission quality. Recommendations for further change are discussed within each domain. In particular, it is important to grow and disseminate data underscoring the promise and effectiveness of TMH, integrate videoconferencing capabilities into electronic medical record platforms, expand TMH reimbursement, and modify licensure standards.
许多提供者都对使用远程心理健康技术犹豫不决。当询问提供者时，会出现各种障碍，例如临床医生对远程心理健康（TMH）的有效性持怀疑态度，认为远程医疗技术不方便，或者报告医疗报销困难。提供者对 TMH 的支持对于其推广至关重要，因为临床医生通常是远程医疗实施和项目成功的初始把关者。在本文中，我们从三个广泛的领域解决了提供者的担忧：（1）个人障碍，（2）临床工作流程和技术障碍，（3）许可、认证和报销障碍。我们发现证据表明，尽管多年来文献中已经讨论了许多障碍，但 TMH 的进步已迅速减少了其使用的障碍。改进包括广泛的培训机会、越来越多的证据支持积极的 TMH 结果，以及改善提供者便利性和传输质量的技术变革。在每个领域都讨论了进一步变革的建议。特别是，重要的是要增长和传播数据，强调 TMH 的承诺和有效性，将视频会议功能集成到电子病历平台中，扩大 TMH 的报销范围，并修改许可标准。
