Beste Lauren A, Mattox Elizabeth A, Pichler Raimund, Young Bessie A, Au David H, Kirsh Susan F, Germani Maureen W, Hedeen Ashley, Harp Bonnie K, Chang Michael F
1 General Medicine Service, VA Puget Sound Health Care System , Seattle, Washington.
2 Health Services Research and Development Center for Innovation , VA Puget Sound Health Care System, Seattle, Washington.
Telemed J E Health. 2016 Aug;22(8):699-706. doi: 10.1089/tmj.2015.0185. Epub 2016 Mar 9.
Primary care providers who participate in structured specialty telemedicine mentorship report improvements in clinical content mastery, professional satisfaction, and specialist communication.
Although these programs require investments of infrastructure resources and time, the duration of participation required to accrue optimal benefits is not known. We aimed to assess whether duration of participation is related to improved benefits of a longitudinal telemedicine-based mentorship program, specifically regarding perceived specialty care access, acquisition of new knowledge and skills, team integration, and overall job satisfaction.
We conducted an e-mail survey of Veterans Affairs-based primary care team members in the United States' Pacific Northwest region who engaged in a longitudinal telemedicine mentorship program (n = 78).
After adjustment for potential confounding factors, respondents who engaged in telemedicine mentorship for ≥1 year were significantly more likely to strongly agree that telemedicine mentorship improved patient access to specialty care (adjusted odds ratio [AOR] = 9.3, p < 0.005) and was useful in treating other patients on their panels (AOR = 3.7, p = 0.04). Participation ≥1 year was also associated with higher self-reported knowledge and competencies (AOR = 4.0, p = 0.03) and with perception of integration into a clinical team (AOR = 5.6, p = 0.01), but not with overall job satisfaction.
Telemedicine-based specialty mentorship programs are highly valued by primary care-based participants, and self-reported benefits accumulate beyond 1 year of participation.
参与结构化专科远程医疗指导的基层医疗服务提供者报告称，他们在临床内容掌握、职业满意度和与专科医生沟通方面有所改善。
尽管这些项目需要投入基础设施资源和时间，但获得最佳效益所需的参与时长尚不清楚。我们旨在评估参与时长是否与基于远程医疗的纵向指导项目的效益改善有关，特别是在专科护理可及性、新知识和技能的获取、团队整合以及总体工作满意度方面。
我们对美国太平洋西北地区参与纵向远程医疗指导项目的退伍军人事务部基层医疗团队成员进行了电子邮件调查（n = 78）。
在对潜在混杂因素进行调整后，参与远程医疗指导≥1年的受访者更有可能强烈同意远程医疗指导改善了患者获得专科护理的机会（调整后的优势比[AOR]=9.3，p<0.005），并且有助于治疗他们负责的其他患者（AOR = 3.7，p = 0.04）。参与≥1年还与更高的自我报告知识和能力（AOR = 4.0，p = 0.03）以及融入临床团队的感知（AOR = 5.6，p = 0.01）相关，但与总体工作满意度无关。
基于远程医疗的专科指导项目受到基层医疗参与者的高度重视，自我报告的效益在参与1年后会不断累积。
