Warmington Kelly, Flewelling Carol, Kennedy Carol A, Shupak Rachel, Papachristos Angelo, Jones Caroline, Linton Denise, Beaton Dorcas E, Lineker Sydney
Learning Institute, The Hospital for Sick Children.
Telemedicine Program.
Open Access Rheumatol. 2017 Feb 24;9:11-19. doi: 10.2147/OARRR.S122015. eCollection 2017.
Telemedicine-based approaches to health care service delivery improve access to care. It was recognized that adults with inflammatory arthritis (IA) living in remote areas had limited access to patient education and could benefit from the 1-day Prescription for Education (RxEd) program. The program was delivered by extended role practitioners with advanced training in arthritis care. Normally offered at one urban center, RxEd was adapted for videoconference delivery through two educator development workshops that addressed telemedicine and adult education best practices. This study explores the feasibility of and participant satisfaction with telemedicine delivery of the RxEd program in remote communities.
Participants included adults with IA attending the RxEd program at one of six rural sites. They completed post-course program evaluations and follow-up interviews. Educators provided post-course feedback to identify program improvements that were later implemented.
In total, 123 people (36 in-person and 87 remote, across 6 sites) participated, attending one of three RxEd sessions. Remote participants were satisfied with the quality of the video-conference (% agree/strongly agree): could hear the presenter (92.9%) and discussion between sites (82.4%); could see who was speaking at other remote sites (85.7%); could see the slides (95.3%); and interaction between sites adequately facilitated (94.0%). Educator and participant feedback were consistent. Suggested improvements included: use of two screens (speaker and slides); frontal camera angles; equal interaction with remote sites; and slide modifications to improve the readability on screen. Interview data included similar constructive feedback but highlighted the educational and social benefits of the program, which participants noted would have been inaccessible if not offered via telemedicine.
Study findings confirm the feasibility of delivering the RxEd program to remote communities by using telemedicine. Future research with a focus on the sustainability of this and other models of technology-supported patient education for adults with IA across Ontario is warranted.
基于远程医疗的医疗服务提供方式可改善医疗服务的可及性。人们认识到，居住在偏远地区的患有炎性关节炎（IA）的成年人获得患者教育的机会有限，且能从为期一天的教育处方（RxEd）项目中受益。该项目由在关节炎护理方面接受过高级培训的扩展角色从业者提供。RxEd通常在一个城市中心开展，通过两个针对远程医疗和成人教育最佳实践的教育者发展研讨会，对其进行了视频会议形式的调整。本研究探讨了在偏远社区通过远程医疗提供RxEd项目的可行性以及参与者的满意度。
参与者包括在六个农村站点之一参加RxEd项目的患有IA的成年人。他们完成了课程后的项目评估和后续访谈。教育者提供了课程后的反馈，以确定随后实施的项目改进措施。
共有123人（6个站点中36人现场参与，87人远程参与）参加了三场RxEd课程中的一场。远程参与者对视频会议的质量感到满意（%同意/强烈同意）：能听到主讲人讲话（92.9%）以及站点间的讨论（82.4%）；能看到其他远程站点谁在讲话（85.7%）；能看到幻灯片（95.3%）；站点间的互动得到充分促进（94.0%）。教育者和参与者的反馈一致。建议的改进措施包括：使用两个屏幕（主讲人和幻灯片）；正面摄像头角度；与远程站点的平等互动；以及对幻灯片进行修改以提高屏幕上的可读性。访谈数据包括类似的建设性反馈，但突出了该项目的教育和社会效益，参与者指出，如果不是通过远程医疗提供，这些效益是无法获得的。
研究结果证实了通过远程医疗向偏远社区提供RxEd项目的可行性。未来有必要开展研究，重点关注此模式以及安大略省其他针对患有IA的成年人的技术支持患者教育模式的可持续性。
