Bidmead Elaine, Lie Mabel, Marshall Alison, Robson Stephen, Smith Vikki J
Institute of Health, University of Cumbria, UK.
Population and Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK.
Digit Health. 2020 May 14;6:2055207620925929. doi: 10.1177/2055207620925929. eCollection 2020 Jan-Dec.
We present qualitative findings from interviews with frontline clinicians and service users of a fetal telemedicine service.
Semi-structured interviews with clinical stakeholders and service users were conducted, undertaken as part of a service evaluation. Data collection was undertaken by different teams, using interview schedules aligned to independent evaluation aims. Data were subjected to thematic analysis.
Sonographers reported four main challenges: delivering a shared consultation; the requirement to resist scanning intuitively; communications during the scan; and restricted room space. Notwithstanding, all clinicians reported that participating women were accepting of the technology. Service users reported few concerns. The main benefits of fetal telemedicine were identified as upskilled staff, increased access to specialist support and improved management of complex pregnancies. Convenience was identified as the main benefit by service users, including savings in time and money from not having to travel, take time off work, and arrange childcare.
Service users and clinical stakeholders were accepting of the service. Service users reported satisfaction with communications during the consultation and awareness that telemedicine had facilitated local access to clinical expertise. Whilst clinical stakeholders reported challenges, the iterative nature of the evaluation meant that concerns were discussed, responded to, and overcome as the pilot developed. Clinical stakeholders' perception of benefits for service users encouraged their acceptance. Moreover, the evaluation established that fetal ultrasound telemedicine is a viable method to access expertise safely and remotely. It provided demonstrable evidence of a potential solution to some of the healthcare challenges facing rural hospitals.
我们展示了对胎儿远程医疗服务的一线临床医生和服务使用者进行访谈的定性研究结果。
作为服务评估的一部分，对临床利益相关者和服务使用者进行了半结构化访谈。数据收集由不同团队进行，使用与独立评估目标一致的访谈提纲。对数据进行了主题分析。
超声医师报告了四个主要挑战：进行共享会诊；需要抑制直观扫描的冲动；扫描过程中的沟通；以及空间受限。尽管如此，所有临床医生都报告称参与的女性接受这项技术。服务使用者表示担忧较少。胎儿远程医疗的主要益处被确定为工作人员技能提升、获得专家支持的机会增加以及复杂妊娠管理的改善。服务使用者将便利性确定为主要益处，包括无需出行、请假和安排 childcare 所节省的时间和金钱。
服务使用者和临床利益相关者接受这项服务。服务使用者对会诊期间的沟通表示满意，并意识到远程医疗促进了在当地获得临床专业知识。虽然临床利益相关者报告了挑战，但评估的迭代性质意味着随着试点的开展，相关问题得到了讨论、回应和克服。临床利益相关者对服务使用者益处的认知促使他们接受这项服务。此外，评估确定胎儿超声远程医疗是一种安全、远程获取专业知识的可行方法。它为农村医院面临的一些医疗保健挑战提供了潜在解决方案的可证明证据。
