Burton Lindsay, Rush Kathy L, Smith Mindy A, Görges Matthias, Currie Leanne M, Davis Selena, Mattei Mona, Ellis Jennifer
School of Nursing, University of British Columbia-Okanagan, Kelowna, BC, Canada.
Patient Voices Network, Vancouver, BC, Canada.
Health Serv Insights. 2022 May 17;15:11786329221096033. doi: 10.1177/11786329221096033. eCollection 2022.
We investigated the uptake and perceptions of virtual care solutions by rural Canadian primary and specialist providers during the early phase (May-June 2020) of the COVID-19 pandemic. A web-based, cross-sectional survey of rural primary and specialty care providers examined types of virtual care platforms used (eg, phone, video), appointment length, experience and satisfaction with the solution used, plans for future use of virtual care, and patients' use of virtual care services. Targeted participants were actively-practicing providers in rural Western Canada who were emailed an invitation for the study and its survey link. Fifty-nine providers (26% response rate) completed the survey. During the pandemic, 78% of providers reported using virtual care for more than 60% of their appointments, while only 3% did so frequently pre-pandemic. Most providers used phone consultations, despite believing that video provided a better virtual visit. Key barriers included workflow interruptions, unique concerns about quality of care, remuneration and sustainability, or poor internet access and bandwidth for both providers and patients. The key opportunity noted was improved access to care. While most virtual care visits were not conducted using video technologies, overall virtual care resulted in high provider satisfaction, while not increasing workload. Virtual care will continue to play an important role in future rural care practice; however, sustainability will require both provider-level and system-level changes.
我们调查了加拿大农村地区的初级和专科医疗服务提供者在2019冠状病毒病大流行早期阶段（2020年5月至6月）对虚拟医疗解决方案的接受情况和看法。一项针对农村初级和专科医疗服务提供者的基于网络的横断面调查，考察了所使用的虚拟医疗平台类型（如电话、视频）、预约时长、对所使用解决方案的体验和满意度、虚拟医疗未来使用计划以及患者对虚拟医疗服务的使用情况。目标参与者是加拿大西部农村地区的在职医疗服务提供者，他们通过电子邮件收到了研究邀请及其调查链接。59名提供者（回复率26%）完成了调查。在大流行期间，78%的提供者报告称其超过60%的预约采用了虚拟医疗，而在大流行前只有3%的提供者经常这样做。尽管大多数提供者认为视频能提供更好的虚拟就诊体验，但他们大多还是采用电话咨询。主要障碍包括工作流程中断、对医疗质量、薪酬和可持续性的独特担忧，以及提供者和患者的网络接入和带宽不足。所指出的关键机遇是改善医疗服务的可及性。虽然大多数虚拟医疗就诊并非使用视频技术进行，但总体而言，虚拟医疗使提供者满意度较高，且并未增加工作量。虚拟医疗将在未来农村医疗实践中继续发挥重要作用；然而，其可持续性需要提供者层面和系统层面的变革。
