Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, 1513 University Ave., WI, 53706, Madison, USA.
Center for Alcohol and Addictions Studies, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA.
BMC Health Serv Res. 2022 Jun 13;22(1):775. doi: 10.1186/s12913-022-08114-y.
Due to the COVID-19 pandemic, healthcare providers were forced to shift many services quickly from in-person to virtual, including substance use disorder (SUD) and mental health (MH) treatment services. This led to a sharp increase in telehealth services, with health systems seeing patients virtually at hundreds of times the rate as before the onset of the COVID-19 pandemic. By analyzing qualitative data about SUD and MH care organizations' experiences using telehealth, this study aims to elucidate emergent themes related to telehealth use by the front-line behavioral health workforce.
This study uses qualitative data from large-scale web surveys distributed to SUD and MH organizations between May and August 2020. At the end of these surveys, the following question was posed in free-response form: "Is there anything else you would like to say about use of telehealth during or after the COVID-19 pandemic?" Respondents were asked to answer on behalf of their organizations. The 391 responses to this question were analyzed for emergent themes using a conventional approach to content analysis.
Three major themes emerged: COVID-specific experiences with telehealth, general experiences with telehealth, and recommendations to continue telehealth delivery. Convenience, access to new populations, and lack of commute were frequently cited advantages of telehealth, while perceived ineffectiveness of and limited access to technology were frequently cited disadvantages. Also commonly mentioned was the relaxation of reimbursement regulations. Respondents supported continuation of relaxed regulations, increased institutional support, and using a combination of telehealth and in-person care in their practices.
This study advanced our knowledge of how the behavioral health workforce experiences telehealth delivery. Further longitudinal research comparing treatment outcomes of those receiving in-person and virtual services will be necessary to undergird organizations' financial support, and perhaps also legislative support, for virtual SUD and MH services.
由于 COVID-19 大流行，医疗保健提供者被迫迅速将许多服务从面对面转移到虚拟，包括物质使用障碍 (SUD) 和心理健康 (MH) 治疗服务。这导致远程医疗服务急剧增加，卫生系统以 COVID-19 大流行前的数百倍的速度虚拟治疗患者。通过分析关于 SUD 和 MH 护理组织使用远程医疗的经验的定性数据，本研究旨在阐明与一线行为健康劳动力使用远程医疗相关的新兴主题。
本研究使用了 2020 年 5 月至 8 月期间向 SUD 和 MH 组织分发的大规模网络调查的定性数据。在这些调查结束时，以自由回答的形式提出了以下问题：“在 COVID-19 大流行期间或之后，您是否还有其他关于使用远程医疗的信息？”要求受访者代表其组织回答。对这一问题的 391 个回复进行了主题分析，采用了内容分析的传统方法。
出现了三个主要主题：与远程医疗相关的 COVID 特定经验、一般的远程医疗经验以及继续远程医疗的建议。便利性、新人群的可及性以及减少通勤是远程医疗的常见优势，而技术的感知效果不佳和有限的可及性则是常见的劣势。报销法规的放宽也经常被提及。受访者支持继续放宽法规、增加机构支持以及在实践中结合使用远程医疗和面对面护理。
本研究提高了我们对行为健康劳动力体验远程医疗的理解。进一步的纵向研究比较接受面对面和虚拟服务的治疗效果，将有必要为虚拟 SUD 和 MH 服务提供组织的财务支持，也许还需要立法支持。
