Meese Katherine A, Hall Allyson G, Feldman Sue S, Colón-López Alejandra, Rogers David A, Singh Jasvinder A
Department of Health Services Administration, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
UAB Medicine Office of Wellness, Birmingham, Alabama, USA.
Telemed Rep. 2022 Jan 10;3(1):7-14. doi: 10.1089/tmr.2021.0034. eCollection 2022.
Many health systems transitioned rapidly to using inpatient and outpatient telemedicine during the COVID-19 pandemic. Prior research has examined clinician satisfaction and experiences with telemedicine in a siloed approach for specific provider types. Less is known about how experiences with the rapid transition to telemedicine affected the entire clinical team, and how this contributed to their overall distress. A survey was conducted within a large academic medical center in the Southeastern United States during June of 2020. The survey asked about experiences with inpatient and outpatient telemedicine and overall distress. Analysis of variance was calculated to examine differences in experiences among physicians, nurses, and advanced practice providers (APPs) with both inpatient and outpatient telemedicine. Multivariate regression analysis was conducted to determine whether reported telemedicine stressors were associated with changes in overall distress scores. Qualitative comments provided during the survey were included to illustrate the quantitative findings. Of the 1130 survey respondents, 237 indicated that they used telemedicine. Telemedicine use was not statistically significantly associated with overall distress scores. The APPs indicated the greatest satisfaction with telemedicine, followed by physicians and then nurses. Team members differed on their perceptions of quality of care and safety for inpatient and outpatient telemedicine. Physicians (70%) and APPs (64%) felt safer having the option to use inpatient telemedicine, whereas only 26% of nurses reported the same. Overall, >70% of physicians and APPs would like to continue having the option to use inpatient and outpatient telemedicine in the future, whereas <50% of nurses reported the same. These results suggest that telemedicine holds promise for providing care beyond the pandemic, and it may be a mechanism to improve flexibility, autonomy, and expand patient access. Implementation of new technologies must consider the experiences of the entire team, rather than a siloed approach to determining satisfaction with the changes.
在新冠疫情期间，许多医疗系统迅速转向使用住院和门诊远程医疗。先前的研究以孤立的方式考察了特定医疗服务提供者类型的临床医生对远程医疗的满意度和体验。对于向远程医疗的快速转变如何影响整个临床团队，以及这如何导致他们的整体困扰，人们了解得较少。2020年6月在美国东南部的一家大型学术医疗中心进行了一项调查。该调查询问了住院和门诊远程医疗的体验以及整体困扰情况。计算方差分析以检验医生、护士和高级实践提供者（APP）在住院和门诊远程医疗体验方面的差异。进行多变量回归分析以确定报告的远程医疗压力源是否与整体困扰评分的变化相关。调查期间提供的定性评论被纳入以阐明定量结果。在1130名调查受访者中，237人表示他们使用了远程医疗。远程医疗的使用与整体困扰评分在统计学上无显著关联。APP对远程医疗的满意度最高，其次是医生，然后是护士。团队成员对住院和门诊远程医疗的护理质量和安全性的看法存在差异。70%的医生和64%的APP认为可以选择使用住院远程医疗会更安全，而只有26%的护士有同样的看法。总体而言，超过70%的医生和APP希望未来继续能够选择使用住院和门诊远程医疗，而只有不到50%的护士有同样的表示。这些结果表明，远程医疗有望在疫情之后继续提供医疗服务，并且它可能是一种提高灵活性、自主性和扩大患者就医机会的机制。新技术的实施必须考虑整个团队的体验，而不是采用孤立的方法来确定对这些变化的满意度。
