Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Post office box 235, 3603, Kongsberg, Norway.
BMC Health Serv Res. 2022 Aug 13;22(1):1036. doi: 10.1186/s12913-022-08428-x.
Acute ischemic stroke requires early medical imaging with a computed tomography (CT) scan and immediate thrombolysis treatment. In rural areas, the long distance to the nearest hospital reduce the patients' probability of receiving medical assistance within the 4.5-h period. The aim of this study was to assess how the service was set-up, and how managers and personnel experience the organisation and value of a rural telemedicine, remote controlled CT stroke service.
Ten semi-structured individual interviews and one semi-structured focus group interview were conducted. The sample included 15 participants involved in the telemedicine service in Hallingdal, Norway. The interview guide consisted of questions on the service, experience of working with the service, value and quality, management, and challenges. Interviews were recorded and transcribed verbatim. Thematic content analysis was used to develop a narrative of the findings.
Findings were categorised into three main categories; value of the service, organisation of the project, and from project to permanent service. Participants perceived the service to be valuable for patients and the local community. The service included task shifting from radiographers and junior doctors to the local paramedics. To enable long- term operation of the service the participants suggested management, coordination, and continuous training as important factors.
The service was perceived as valuable to the local community, providing a sense of healthcare security and equitability. Management's involvement, flexibility, and coordination appears to be a key factor for successful implementation and long-term sustainability of the service.
急性缺血性脑卒中需要进行早期的计算机断层扫描（CT）影像学检查，并立即进行溶栓治疗。在农村地区，由于到最近医院的距离较远，患者在 4.5 小时内获得医疗救助的概率降低。本研究旨在评估服务的设置情况，以及管理人员和人员如何体验农村远程医疗、远程控制 CT 脑卒中服务的组织和价值。
对挪威哈灵达尔的远程医疗服务进行了 10 次半结构化个人访谈和 1 次半结构化焦点小组访谈。样本包括参与远程医疗服务的 15 名参与者。访谈指南包括有关服务、与服务合作的经验、价值和质量、管理和挑战的问题。访谈进行了录音和逐字记录。使用主题内容分析来发展发现的叙述。
研究结果分为三个主要类别：服务的价值、项目的组织以及从项目到永久服务。参与者认为该服务对患者和当地社区具有价值。该服务包括将任务从放射技师和初级医生转移到当地护理人员。为了实现服务的长期运行，参与者建议管理、协调和持续培训是重要因素。
该服务被认为对当地社区具有价值，为当地社区提供了一种医疗保健安全和平等的感觉。管理层的参与、灵活性和协调似乎是成功实施和长期可持续性服务的关键因素。
