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虚拟医疗保健的采用——学术基层医疗从业者视角下的挑战与机遇。

Virtual Care Adoption-Challenges and Opportunities From the Lens of Academic Primary Care Practitioners.

机构信息

Department of Medicine (Dr Teng), Population Health Research Institute (Ms Kanuch and Dr Caron), The MetroHealth System (Ms Russo), Case Western Reserve University School of Medicine, Cleveland, Ohio.

出版信息

J Public Health Manag Pract. 2022;28(6):599-602. doi: 10.1097/PHH.0000000000001548. Epub 2022 Aug 27.

Abstract

Telehealth and virtual care quickly became important tools in caring for patients while the COVID-19 pandemic evolved. Telehealth implementation can increase affordability for patients, eliminate access barriers, and improve patient satisfaction. Multiple challenges to successful telehealth implementation have been documented in the literature and are generally categorized as structural barriers of the health system, clinical barriers of the provider, and patient-centered barriers. In this study, we sought to collect themes and observations about this rapid transition to telehealth from practicing primary care clinicians, with the goal of identifying opportunities to improve adoption of telehealth. Themes reported in this article emerged from physician and physician assistant fellows of 2 HRSA-funded grants: (1) Primary Care Training and Enhancement (PCTE) and (2) Primary Care Training and Enhancement Training Primary Care Champions (Champions). The PCTE participants consisted of 8 providers from The MetroHealth System (MHS). The Champions participants consisted of 20 providers from MHS and Federally Qualified Health Centers in Northeast Ohio and Michigan. Participants identified 5 major themes that affected telehealth delivery in an academic medical system: reimbursement and productivity; social determinants of health; privacy and environment of care concerns; teaching; and communication skills. Examples within each theme are provided along with an identified improvement opportunity. As we create solutions to address these challenges, our hope is to pool our experience with others so that we can collectively learn how to best evolve and improve the telehealth experience for all.

摘要

远程医疗和虚拟护理在 COVID-19 大流行期间迅速成为照顾患者的重要工具。远程医疗的实施可以提高患者的负担能力,消除获得医疗服务的障碍,并提高患者的满意度。文献中记录了许多成功实施远程医疗的挑战,这些挑战通常可分为卫生系统的结构性障碍、提供者的临床障碍和以患者为中心的障碍。在这项研究中,我们试图从执业初级保健临床医生那里收集关于这种向远程医疗快速过渡的主题和观察结果,目的是确定改善远程医疗采用的机会。本文报道的主题来自 2 项 HRSA 资助的赠款的医师和医师助理研究员:(1)初级保健培训和增强(PCTE)和(2)初级保健培训和增强培训初级保健冠军(Champions)。PCTE 参与者包括来自 MetroHealth 系统(MHS)的 8 名提供者。冠军参与者包括来自 MHS 和俄亥俄州东北部和密歇根州的联邦合格医疗中心的 20 名提供者。参与者确定了影响学术医疗系统中远程医疗服务的 5 个主要主题:报销和生产力;健康的社会决定因素;隐私和护理环境问题;教学;和沟通技巧。每个主题都提供了示例,并确定了一个改进机会。在我们提出解决方案来应对这些挑战的同时,我们希望与他人分享我们的经验,以便我们能够共同学习如何最好地为所有人改进远程医疗体验。

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