Huang Iris, Delay Rebecca, Boulware Angel, McHugh Ashley, Wong Zarina Jaffer, Whitaker Amy K, Stulberg Debra, Hasselbacher Lee
Pritzker School of Medicine, University of Chicago, Chicago, IL, United States.
Ci3, University of Chicago, Chicago, IL, United States.
Contracept X. 2022 Aug 14;4:100083. doi: 10.1016/j.conx.2022.100083. eCollection 2022.
To solicit Illinois staff and clinician perspectives on rapid implementation of telehealth for contraceptive counseling and recommendations to improve and sustain it in the long term.
Researchers recruited and interviewed clinicians ( = 20) in primary care and obstetrics/gynecology clinics across 13 health care systems in Illinois, as well as clinicians ( = 11), leadership ( = 6) and staff ( = 7) from Planned Parenthood of Illinois clinics. Guided by the Consolidated Framework for Implementation Research, we coded and analyzed interview transcripts in Dedoose with a focus on themes regarding steps to improve quality and sustainability of telehealth.
Participants expressed generally positive attitudes towards telehealth, noting that it increased access to care and time for patient education. Still, many highlighted areas of implementation that needed improvement. Clinic operations were complicated by gaps in telehealth training and the logistical needs of balancing telehealth and in-person appointments. Clinics had difficulty ensuring patient awareness of telehealth as an option for care, in addition to deficiencies with the telehealth technology itself. Finally, innovative resources for telehealth patients, while existent, have not been evenly offered across clinics. This includes the use of self-injection birth control, as well as providing medical equipment such as blood pressure cuffs in community settings. Some themes reflect issues specific to contraceptive counseling while others reflect issues with telehealth implementation in general, including confusion about reimbursement.
Illinois contraceptive care providers and staff wish to sustain telehealth for the long term, while also recommending specific improvements to patient communications, clinic operations, and access to supportive resources.
Our study highlights considerations for clinics to optimize implementation of telehealth services for contraceptive care. Providers described the value of clear workflows to balance in-person and telehealth visits, streamlined communications platforms, targeted patient outreach, training on providing virtual contraceptive care, and creative approaches to ensuring patient access to resources.
征求伊利诺伊州工作人员和临床医生对快速实施远程医疗进行避孕咨询的看法，并获取有关长期改进和维持远程医疗的建议。
研究人员招募并采访了伊利诺伊州13个医疗系统中初级保健和妇产科诊所的临床医生（n = 20），以及伊利诺伊州计划生育诊所的临床医生（n = 11）、领导层（n = 6）和工作人员（n = 7）。在实施研究综合框架的指导下，我们在Dedoose中对访谈记录进行编码和分析，重点关注有关提高远程医疗质量和可持续性的步骤的主题。
参与者对远程医疗普遍持积极态度，指出它增加了获得护理的机会和患者教育的时间。尽管如此，许多人强调了需要改进的实施领域。远程医疗培训方面的差距以及平衡远程医疗和面对面预约的后勤需求使诊所运营变得复杂。除了远程医疗技术本身存在缺陷外，诊所难以确保患者知晓远程医疗是一种护理选择。最后，针对远程医疗患者的创新资源虽然存在，但在各诊所之间并未得到均衡提供。这包括使用自我注射避孕药具，以及在社区环境中提供血压袖带等医疗设备。一些主题反映了避孕咨询特有的问题，而其他主题则反映了远程医疗实施的一般问题，包括对报销的困惑。
伊利诺伊州的避孕护理提供者和工作人员希望长期维持远程医疗，同时也建议在患者沟通、诊所运营和获得支持资源方面进行具体改进。
我们的研究突出了诊所优化避孕护理远程医疗服务实施时应考虑的因素。提供者描述了清晰的工作流程对于平衡面对面和远程医疗就诊的价值、简化的通信平台、有针对性的患者宣传、提供虚拟避孕护理的培训以及确保患者获得资源的创新方法。
