Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
New York City Health+Hospitals, New York, NY, USA.
J Telemed Telecare. 2024 Aug;30(7):1190-1201. doi: 10.1177/1357633X221131220. Epub 2022 Oct 12.
COVID-19 forced health systems to rapidly implement telehealth for routine practice, often without sufficient training or standards. We conducted a longitudinal survey of physicians to explore changes in their perceptions of the challenges and benefits of telehealth and identify recommendations for future practice.
An anonymous online survey was distributed to a cohort of internal medicine physicians in May to June 2020 and March to June 2021. Changes in responses between 2020 and 2021 and by site (private vs. public) were described. These findings, along with those of a thematic analysis of open-ended responses to questions on telehealth experiences, informed a set of recommendations.
The survey response rate was 111/391 in 2021 compared to 122/378 in 2020. Fewer physicians reported that telehealth was more difficult than in person with regards to taking a history (49% in 2020, 33% in 2021, = 0.015), maximizing patient adherence (33% in 2020, 19% in 2021, = 0.028), and maintaining patient relationships (31%, 25%, = 0.009) in 2021. Similar proportions of physicians reported continued challenges with building new patient relationships (75%, 77%, = 0.075), educating patients (40%, 32%, = 0.393), and working collaboratively with their team (38%, 41%, = 0.794). Physicians reported increased satisfaction with tele-visits over in-person visits (13%, 27%, = 0.006) and less worry over doing future tele-visits (45%, 31%, = 0.027). Physicians' open-ended responses identified recommendations for further improving the design and use of telehealth.
Results suggest that physician experience with telehealth improved but opportunities for training and improved integration remain. Longitudinal assessment can deepen understanding of the evolution of telehealth care.
COVID-19 迫使医疗系统迅速将远程医疗应用于常规实践，而通常缺乏足够的培训或标准。我们对医生进行了一项纵向调查，以探讨他们对远程医疗挑战和益处的看法的变化，并确定未来实践的建议。
2020 年 5 月至 6 月和 2021 年 3 月至 6 月期间，向一组内科医生分发了匿名在线调查。描述了 2020 年至 2021 年期间以及不同地点（私人与公共）之间的回答变化。这些发现，以及对远程医疗体验问题的开放式回答的主题分析结果，为一套建议提供了信息。
2021 年的调查回复率为 111/391，而 2020 年为 122/378。与面对面相比，较少的医生报告远程医疗在获取病史（2020 年为 49%，2021 年为 33%，=0.015）、最大限度提高患者依从性（2020 年为 33%，2021 年为 19%，=0.028）和维持患者关系（31%，25%，=0.009）方面更加困难。报告继续面临建立新患者关系（75%，77%，=0.075）、教育患者（40%，32%，=0.393）和与团队合作（38%，41%，=0.794）挑战的医生比例相似。与面对面就诊相比，医生报告对远程就诊的满意度增加（13%，27%，=0.006），对未来远程就诊的担忧减少（45%，31%，=0.027）。医生的开放式回答确定了进一步改进远程医疗设计和使用的建议。
结果表明，医生远程医疗的经验有所改善，但培训和改进整合的机会仍然存在。纵向评估可以加深对远程医疗护理演变的理解。
