Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Department of Health Policy and Management, Fielding School of Public Health at UCLA, Los Angeles, California, USA.
BMC Health Serv Res. 2023 Feb 15;23(1):156. doi: 10.1186/s12913-023-09107-1.
The SARS-CoV-2 pandemic has resulted in an increase in telemedicine utilization for routine HIV care. However, there is limited information on perceptions of and experiences with telemedicine from United States (U.S.) federally qualified health centers (FQHCs) offering HIV care. We sought to understand telemedicine experiences of stakeholders with various roles: people living with HIV (PLHIV), clinical (clinicians and case managers), programmatic (clinic administrators), and policy (policymakers).
Qualitative interviews about benefits and challenges of telemedicine (telephone and video) for HIV care were conducted with 31 PLHIV and 23 other stakeholders (clinicians, case managers, clinic administrators, and policymakers). Interviews were transcribed, translated to English if conducted in Spanish, coded, and analyzed for major themes.
Almost all PLHIV felt capable of engaging in telephone visits, with some expressing interest in learning how to use video visits as well. Nearly all PLHIV wanted to continue telemedicine as part of their routine HIV care, and this was also endorsed by clinical, programmatic and policy stakeholders. Interviewees agreed that telemedicine for HIV care has benefits for PLHIV, especially savings of time and transportation costs, which also reduced stress. Clinical, programmatic, and policy stakeholders expressed concerns around patients' technological literacy and resources, as well as their access to privacy, and some felt that PLHIV strongly preferred in-person visits. These stakeholders also commonly reported clinic-level implementation challenges, including integrating telephone and video telemedicine into workflows and difficulty with video visit platforms.
Telemedicine for HIV care, largely delivered via telephone (audio-only), was highly acceptable and feasible for both PLHIV, clinicians, and other stakeholders. Addressing barriers for stakeholders in incorporating video visits will be important for the successful implementation of telemedicine with video as part of routine HIV care at FQHCs.
SARS-CoV-2 大流行导致常规 HIV 护理中远程医疗的使用有所增加。然而，对于提供 HIV 护理的美国（美国）联邦合格健康中心（FQHC），关于远程医疗的看法和经验的信息有限。我们试图了解具有不同角色的利益相关者的远程医疗体验：艾滋病毒感染者（PLHIV）、临床医生（临床医生和个案经理）、项目（诊所管理人员）和政策（政策制定者）。
对 31 名 PLHIV 和 23 名其他利益相关者（临床医生、个案经理、诊所管理人员和政策制定者）进行了有关 HIV 护理中远程医疗（电话和视频）的益处和挑战的定性访谈。对访谈进行了转录，如果是用西班牙语进行的访谈，则翻译成英文，进行编码，并分析主要主题。
几乎所有 PLHIV 都认为自己能够进行电话访问，有些还表示有兴趣学习如何使用视频访问。几乎所有 PLHIV 都希望继续将远程医疗作为其常规 HIV 护理的一部分，临床、项目和政策利益相关者也表示赞同。受访者一致认为，远程医疗对 HIV 护理有好处，特别是节省时间和交通成本，这也减轻了压力。临床、项目和政策利益相关者对患者的技术素养和资源、隐私获取以及一些人认为 PLHIV 强烈偏好面对面访问表示关注。这些利益相关者还普遍报告了诊所层面的实施挑战，包括将电话和视频远程医疗纳入工作流程以及视频访问平台的困难。
艾滋病毒护理的远程医疗主要通过电话（仅音频）提供，对 PLHIV、临床医生和其他利益相关者来说都是高度可接受和可行的。解决利益相关者在纳入视频访问方面的障碍对于成功实施远程医疗以将视频作为 FQHC 常规 HIV 护理的一部分将非常重要。
