Department of Population Health Sciences, Weill Cornell Medicine.
New York University Grossman School of Medicine, New York, NY.
Med Care. 2023 Apr 1;61(Suppl 1):S83-S88. doi: 10.1097/MLR.0000000000001808. Epub 2023 Mar 9.
The COVID-19 pandemic has necessitated a rapid uptake of telemedicine in primary care requiring both patients and providers to learn how to navigate care remotely. This change can impact the patient-provider relationship that often defines care, especially in primary care.
This study aims to provide insight into the experiences of patients and providers with telemedicine during the pandemic, and the impact it had on their relationship.
A qualitative study using thematic analysis of semistructured interviews.
Primary care providers (n=21) and adult patients (n=65) with chronic disease across primary care practices in 3 National Patient-centered Clinical Research Network sites in New York City, North Carolina, and Florida.
Experiences with telemedicine during the COVID-19 pandemic in primary care. Codes related to the patient-provider relationship were analyzed for this study.
A recurrent theme was the challenge telemedicine posed on rapport building and alliance. Patients felt that telemedicine affected provider's attentiveness in varying ways, whereas providers appreciated that telemedicine provided unique insight into patients' lives and living situations. Finally, both patients and providers described communication challenges.
Telemedicine has altered structure and process aspects of primary health care such as the physical spaces of encounters, creating a new setting to which both patients and providers must adjust. It is important to recognize the opportunities and limits that this new technology has to help providers maintain the type of one-on-one attention that patients expect and that contributes to relationship building.
COVID-19 大流行促使初级保健中迅速采用远程医疗，这需要患者和医务人员学习如何远程管理医疗。这种变化会影响到通常决定医疗服务的医患关系，尤其是在初级保健中。
本研究旨在深入了解患者和医务人员在大流行期间远程医疗的体验，以及它对医患关系的影响。
采用对来自纽约市、北卡罗来纳州和佛罗里达州的 3 个国家以患者为中心的临床研究网络地点的初级保健实践中的慢性病成年患者（n=65）和初级保健提供者（n=21）的半结构式访谈进行的定性研究和主题分析。
初级保健中 COVID-19 大流行期间远程医疗的体验。针对本研究分析了与医患关系相关的代码。
一个反复出现的主题是远程医疗对建立融洽关系和联盟的挑战。患者认为远程医疗以不同的方式影响提供者的关注度，而提供者则赞赏远程医疗提供了对患者生活和生活环境的独特了解。最后，患者和提供者都描述了沟通方面的挑战。
远程医疗改变了初级保健的结构和流程方面，例如相遇的物理空间，创造了一个新的环境，患者和提供者都必须适应。重要的是要认识到这项新技术的机遇和局限性，以帮助提供者保持患者期望的那种一对一的关注，这有助于建立医患关系。
