Khairat Saif, Chourasia Prabal, Muellers Kimberly A, Andreadis Katerina, Lin Jenny J, Ancker Jessica S
Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
School of Nursing, University of North Carolina at Chapel Hill, North Carolina, USA.
Telemed Rep. 2023 Mar 20;4(1):21-29. doi: 10.1089/tmr.2023.0002. eCollection 2023.
The purpose of this study was to explore telemedicine use and obtain actionable recommendations to improve telemedicine user experience from a diverse group of patients and providers.
We interviewed adult patients and primary care providers (PCPs) across three National Patient-Centered Clinical Research Network (PCORnet) sites in New York City, North Carolina, and Florida. Both patients and providers could participate via phone or videoconferencing; patients could complete the interview in English or Spanish. Spanish interviews were conducted by a member of the research team who spoke Spanish fluently. Interviews were audio-recorded, transcribed verbatim, and when necessary, professionally translated.
We interviewed 21 PCPs and 65 patients between March and October 2021. We found that patients' and providers' perspectives on ways to improve the telemedicine experience focused on three recommendation themes: (1) expectations of care provided via telemedicine, (2) innovations to support usability, and (3) alleviation of physician burden. Key recommendations were related to expectations regarding (1) care provided, for example, adding educational content for the patients, and clarity about long-term payment models; (2) support innovation to improve telemedicine usability, for example, providing patients with remote monitoring devices, integrating in-home testing and nursing evaluation; (3) and reduce physician burden, for example, virtual rooming, reimbursement of time spent outside of the telemedicine encounter.
Primary care patients and providers see merit in telemedicine. However, both groups recommended novel ways to improve the quality of care and user experience. Findings from this article suggest that policymakers would be best served by addressing current gaps in patient digital literacy by creating technical support strategies, and gaps in telemedicine reimbursement to present an equitable form of payment.
本研究旨在探索远程医疗的使用情况,并从不同的患者和医疗服务提供者群体中获取可行的建议,以改善远程医疗用户体验。
我们采访了纽约市、北卡罗来纳州和佛罗里达州三个以患者为中心的国家临床研究网络(PCORnet)站点的成年患者和初级保健提供者(PCP)。患者和提供者都可以通过电话或视频会议参与;患者可以用英语或西班牙语完成访谈。西班牙语访谈由一位能流利说西班牙语的研究团队成员进行。访谈进行了录音,逐字转录,必要时进行专业翻译。
在2021年3月至10月期间,我们采访了21名初级保健提供者和65名患者。我们发现,患者和提供者对改善远程医疗体验的方法的看法集中在三个建议主题上:(1)对通过远程医疗提供的护理的期望;(2)支持可用性的创新;(3)减轻医生负担。关键建议涉及以下方面的期望:(1)提供的护理,例如为患者添加教育内容,以及明确长期支付模式;(2)支持创新以提高远程医疗的可用性,例如为患者提供远程监测设备,整合家庭检测和护理评估;(3)减轻医生负担,例如虚拟预检,报销远程医疗会诊之外花费的时间。
初级保健患者和提供者认为远程医疗有价值。然而,两组都推荐了改善护理质量和用户体验的新方法。本文的研究结果表明,政策制定者最好通过制定技术支持策略来解决患者数字素养方面的当前差距,以及解决远程医疗报销方面的差距,以提供公平的支付形式。