Berry Carolyn A, Kwok Lorraine, Gofine Miriam, Kaufman Matthew, Williams Debra A, Terlizzi Kelly, Alvaro Mike, Neighbors Charles J
Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.
StationMD, Maplewood, New Jersey, USA.
Telemed Rep. 2023 Jul 31;4(1):204-214. doi: 10.1089/tmr.2023.0024. eCollection 2023.
Non-emergent medical problems that arise when a usual provider is unavailable can often result in emergency department or urgent care visits, which can be particularly distressing to people with intellectual and developmental disabilities (PIDD). On-demand, synchronous telemedicine may be a promising supplement when immediate care from usual sources is unavailable. Prior research demonstrated that high-quality telemedicine can be effectively delivered to PIDD. The aim of this article is to describe the utilization and staff perspectives on the implementation of the Telemedicine Triage Project (TTP), an innovative model that provides telemedicine consultations for PIDD who reside in state-certified group residences and present with an urgent but non-emergent medical concern when their usual provider is unavailable.
Call frequency data for calendar years 2020 and 2021 were reviewed. The study team conducted semi-structured interviews, with 19 key informants representing organizational- and agency-level leadership and staff. The interview data were analyzed using a protocol-driven, rapid qualitative methodology.
Telemedicine consultations increased from 7953 in 2020 to 15,011 calls in 2021, and call volume peaked between 10 am and 1 pm. Key informants reported high satisfaction with TTP; universal benefits and a few barriers to implementation; and strong interest in maintaining the program beyond the grant period.
Over the first 2 years of its implementation, the TTP program was widely utilized and proved extremely feasible and acceptable to staff. This model is a promising and highly feasible way to provide equitable access to telemedicine for PIDD by addressing barriers to and disparities in access to health care that affect PIDD.
当常规医疗服务提供者无法提供服务时出现的非紧急医疗问题，往往会导致患者前往急诊科或紧急护理机构就诊，这对智力和发育障碍患者（PIDD）来说可能会特别痛苦。当无法从常规渠道获得即时护理时，按需同步远程医疗可能是一种有前景的补充方式。先前的研究表明，可以有效地为PIDD提供高质量的远程医疗服务。本文的目的是描述远程医疗分诊项目（TTP）的实施情况、使用情况以及工作人员的看法，该项目是一种创新模式，为居住在州认证集体住所中的PIDD提供远程医疗咨询服务，当他们的常规医疗服务提供者无法提供服务时，这些患者出现了紧急但非急诊的医疗问题。
回顾了2020年和2021年历年的呼叫频率数据。研究团队对19名关键信息提供者进行了半结构化访谈，这些信息提供者代表组织和机构层面的领导及工作人员。使用协议驱动的快速定性方法对访谈数据进行了分析。
远程医疗咨询从2020年的7953次增加到2021年的15011次呼叫，呼叫量在上午10点至下午1点之间达到峰值。关键信息提供者对TTP表示高度满意；普遍认为该项目有好处，但也存在一些实施障碍；并且强烈希望在拨款期结束后继续维持该项目。
在实施的头两年里，TTP项目得到了广泛应用，并被证明对工作人员来说极其可行且可接受。这种模式是一种有前景且高度可行的方式，通过解决影响PIDD获得医疗服务的障碍和差异，为PIDD提供公平的远程医疗服务。
