van Eijk Jorna, Trappenburg Jaap, Asselbergs Folkert W, Jaarsma Tiny
Julius Center for Health Sciences and Primary Care, Department General Practice and Nursing Science, University Medical Center Utrecht, Utrecht, the Netherlands.
The Healthcare Innovation Center, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Digit Health. 2024 Aug 28;10:20552076241272570. doi: 10.1177/20552076241272570. eCollection 2024 Jan-Dec.
To describe the experiences of healthcare professionals with integrating telemedicine in routine heart failure (HF) care.
Semi-structured interviews were conducted with healthcare professionals ( = 19) in the Netherlands who were involved in decision-making, implementation or routine use of telemedicine in HF management. Using purposive sampling, nurses, cardiologists and managers were selected to be interviewed. Interviews were performed in-person, recorded and transcribed verbatim. Interview data were analysed using a reflexive thematic analysis.
This study identified four themes: (1) Responsibility - the lack of a clear delineation of roles and responsibilities among healthcare professionals, patients and suppliers in telemedicine. (2) Confidence and safety - telemedicine is seen by healthcare professionals as capable of enhancing safety, yet also introduces the risk of fostering a false sense of security among patients. (3) Collaboration - actively involving end-users in the development and implementation of telemedicine promotes the adoption. (4) Processes and mutual agreements - rather than replacing traditional care, telemedicine is perceived as an adjunct to it. Structured care pathways support telemedicine implementation, and personalised telemedicine can empower patients in self-care.
Telemedicine is a promising intervention in the management of HF. However, existing systems and care pathways have resulted in limited adoption. Improvements in the collaboration and establishing clear agreements on responsibilities between professional, patient and supplier can lead to more confidence in adopting telemedicine. Structured care pathways can be supportive. A personalised telemedicine approach can ensure that telemedicine remains manageable for patient and professional.
描述医疗保健专业人员在将远程医疗整合到常规心力衰竭（HF）护理中的经历。
对荷兰参与心力衰竭管理中远程医疗决策、实施或常规使用的医疗保健专业人员（n = 19）进行了半结构化访谈。采用目的抽样法，选取护士、心脏病专家和管理人员进行访谈。访谈采用面对面的方式进行，录音并逐字转录。访谈数据采用反思性主题分析法进行分析。
本研究确定了四个主题：（1）责任——在远程医疗中，医疗保健专业人员、患者和供应商之间缺乏明确的角色和责任划分。（2）信心与安全——医疗保健专业人员认为远程医疗能够提高安全性，但也带来了在患者中培养错误安全感的风险。（3）协作——让最终用户积极参与远程医疗的开发和实施可促进其采用。（4）流程与相互协议——远程医疗被视为传统护理的辅助手段，而非取代传统护理。结构化护理路径支持远程医疗的实施，个性化远程医疗可增强患者的自我护理能力。
远程医疗在心力衰竭管理中是一种有前景的干预措施。然而，现有系统和护理路径导致其采用率有限。改善协作并在专业人员、患者和供应商之间就责任达成明确协议，可增强对采用远程医疗的信心。结构化护理路径可提供支持。个性化远程医疗方法可确保远程医疗对患者和专业人员来说仍然易于管理。
