Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, Health Sciences, La Trobe University, Melbourne, Victoria, Australia.
IIMPACT in Health, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
PLoS One. 2024 Oct 24;19(10):e0309194. doi: 10.1371/journal.pone.0309194. eCollection 2024.
Innovative models of healthcare, such as telehealth, are required to meet the growing demand for orthotic/prosthetic (O&P) services. While O&P users report being very satisfied with telehealth, many clinical facilities have reverted to in-person modes of care as COVID-19 restrictions have eased. As such, there is a disconnect between benefits of telehealth to O&P users, and the clinical services being delivered in-person. The aim of this study was to explore the orthotist/prosthetist's perspective of the barriers and facilitators influencing use of telehealth in the United States of America (USA). O&P practitioners were recruited from across the USA. In-depth, semi-structured interviews were used to document practitioner demographics, the services being provided using telehealth, and practitioners' perspective of the barriers and facilitators influencing use of telehealth. Data describing participant demographics and services were summarised. Interviews were transcribed verbatim and analysed using thematic analysis. 30 practitioners from across the USA participated. Telehealth was used to deliver a range of O&P services including: initial evaluations, routine follow-ups, and delivery of a device in rare circumstances. Barriers to using telehealth included: poor phone/internet connection and lack of access to technology. Facilitators to using telehealth included: a patient-focussed attitude, and recognition of the benefit of telehealth. Telehealth is being used across the entire spectrum of O&P care. Once the significant barriers were resolved, like access to reliable internet/phone reception, telehealth was feasible. An outstanding telehealth experience was facilitated by practitioners who focused on the benefits that telehealth can provide (not the limitations), as well as giving O&P users agency over the choice to use telehealth. There are opportunities to improve access to safe and effective O&P telehealth services by adopting a right-touch approach to practitioner regulation, and advocating for reimbursement that supports better systems and procedures within clinical facilities.
创新的医疗模式，如远程医疗，是满足日益增长的矫形/假肢 (O&P) 服务需求所必需的。虽然 O&P 用户报告对远程医疗非常满意，但随着 COVID-19 限制的放宽，许多临床机构已经恢复了面对面的护理模式。因此，远程医疗给 O&P 用户带来的好处与临床服务的实际情况之间存在脱节。本研究旨在探讨美国 (USA) 矫形/假肢技师对影响远程医疗使用的障碍和促进因素的看法。从美国各地招募了 O&P 从业者。使用深入的半结构化访谈记录从业者的人口统计学特征、使用远程医疗提供的服务以及从业者对影响远程医疗使用的障碍和促进因素的看法。描述参与者人口统计学特征和服务的数据进行了总结。访谈逐字转录并进行主题分析。来自美国各地的 30 名从业者参加了研究。远程医疗用于提供各种 O&P 服务，包括：初步评估、常规随访以及在极少数情况下交付设备。使用远程医疗的障碍包括：电话/互联网连接不良和缺乏技术访问。使用远程医疗的促进因素包括：以患者为中心的态度以及对远程医疗益处的认识。远程医疗正在整个 O&P 护理范围内使用。一旦解决了重大障碍，例如可靠的互联网/电话接收访问，远程医疗就变得可行了。经验丰富的从业者专注于远程医疗可以提供的好处（而不是局限性），以及让 O&P 用户自主选择使用远程医疗，这为远程医疗体验增色不少。通过采取对从业者监管的适度方法，并倡导支持临床机构内更好的系统和程序的报销，有机会改善安全有效的 O&P 远程医疗服务的获取。
