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远程医疗中的价值共创:意大利一家儿科医院关于儿科医生对远程家庭护理实施期望的定性研究

Value Co-Creation in Telemedicine: A Qualitative Study of Pediatricians' Expectations Regarding Telehomecare Implementation in an Italian Pediatric Hospital.

作者信息

Bernuzzi Chiara, Piccardo Maria Adele, Marsilio Marta, Calcaterra Valeria, Zuccotti Gianvincenzo, Guglielmetti Chiara

机构信息

Department of Economics, Management and Quantitative Methods (DEMM), University of Milan, Milan, 20122, Italy.

Department of Biomedical and Clinical Science, University of Milan, Milan, 20157, Italy.

出版信息

J Healthc Leadersh. 2024 Nov 14;16:485-500. doi: 10.2147/JHL.S467155. eCollection 2024.

Abstract

PURPOSE

The widespread adoption of telemedicine tools poses new and little-known challenges for healthcare professionals, who are required to adapt their knowledge, skills, and work practices to this innovative scenario. Understanding healthcare professionals' expectations and concerns about adopting telemedicine can facilitate its effective integration. Therefore, drawing upon the Value Co-Creation in Healthcare model, the current study aims to investigate pediatricians' expectations regarding antecedents, outcomes, and management activities relevant to the implementation of a telehomecare service.

METHODS

Interviews invitations were sent to all pediatricians (n=13) involved in a pilot study using the TytoCare device, a telehomecare tool that enables remote medical examinations, at an Italian pediatric hospital. All invited pediatricians agreed to participate. The semi-structured interviews, each lasting approximately 30 to 45 minutes, were conducted remotely via Microsoft Teams prior to the use of the TytoCare device. All interviews were recorded and transcribed verbatim. The content was subsequently analyzed through thematic analysis using MAXQDA software.

RESULTS

Five overarching thematic areas emerged from the interviews: factors influencing the adoption of the telehomecare device, advantages of its use, impacts on work practices, changes in the patient-professional relationship, and management activities. While concerns exist about the adequacy of telehomecare compared to in-person visits, the device offers potential benefits, such as improving the hospital experience for children by shortening hospital stays. However, it may lead to an increased workload and necessitate stronger trust and communication in remote care. Successful integration requires dedicated support staff, regulatory adjustments, and effective leadership, with active involvement of healthcare professionals in decision-making.

CONCLUSION

By shedding light on healthcare professionals' expectations about telehomecare device, this study provides useful insights to healthcare leaders to tailor interventions to accompany technology within care practices to valorize its benefits and promote value co-creation processes.

摘要

目的

远程医疗工具的广泛应用给医疗保健专业人员带来了新的、鲜为人知的挑战,他们需要使自己的知识、技能和工作实践适应这种创新场景。了解医疗保健专业人员对采用远程医疗的期望和担忧有助于其有效整合。因此,本研究借鉴医疗保健领域价值共创模型,旨在调查儿科医生对与远程家庭护理服务实施相关的前因、结果和管理活动的期望。

方法

向意大利一家儿科医院参与使用TytoCare设备(一种能够进行远程医疗检查的远程家庭护理工具)的试点研究的所有儿科医生(n = 13)发送访谈邀请。所有受邀儿科医生均同意参与。在使用TytoCare设备之前,通过Microsoft Teams远程进行了半结构化访谈,每次访谈持续约30至45分钟。所有访谈均进行了录音并逐字转录。随后使用MAXQDA软件通过主题分析对内容进行了分析。

结果

访谈中出现了五个总体主题领域:影响远程家庭护理设备采用的因素、其使用的优势、对工作实践的影响、医患关系的变化以及管理活动。虽然有人担心远程家庭护理与面对面就诊相比是否足够,但该设备提供了潜在的好处,例如通过缩短住院时间改善儿童的住院体验。然而,这可能会导致工作量增加,并且在远程护理中需要更强的信任和沟通。成功整合需要有专门的支持人员、监管调整和有效的领导,医疗保健专业人员要积极参与决策。

结论

通过揭示医疗保健专业人员对远程家庭护理设备的期望,本研究为医疗保健领导者提供了有用的见解,以便他们调整干预措施,在护理实践中配合技术应用,以实现其益处并促进价值共创过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/383a/11574288/a28111f3dcf8/JHL-16-485-g0001.jpg

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