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医疗服务提供者对通过远程医疗为居住在城市社区的艾滋病毒感染者提供医疗服务的看法。

Provider perspectives on healthcare provision via telemedicine to persons with HIV living in an urban community.

作者信息

Grewal Reetu, Jones Ross, Webb Fern, Webster-Bass Selena, Peters Jessica, Smotherman Carmen, Gelaude Deborah

机构信息

University of Florida, College of Medicine, Department of Community Health and Family Medicine, Jacksonville, FL, United States.

University of Florida, College of Medicine, Department of Surgery, Jacksonville, FL, United States.

出版信息

Health Policy Technol. 2024 Jun;13(2). doi: 10.1016/j.hlpt.2024.100853.

Abstract

OBJECTIVES

Engaging in HIV care is key to maintaining successful health outcomes for persons with HIV (PWH). Barriers to care affect engagement and can include access to transportation. Telemedicine has been used to overcome geographical barriers in rural settings, and PWH in urban areas without public transportation can also benefit from this strategy. The aim of this research is to explore the attitudes of providers in one health system about telemedicine after receiving training.

METHODS

From 2018-2020, a convenience sample of 112 providers at University of Florida Health in Jacksonville, FL were offered telemedicine training consisting of didactic, hands-on, and in-person support. Provider attitudes were assessed in pre- and post-training surveys, focus groups, and after telemedicine visits. Descriptive statistics and paired -tests were used to analyze pre- and post-training surveys.

RESULTS

Readiness and willingness to conduct telemedicine with PWH after training significantly increased among providers ( = 73). Providers reported increased readiness to conduct telemedicine visits ( < 0.0001), increased ability to communicate during telemedicine visits ( < 0.001), and increased confidence in troubleshooting technology issues ( < 0.0001). Of the 29 providers completing surveys after conducting telemedicine visits with PWH, 93 % reported that it was easy to access and use. Providers did report a sense of decreased patient-provider interaction via telemedicine.

CONCLUSION

Future research should further explore provider experiences with telemedicine training and delivery to improve telemedicine training and to identify best practices and strategies/activities that promote remote efficient patient-provider interaction.

PUBLIC INTEREST SUMMARY

The use of telemedicine has increased in all areas of health care, especially since the COVID-19 pandemic. Training providers to successfully care for patients in remote settings is essential, especially as technology platforms and capabilities evolve or become more complex. Telemedicine trainings help providers increase capacity to conduct telemedicine visits. Trainings standardize visit protocols, control provider and patient expectations, identify how to incorporate remote visits into routine clinic flows, provide tools for increasing provider competency to interact with patients and use technology features, and increase understanding of types of ongoing support providers require, such as administrative. This paper describes the attitudes of providers from University of Florida Health in Jacksonville, FL receiving training to deliver telemedicine to persons with HIV residing in an urban setting.

摘要

目标

参与艾滋病病毒(HIV)护理是维持HIV感染者(PWH)健康良好结局的关键。护理障碍会影响参与度,其中可能包括交通问题。远程医疗已被用于克服农村地区的地理障碍,而在没有公共交通的城市地区,HIV感染者也可从这一策略中受益。本研究的目的是探讨一个医疗系统中的医护人员在接受培训后对远程医疗的态度。

方法

2018年至2020年,佛罗里达州杰克逊维尔市佛罗里达大学健康中心的112名医护人员组成的便利样本接受了由理论教学、实践操作和现场支持组成的远程医疗培训。在培训前和培训后的调查、焦点小组以及远程医疗问诊后对医护人员的态度进行评估。使用描述性统计和配对检验来分析培训前和培训后的调查结果。

结果

培训后,医护人员对与HIV感染者进行远程医疗的准备度和意愿显著提高(n = 73)。医护人员报告称,进行远程医疗问诊的准备度提高(P < 0.0001),在远程医疗问诊期间的沟通能力提高(P < 0.001),以及解决技术问题的信心增强(P < 0.0001)。在与HIV感染者进行远程医疗问诊后完成调查的29名医护人员中,93%报告称其易于访问和使用。医护人员确实报告称,通过远程医疗,医患互动感有所下降。

结论

未来的研究应进一步探索医护人员在远程医疗培训和服务方面的经验,以改进远程医疗培训,并确定促进远程高效医患互动的最佳实践和策略/活动。

公众利益概述

远程医疗在医疗保健的各个领域都有所增加,尤其是自新冠疫情以来。培训医护人员在远程环境中成功护理患者至关重要,特别是随着技术平台和功能不断发展或变得更加复杂。远程医疗培训有助于医护人员提高进行远程医疗问诊的能力。培训使问诊流程标准化,控制医护人员和患者的期望,确定如何将远程问诊纳入常规门诊流程,提供提高医护人员与患者互动及使用技术功能能力的工具,并增进对医护人员所需持续支持类型(如行政支持)的理解。本文描述了佛罗里达州杰克逊维尔市佛罗里达大学健康中心的医护人员在接受培训为居住在城市环境中的HIV感染者提供远程医疗服务后的态度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1c5/12392305/1c5d7a584b25/nihms-2103819-f0001.jpg

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