Provider perspectives on telemental health implementation: Lessons learned during the COVID-19 pandemic and paths forward.
Provider perspectives on telemental health implementation: Lessons learned during the COVID-19 pandemic and paths forward.
复制标题
DOI：
10.1037/ser0000625
复制
发表时间：
2023
影响因子：
2.3
通讯作者：
Bidargaddi, Niranjan
中科院分区：
文献类型：
--
作者：
Lipschitz, Jessica M.;Connolly, Samantha L.;Van Boxtel, Rachel;Potter, Julia R.;Nixon, Neil;Bidargaddi, Niranjan
多年来，远程精神卫生的实施缓慢且支离破碎，COVID-19大流行使其有必要得到广泛采用。随着最初的突发公共卫生事件已经过去，我们正处于一个决定点，即是继续实施TMH还是回归到主要的面对面护理模式。在本质性研究中，我们调查了临床医生对TMH在门诊精神卫生保健中的利弊的看法，以及未来实施的考虑。我们对门诊心理健康提供者进行了29次半结构化访谈。数据分析采用快速定性分析方法。优势包括提高服务利用率，改善治疗过程，改善提供者福利。然而，供应商也注意到TMH在治疗过程和供应商福利方面存在一些缺点，他们报告技术问题是另一个缺点。总的来说，供应商报告说他们可以通过TMH提供高质量的护理，但指出一些患者群体和预约类型更适合亲自服务。大多数医疗服务提供者更倾向于采用混合医疗模式，以补偿差异和州外许可限制为障碍。他们指出，随着TMH成为精神病学护理的支柱，培训和专业指导将是重要的。如果适用于合适的患者群体和预约类型，继续实施TMH和亲自护理可能会改善获取机会并提高服务质量。有效实施可能需要政策和系统层面的支持，包括公平的报销率、州外许可限制和提供TMH的专业指南。
After years of slow and fragmented implementation of telemental health (TMH), the COVID-19 pandemic necessitated widespread adoption. With the initial state of public health emergency behind us, we are at a decision point on whether to continue with TMH or return to a largely in-person care model. In this qualitative study, we investigated clinicians’ perspectives on advantages and disadvantages of TMH in outpatient mental healthcare as well as considerations for future implementation. We conducted 29 semi-structured interviews with outpatient mental health providers. Data were analyzed using rapid qualitative analysis methodology. Advantages included increased utilization of services, improved therapeutic processes, and improved provider wellbeing. Providers, however, also noted that TMH has some disadvantages in terms of therapeutic processes and provider wellbeing, and they reported technology issues as an additional disadvantage. Overall providers reported they can provide high quality care via TMH, but indicated some patient populations and appointment types are a better fit for in-person services. Most providers preferred a hybrid model of care moving forward with reimbursement discrepancies and out-of-state licensure restrictions as barriers. They indicated that, as TMH becomes a mainstay in psychiatric care, training and professional guidelines will be important. Continued implementation of TMH alongside in-person care is likely to offer improved access and enhanced service quality when applied to the right patient populations and appointment types. Effective implementation may require policy and systems level support on equitable reimbursement rates, out-of-state licensure restrictions and professional guidelines for delivering TMH.
登录
查看更多内容
影响因子：
2.9
作者：
Taylor, Beck;Henshall, Catherine;Greenfield, Sheila
通讯作者：
Greenfield, Sheila
影响因子：
11.3
作者：
Hanailton, Alison B.;Finley, Erin P.
通讯作者：
Finley, Erin P.
影响因子：
4.6
作者：
Simms, Deanne C.;Gibson, Kerri;O'Donnell, Susan
通讯作者：
O'Donnell, Susan
影响因子：
1.5
作者：
Perle, Jonathan G.;Burt, Jennifer;Higgins, William J.
通讯作者：
Higgins, William J.
影响因子：
5.8
作者：
Connolly, Samantha L.;Miller, Christopher J.;Lindsay, Jan A.;Bauer, Mark S.
通讯作者：
Bauer, Mark S.