Telemedicine implementation and use in community health centers during COVID-19: Clinic personnel and patient perspectives.
Telemedicine implementation and use in community health centers during COVID-19: Clinic personnel and patient perspectives.
复制标题
DOI：
10.1016/j.ssmqr.2022.100054
复制
发表时间：
2022-12
期刊：
影响因子：
--
通讯作者：
Rodriguez HP
中科院分区：
文献类型：
--
作者：
Payán DD;Frehn JL;Garcia L;Tierney AA;Rodriguez HP
2020年3月，联邦和州远程医疗政策的变化促进了远程医疗在社区卫生中心的采用和使用。在这些安全网设置中，远程医疗的实施和使用缺乏证据，而且缺乏反映英语水平有限的患者观点的信息。在大流行期间，我们在两家主要为中国和拉丁裔移民服务的联邦合格医疗中心对诊所工作人员和患者进行了深入访谈。在2020年12月至2021年4月期间远程完成了24次访谈（临床人员= 15；主要讲英语以外语言的患者= 9）。访谈脚本包括关于他们的远程医疗经验、技术、资源和需求、障碍、促进因素、语言获取和继续使用的问题，以及简短的社会人口调查。数据分析主要包括演绎方法和对成绩单内容的专题分析。两家fqhc都在几周内采用了远程医疗，并在两个月内主要过渡到视频和音频就诊。调查结果显示，第三方语言翻译服务很难整合到远程医疗视频访问中。提供语言协调护理的双语人员被视为高效和高质量患者远程医疗体验的必要条件。对于年龄较大、英语水平有限、数字读写能力有限的患者来说，纯音频访问尤其有益。是否继续使用远程医疗取决于报销政策的决定和提高患者数字素养和技术资源的干预措施。结果突出了大流行后报销纯音频访问的重要性，并投资于提高远程医疗会诊中语言服务质量的努力。
In March 2020, federal and state telehealth policy changes catalyzed telemedicine adoption and use in community health centers. There is a dearth of evidence on telemedicine implementation and use in these safety net settings and a lack of information reflecting the perspectives of patients with limited English proficiency. We conducted in-depth interviews with clinic personnel and patients during the pandemic in two federally qualified health centers that primarily serve Chinese and Latino immigrants. Twenty-four interviews (clinic personnel = 15; patients who primarily speak a language other than English = 9) were completed remotely between December 2020 and April 2021. Interview scripts included questions about their telemedicine experiences, technology, resources and needs, barriers, facilitators, language access, and continued use, with a brief socio-demographic survey. Data analyses involved a primarily deductive approach and thematic analysis of transcript content. Both FQHCs adopted telemedicine in a few weeks and transitioned primarily to video and audio-only visits within two months. Findings reveal third-party language interpretation services were challenging to integrate into telemedicine video visits. Bilingual personnel who provided language concordant care were seen as essential for efficient and high-quality patient telemedicine experiences. Audio-only visits were of particular benefit to reach patients of older age, with limited English proficiency, and with limited digital literacy. Continued use of telemedicine is contingent on reimbursement policy decisions and interventions to increase patient digital literacy and technological resources. Results highlight the importance of reimbursing audio-only visits post-pandemic and investing in efforts to improve the quality of language services in telemedicine encounters.
登录
查看更多内容
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
13.8
作者：
Fischer SH;Ray KN;Mehrotra A;Bloom EL;Uscher-Pines L
通讯作者：
Uscher-Pines L
影响因子：
9.7
作者：
Anthony, Denise L.;Campos-Castillo, Celeste;Lim, Paulina S.
通讯作者：
Lim, Paulina S.
影响因子：
9.7
作者：
Lau, Jen;Knudsen, Janine;Chokshi, Dave A.
通讯作者：
Chokshi, Dave A.
影响因子：
7.4
作者：
Lyles, Courtney Rees;Allen, Jill Y.;Garrido, Terhilda
通讯作者：
Garrido, Terhilda