Suddenly Becoming a "Virtual Doctor": Experiences of Psychiatrists Transitioning to Telemedicine During the COVID-19 Pandemic.
Suddenly Becoming a "Virtual Doctor": Experiences of Psychiatrists Transitioning to Telemedicine During the COVID-19 Pandemic.
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DOI：
10.1176/appi.ps.202000250
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发表时间：
2020-11-01
期刊：
影响因子：
--
通讯作者：
Huskamp HA
中科院分区：
文献类型：
--
作者：
Uscher-Pines L;Sousa J;Raja P;Mehrotra A;Barnett ML;Huskamp HA
为了应对新冠肺炎疫情，许多精神科医生迅速过渡到远程医疗。进行了一项定性研究，以了解这种巨大的分娩变化如何影响护理，包括精神科医生如何提供远程医疗，遇到的障碍，以及未来的计划。其目的是为正在进行的新冠肺炎应对提供信息，并将所学到的经验教训传递给开始提供远程医疗的精神科医生。从2020年3月31日至4月9日，对在新冠肺炎早期显著活跃的州执业的门诊精神科医生进行了20次半结构化访谈。采用归纳和演绎的方法编制访谈摘要，并进行矩阵分析以确定和提炼主题。在采访时，所有精神科医生都已经使用远程医疗2-4周了。远程医疗包括视频访问、电话访问或这两种方式的某种组合。尽管许多人继续倾向于面对面护理，并计划在大流行后重返面对面护理，但精神病学家对过渡的看法基本上是积极的。然而，一些值得注意的挑战，如用于评估的临床数据减少，患者隐私减少，以及家庭环境中影响提供者与患者互动质量的分心增加。几位精神病学家还指出，他们的弱势患者缺乏可靠的智能手机或电脑以及互联网。与会者确定了一些有希望的战略，帮助他们提高远程医疗访问的质量。新冠肺炎疫情推动了精神科医生提供护理服务的方式发生了戏剧性的转变。研究结果表明，尽管精神病学家对这些接触的质量表示了一些担忧，但这种转变对患者和医生来说基本上都是积极的。
In response to the COVID-19 pandemic, many psychiatrists have rapidly transitioned to telemedicine. A qualitative study was conducted to understand how this dramatic change in delivery has impacted care, including how telemedicine was provided by psychiatrists, barriers encountered, and plans for the future. The aim was to inform the ongoing COVID-19 response and pass on lessons learned to psychiatrists who are starting to offer telemedicine. From March 31-April 9, 2020, 20 semi-structured interviews were conducted with outpatient psychiatrists practicing in states with significant early COVID-19 activity. Inductive and deductive approaches were used to develop interview summaries, and a matrix analysis was conducted to identify and refine themes. At the time of the interviews, all psychiatrists had been using telemedicine for 2–4 weeks. Telemedicine encompassed video visits, phone visits, or some combination of the two modalities. Although many continued to prefer in-person care and planned to return to in-person care after the pandemic, psychiatrists had largely positive perceptions of the transition. However, several noted challenges such as decreased clinical data for assessment, diminished patient privacy, and increased distractions in the home setting that impacted the quality of provider-patient interactions. Several psychiatrists also pointed that their disadvantaged patients lacked reliable access to a smart phone or computer as well as the Internet. Participants identified a number of promising strategies that helped them improve the quality of telemedicine visits. The COVID-19 pandemic has driven a dramatic shift in how psychiatrists deliver care. Findings highlight that although psychiatrists express some concerns about the quality of these encounters, the transition has been largely positive for both patients and physicians.
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