Delivering Urgent Care Using Telemedicine: Insights from Experienced Clinicians at Academic Medical Centers.
J Gen Intern Med
; 37(4): 707-713, 2022 03.
Article
in English
| MEDLINE | ID: covidwho-1579038
ABSTRACT
BACKGROUND:
Care delivered using telemedicine has been steadily growing in the USA but represented a small fraction of overall visits before the COVID-19 pandemic as few clinicians had been providing care using telemedicine. Understanding how experienced clinicians have practiced telemedicine can help guide today's exponential adoption of telemedicine.OBJECTIVE:
The objective of this study was to explore barriers and facilitators to providing effective, high-quality urgent care using telemedicine ("tele-urgent care") from the perspective of clinicians experienced in telemedicine.APPROACH:
We conducted semi-structured interviews between July 2018 and March 2019 of clinicians who had been providing tele-urgent care services to patients as a part of their routine clinical practice. Themes were identified using content analysis with a constant comparative coding approach. KEYRESULTS:
Among the 20 clinicians interviewed, the majority were female (90%) and nurse practitioners (65%). We identified four themes related to barriers and facilitators to providing effective, high-quality tele-urgent care. Workplace factors such as a strong information technology (IT) infrastructure, real-time IT support, an electronic health record, and a collegial work environment, often virtual, were necessary standards. Communication and exam techniques from in-person encounters were adapted to tele-urgent care including active listening skills and teaching patients to conduct specific exam maneuvers virtually. The convenience of tele-urgent care should be preserved to support improvements in access to care. Finally, patients and clinicians occasionally had mismatched expectations about what could or would be provided during a tele-urgent care encounter. Managing the added tension that can occur during a telemedicine encounter was important.CONCLUSION:
As telemedicine becomes an integral part of the care continuum, incorporating and accounting for these key insights when we train and support clinicians will be necessary to provide effective, high-quality care to patients in the future.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Telemedicine
/
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Qualitative research
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
J Gen Intern Med
Journal subject:
Internal Medicine
Year:
2022
Document Type:
Article
Affiliation country:
S11606-020-06395-9
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