Long-Term Adoption of Televisits in Nursing Homes During the COVID-19 Crisis and Following Up Into the Postpandemic Setting: Mixed Methods Study.

BACKGROUND: There is growing evidence that telemedicine can improve the access to and quality of health care for nursing home residents. However, it is still unclear how to best manage and guide the implementation process to ensure long-term adoption, especially in the context of a decline in telemedicine use after the COVID-19 crisis. OBJECTIVE: This study aims to identify and address major challenges for the implementation of televisits among residents in a nursing home, their caring nurses, and their treating general practitioners (GPs). It also evaluated the impact of televisits on the nurses' workload and their nursing practice. METHODS: A telemedical system with integrated medical devices was introduced in 2 nursing homes and their cooperating GP offices in rural Germany. The implementation process was closely monitored from the initial decision to introduce telemedicine in November 2019 to its long-term routine use until March 2023. Regular evaluation was based on a mixed methods approach combining rigorous qualitative approaches with quantitative measurements. RESULTS: In the first phase during the COVID-19 pandemic, both nursing homes achieved short-term adoption. In the postpandemic phase, an action-oriented approach made it possible to identify barriers and take control actions for long-term adoption. The implementation of asynchronous visits, strong leadership, and sustained training of the nurses were critical elements in achieving long-term implementation in 1 nursing home. The implementation led to enhanced clinical skills, higher professional recognition, and less psychological distress among the nursing staff. Televisits resulted in a modest increase in time demands for the nursing staff compared to organizing in-person home visits with the GPs. CONCLUSIONS: Focusing on health care workflow and change management aspects depending on the individual setting is of utmost importance to achieve successful long-term implementation of telemedicine.

[Factors influencing the intention of caregivers to use digital technologies in outpatient care - A case study examining the introduction of a textile sensor mat]. / Einflussfaktoren auf die Nutzungsintention von Pflegekräften zur Verwendung digitaler Technologien in der ambulanten Pflege ­ Fallstudie zur Einführung eines Sensortextils.

Operational processes in the care sector are becoming increasingly digitalized due to rising workload. Insufficient involvement of caregivers in this digitalization process results in poorly integrated technological developments along with a lack of technology acceptance. Therefore, in order to lay a firm foundation for successful technology development, it is utmost essential to understand the intention of professionals to use technology in outpatient care. This paper develops a model that outlines the factors influencing the intention of caregivers to use digital technologies in outpatient care, based on a case study examining the introduction of a textile sensor mat. In the developed model, the care situation is investigated for the first time as a factor influencing the intention to use digital technologies, in addition to technology acceptance. Apart from deriving the factors of the model and inspecting the strength of their influences, the practical relevance for technology developers in other care contexts is also determined.Practical Relevance: Demographic change in the German population is leading to major challenges in various sectors. Specifically, in the outpatient care sector, which is already severely affected by a shortage of skilled workers, this change is particularly noticeable with an increase in patients and a high workload for caregivers. Therefore, digital technologies are increasingly being used to make the daily work of caregivers easier in terms of physical and psychological factors. The model developed in this study describes-based on a case study on the introduction of a textile sensor mat-conducive and obstructive factors for the introduction of technology in outpatient care and thus contributes to successful digitalization in this field.