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Tytuł pozycji:

Telehealth challenges during COVID-19 as reported by primary healthcare physicians in Quebec and Massachusetts.

Tytuł:
Telehealth challenges during COVID-19 as reported by primary healthcare physicians in Quebec and Massachusetts.
Autorzy:
Breton M; Department of Community Health Sciences, Université de Sherbrooke, 150, place Charles-LeMoyne, Room 200, Longueuil, QC, J4K 0A8, Canada. .
Sullivan EE; Healthcare Management, Sawyer School of Business, Suffolk University, Boston, USA.; Department of Global Health and Social Medicine/Center for Primary Care, Harvard Medical School, Boston, USA.
Deville-Stoetzel N; Department of Community Health Sciences, Université de Sherbrooke, 150, place Charles-LeMoyne, Room 200, Longueuil, QC, J4K 0A8, Canada.
McKinstry D; Healthcare Management, Sawyer School of Business, Suffolk University, Boston, USA.
DePuccio M; Department of Health Systems Management, Rush University, College of Health Sciences, Chicago, USA.
Sriharan A; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Deslauriers V; Department of Community Health Sciences, Université de Sherbrooke, 150, place Charles-LeMoyne, Room 200, Longueuil, QC, J4K 0A8, Canada.
Dong A; Mount Sinai Hospital Academic Family Health Team, Toronto, Canada.
McAlearney AS; Department of Family and Community Medicine and Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), Ohio State University, Columbus, USA.
Źródło:
BMC family practice [BMC Fam Pract] 2021 Sep 26; Vol. 22 (1), pp. 192. Date of Electronic Publication: 2021 Sep 26.
Typ publikacji:
Journal Article; Research Support, Non-U.S. Gov't
Język:
English
Imprint Name(s):
Original Publication: London : BioMed Central, [2000-2021]
MeSH Terms:
COVID-19*
Physicians, Primary Care*
Telemedicine*
Canada ; Humans ; Pandemics ; Primary Health Care ; Quebec ; SARS-CoV-2
References:
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Contributed Indexing:
Keywords: COVID-19; Family physicians; Primary healthcare; Telehealth
Entry Date(s):
Date Created: 20210926 Date Completed: 20210930 Latest Revision: 20210930
Update Code:
20240105
PubMed Central ID:
PMC8467009
DOI:
10.1186/s12875-021-01543-4
PMID:
34563113
Czasopismo naukowe
Background: The COVID-19 pandemic has driven primary healthcare (PHC) providers to use telehealth as an alternative to traditional face-to-face consultations. Providing telehealth that meets the needs of patients in a pandemic has presented many challenges for PHC providers. The aim of this study was to describe the positive and negative implications of using telehealth in one Canadian (Quebec) and one American (Massachusetts) PHC setting during the COVID-19 pandemic as reported by physicians.
Methods: We conducted 42 individual semi-structured video interviews with physicians in Quebec (N = 20) and Massachusetts (N = 22) in 2020. Topics covered included their practice history, changes brought by the COVID-19 pandemic, and the advantages and challenges of telehealth. An inductive and deductive thematic analysis was carried out to identify implications of delivering care via telehealth.
Results: Four key themes were identified, each with positive and negative implications: 1) access for patients; 2) efficiency of care delivery; 3) professional impacts; and 4) relational dimensions of care. For patients' access, positive implications referred to increased availability of services; negative implications involved barriers due to difficulties with access to and use of technologies. Positive implications for efficiency were related to improved follow-up care; negative implications involved difficulties in diagnosing in the absence of direct physical examination and non-verbal cues. For professional impacts, positive implications were related to flexibility (teleworking, more availability for patients) and reimbursement, while negative implications were related to technological limitations experienced by both patients and practitioners. For relational dimensions, positive implications included improved communication, as patients were more at ease at home, and the possibility of gathering information from what could be seen of the patient's environment; negative implications were related to concerns around maintaining the therapeutic relationship and changes in patients' engagement and expectations.
Conclusion: Ensuring that health services provision meets patients' needs at all times calls for flexibility in care delivery modalities, role shifting to adapt to virtual care, sustained relationships with patients, and interprofessional collaboration. To succeed, these efforts require guidelines and training, as well as careful attention to technological barriers and interpersonal relationship needs.
(© 2021. The Author(s).)
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