Telehealth challenges during COVID-19 as reported by primary healthcare physicians in Quebec and Massachusetts.
Mylaine Breton,Erin E. Sullivan,Erin E. Sullivan,Nadia Deville-Stoetzel,Danielle McKinstry,Matthew J. DePuccio,Abi Sriharan,Véronique Deslauriers,Anson Dong,Ann Scheck McAlearney +9 more
TLDR
In this paper, the authors describe the positive and negative implications of using telehealth in one Canadian (Quebec) and one American (Massachusetts) primary healthcare (PHC) setting during the COVID-19 pandemic as reported by physicians.Abstract:
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. 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. 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. 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.read more
Citations
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Journal ArticleDOI
Telehealth for the Longitudinal Management of Chronic Conditions: Systematic Review
Allison A. Lewinski,Conor Walsh,Sharron Rushton,Diana Soliman,Scott M Carlson,Matthew Luedke,David J Halpern,Matthew J Crowley,Ryan J. Shaw,Jason Sharpe,Anastasia-Stefania Alexopoulos,Amir Alishahi Tabriz,Jessica R. Dietch,Diya M. Uthappa,Soohyun Hwang,Katharine A Ball Ricks,Sarah Cantrell,Andrzej S. Kosinski,Belinda Ear,Adelaide M. Gordon,Jennifer M Gierisch,Karen M. Goldstein +21 more
TL;DR: A systematic review found few studies with a variety of designs and interventions that used telehealth as a replacement for in-person care and found no significant differences in clinical outcomes.
Journal ArticleDOI
Telehealth and COVID-19 Pandemic: An Overview of the Telehealth Use, Advantages, Challenges, and Opportunities during COVID-19 Pandemic
TL;DR: In this article , the authors define telehealth and discuss some aspects of its utilization, role, and impact, but also opportunities and future implications particularly during the COVID-19 pandemic.
Journal ArticleDOI
Doctoring from home: Physicians’ perspectives on the advantages of remote care delivery during the COVID-19 pandemic
TL;DR: The authors' data provides preliminary evidence that PCPs and their patients had positive experiences with remote care during the early months of the COVID-19 pandemic and more research is needed to understand how to sustain these benefits beyond the global CO VID-19Pandemic and ensure patients’ needs are met.
Journal ArticleDOI
Video and In-Person Palliative Care Delivery Challenges before and during the COVID-19 Pandemic
Isaac S. Chua,MO Olmsted,Rachel Plotke,Yael Turk,Chardria S. Trotter,Simone Rinaldi,Mihir Kamdar,Vicki A. Jackson,Emily R. Gallagher-Medeiros,Areej El-Jawahri,Jennifer S. Temel,Joseph A. Greer +11 more
TL;DR: In this paper , the authors described trends for in-person and video visit PC delivery challenges before and during the COVID-19 pandemic in the U.S. They performed Pearson's chi-squared, Fisher's exact, and Kruskal-Wallis tests to examine associations.
Posted ContentDOI
Telehealth and COVID 19 pandemic: An overview of the telehealth use, advantages, challenges, and opportunities during COVID 19 pandemic (Preprint)
TL;DR: In this article , the authors define telehealth and discuss some aspects of its utilization, role, and impacts, but also opportunities, and future implications particularly during the COVID-19 pandemic.
References
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Book
Qualitative Data Analysis: An Expanded Sourcebook
TL;DR: This book presents a step-by-step guide to making the research results presented in reports, slideshows, posters, and data visualizations more interesting, and describes how coding initiates qualitative data analysis.
Book
Diffusion of Innovations
TL;DR: A history of diffusion research can be found in this paper, where the authors present a glossary of developments in the field of Diffusion research and discuss the consequences of these developments.
Journal ArticleDOI
Snowball Sampling: Problems and Techniques of Chain Referral Sampling
Patrick Biernacki,Dan Waldorf +1 more
TL;DR: In spite of the fact that chain referral sampling has been widely used in qualitative sociological research, especially in the study of deviant behavior, the problems and techniques involved in its use have not been discussed.
Journal ArticleDOI
Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19).
Anthony C Smith,Emma Thomas,Centaine L. Snoswell,Helen M. Haydon,Ateev Mehrotra,Jane Clemensen,Jane Clemensen,Liam J Caffery +7 more
TL;DR: This article highlights key requirements for telehealth uptake, including flexible funding arrangements, training and accrediting the health workforce, to become a routinely used part of the health system.
Journal ArticleDOI
Covid-19 and Health Care's Digital Revolution.
TL;DR: Covid-19 and Health Care’s Digital Revolution In the face of the Covid- 19 pandemic, Americans are waking up to the limitations of their analogue health care system.