Expansion of telehealth in primary care during the COVID-19 pandemic: benefits and barriers

Dhaliwal, Jaspreet K; Hall, Tara D; Larue, Julie; Maynard, Susan; Pierre, Peterson E; Bransby, Kristen A

doi:10.1097/jxx.0000000000000626

Cited by 36 publications

(21 citation statements)

References 24 publications

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“…Virtual care has been shown to improve access to care for patients, 25,35,36 and lower administrative costs and burdens for health care systems while maintaining patient and provider satisfaction. [5][6][7][8][9][37][38][39][40] Virtual care is becoming more acceptable in APC settings, especially for treating noncomplicated conditions such as UTIs. [21][22][23]41,42 A systematic review of virtual care in urology reported 5 retrospective studies that assessed using virtual care to manage UTIs.…”

Section: Discussionmentioning

confidence: 99%

“…Virtual care has been shown to improve access to care for patients,25,35,36 and lower administrative costs and burdens for health care systems while maintaining patient and provider satisfaction 5–9,37–40. Virtual care is becoming more acceptable in APC settings, especially for treating noncomplicated conditions such as UTIs 21–23,41,42.…”

Section: Discussionmentioning

confidence: 99%

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Virtual Care and Urinary Tract Infection Management

et al. 2023

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Background: During the COVID-19 pandemic, more health care issues were being managed remotely. Urinary tract infections (UTIs) are being managed more often using telehealth although few reports compare the rate of UTI ancillary service orders placed and fulfilled during these visits. Objectives: We aimed to evaluate and compare the rate of ancillary service orders and order fulfillments in incident UTI diagnoses between virtual and in-person encounters. Research Design: The retrospective cohort study involved 3 integrated health care systems: Kaiser Permanente (KP) Colorado, KP Georgia, and KP Mid-Atlantic States. Subjects: We included incident UTI encounters from adult primary care data from January 2019 to June 2021. Measures: Data were categorized as: prepandemic (January 2019–March 2020), COVID-19 Era 1 (April 2020–June 2020), and COVID-19 Era 2 (July 2020–June 2021). UTI-specific ancillary services included medication, laboratory, and imaging. Orders and order fulfillments were dichotomized for analyses. Weighted percentages for orders and fulfillments were calculated using inverse probability treatment weighting from logistic regression and compared between virtual and in-person encounters using χ2 tests. Results: We identified 123,907 incident encounters. Virtual encounters increased from 13.4% prepandemic to 39.1% in COVID-19 Era 2. Ancillary service orders from virtual encounters were not placed as often as in-person encounters. However, the weighted percentage for ancillary service order fulfillment across all services remained above 65.3% across sites and eras, with many fulfillment percentages above 90%. Conclusions: Our study reported a high rate of order fulfillment for both virtual and in-person encounters. Health care systems should encourage providers to place ancillary service orders for uncomplicated diagnoses, such as UTI, to provide enhanced access to patient-centered care.

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Section: Discussionmentioning

confidence: 99%

“…Virtual care has been shown to improve access to care for patients,25,35,36 and lower administrative costs and burdens for health care systems while maintaining patient and provider satisfaction 5–9,37–40. Virtual care is becoming more acceptable in APC settings, especially for treating noncomplicated conditions such as UTIs 21–23,41,42.…”

Section: Discussionmentioning

confidence: 99%

Virtual Care and Urinary Tract Infection Management

et al. 2023

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“…Asynchronous messages is another virtual communication system for patients and clinicians to discuss non-urgent related topics such as scheduling appointments, test results, and questions about medications [44] . More patients are utilizing online messaging systems due to its convenient nature, improving patient satisfaction [45] . Studies have acknowledged clinicians agree asynchronous messaging systems are effective and have increased their efficiency; however, it has also greatly increased their workloads.…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis of outpatient nutrition clinic scheduling outcomes based on in-person and telehealth patient care delivery modalities

Humbert¹,

Mauldin²,

Saarony³

2023

Healthcare Analytics

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“…Governmental restrictions and lockdowns of entire populations affected health systems and disrupted the routine treatment and follow‐up of non‐COVID‐19 patients (Ohannessian et al, 2020). To meet and adequately address the medical needs of most patients, while reducing patients’ and caregivers’ risk of infection, health systems had to start providing remote medical services (telemedicine) immediately (Chang et al, 2021; Dhaliwal et al, 2021; Wilhite et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Diabetes nurse practitioners in the shadow of the COVID‐19 pandemic: Challenges, insights, and suggestions for improvement

Waizinger

Shpigelman

Shental

et al. 2021

J of Nursing Scholarship

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The study examined the role of diabetes nurse practitioners (DiNPs) and their contribution to the quality of care of individuals with diabetes during the COVID-19 pandemic. Specifically, we examined the benefits and barriers of using telemedicine for managing diabetes. Design:A descriptive qualitative research using content analysis of interviews.Methods: Participants were invited through the National DiNPs' Forum. Semistructured interviews were conducted with 24 licensed DiNPs (age range, 37-58 years) who were involved in the clinical care of individuals with diabetes during the COVID-19 pandemic. The interviews were recorded and transcribed, and content analysis was then used for extracting themes and their related categories. Findings: Content analysis revealed five themes: (a) Benefits and barriers of remote diabetes treatment; (b) Teamwork and its implications to DiNPs; (c) Technological challenges, resourcefulness, and creativity; (d) Changed perception of DiNP roles;and (e) Cultural diversity and improving communication skills. The benefits of telemedicine included improved control, efficiency, convenience and satisfaction, while the disadvantages of this method included the inability to provide optimal practical guidance on technical aspects of physical assessments and care. Sectors with limited digital literacy and language barriers had difficulties using telemedicine. Teamwork was reported as a facilitator to managing treatment. Telemedicine provided an opportunity for DiNPs to become more efficient and focused and to clearly define their role in the organization. Conclusions:The COVID-19 pandemic has posed new challenges. Along with the need to adapt the therapeutic approach to remote care, DiNPs improved their professional status, acquired new skills, and were satisfied with their personal and professional growth.Clinical relevance: Telemedicine should become an integral part of diabetes management to enable access to populations who cannot come to the clinic. Patients should be guided on using telemedicine platforms.

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Expansion of telehealth in primary care during the COVID-19 pandemic: benefits and barriers

Cited by 36 publications

References 24 publications

Virtual Care and Urinary Tract Infection Management

Virtual Care and Urinary Tract Infection Management

A comparative analysis of outpatient nutrition clinic scheduling outcomes based on in-person and telehealth patient care delivery modalities

Diabetes nurse practitioners in the shadow of the COVID‐19 pandemic: Challenges, insights, and suggestions for improvement

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