Perceptions and Use of Telehealth Among Mental Health, Primary, and Specialty Care Clinicians During the COVID-19 Pandemic

Connolly, Samantha L.; Miller, Christopher J.; Gifford, Allen L.; Charness, Michael E.

doi:10.1001/jamanetworkopen.2022.16401

Cited by 41 publications

(32 citation statements)

References 39 publications

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“…Most spoke provider respondents felt that TelePain was beneficial for them and their patients, speculating that it improved access to, lowered costs associated with, and improved veteran experiences with pain care, especially for those residing in rural areas. These findings align with the literature regarding the experience of telemedicine and it’s adoption within the VA and for primary care and adds to them with the addition of the hub-and-spoke model (Connolly et al, 2022 ; Der-Matirosian et al 2021 ; Myers et al, 2020 ). The hub-and-spoke model provides sustainable specialty care to remote regions (Elrod & Fortneberry, 2017b ; Rawson et al, 2019 ; Switzer et al, 2013 ).…”

Section: Discussionsupporting

confidence: 85%

Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry

Subramaniam

Chen

Wilkerson

et al. 2022

J. technol. behav. sci.

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The hub-and-spoke telehealth model leverages centrally located providers who utilize telehealth technology to bring specialized care to medically underserved areas. This model has the potential to promote equitable access to healthcare. However, few studies address how to facilitate the adoption and implementation of hub-and-spoke telehealth. We examined spoke site providers’ experiences with TelePain, a national hub-and-spoke model of interdisciplinary chronic pain care, with a focus on improving future implementation. We conducted semi-structured individual interviews (20–45 min) with 27 VA spoke site providers via teleconferencing between August 2020 and February 2021. Interview transcripts were coded in Atlas.ti 8.0 using deductive (identified a priori and used to build the interview guide) and inductive (emerging) codes. Our analysis identified the following themes stressed by the spoke sites: (1) spoke sites needed to envision how TelePain services would work at their site before deciding to adopt; (2) TelePain implementation needed to fit into local existing care processes; (3) hub sites needed to understand spoke sites’ context (e.g., via needs assessment) to tailor the services accordingly, and (4) hub-and-spoke sites needed to establish bidirectional communication. Our findings provide a practical guide to improve future rollout of hub-and-spoke telehealth models. Recommendations focus on the role of the hub site in promoting program adoption by (1) developing a clear and detailed marketing plan and (2) considering how the program can be adapted to fit the local spoke site context. To improve implementation, hub-and-spoke sites must establish ongoing and consistent bidirectional communication; this is particularly critical in the everchanging post-peak pandemic healthcare system. An important next step is the development of recommendations and guidelines for implementing hub-and-spoke telehealth, as well as examining pain outcomes for patients touched by this program.

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Section: Discussionsupporting

confidence: 85%

Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry

Subramaniam

Chen

Wilkerson

et al. 2022

J. technol. behav. sci.

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“…Resultados de outros estudos mostraram que pacientes preferem consultas presenciais do que online. Segundo Connolly et al, fatores como idade avançada e baixa condição socioeconômica podem interferir na adesão devido à dificuldade destes indivíduos em manusearem a equipamentos tecnológicos e a falta de acesso à internet de qualidade para realizar o atendimento (Connolly, et al, 2022). Em concordância, Antoniou et al, relatou que os obstáculos para a telessaúde incluem o avanço da falta de habilidade com a tecnologia, dificuldade de comunicação, insegurança com os profissionais e ceticismo.…”

Section: Discussionunclassified

Análise da satisfação de pacientes Pós-COVID-19 com telemonitoramento para o treinamento da musculatura inspiratória

Iamonti

Simões²,

Oliveira³

et al. 2022

RSD

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Objetivo: A COVID-19 é uma infecção respiratória que pode demandar da utilização prolongada da ventilação mecânica invasiva, com consequente redução na capacidade da musculatura respiratória, estudos têm mostrado que a telemonitoramento traz resultados semelhantes aos da reabilitação pulmonar tradicional. Metodologia: O objetivo do estudo foi verificar a satisfação e adesão de pacientes Pós-COVID-19 com o telemonitoramento e analisar se esta é eficaz para reduzir a dispneia e melhorar a qualidade de vida. Trata-se de um estudo prospectivo de ensaio clínico composto de 36 participantes com infecção respiratória confirmada por COVID-19 por PCR. Resultados: Foram aplicados os protocolos de avaliação da pressão máxima inspiratória sustentada, avaliação do índice de força, avaliação da capacidade de endurance muscular inspiratória, Escala de Likert e realizado o protocolo de telemonitoramento. Conclusão: Verificou-se que no início os participantes não acreditavam que o tratamento daria certo, traria resultados, melhoraria os sintomas de fadiga ou os ajudariam a realizar as atividades básicas de vida diária. Após 30 dias de tratamento, a média de satisfação foi de 93,1% comparado a 65,6% inicial. Foi possível concluir que houve um aumento significativo na satisfação, adesão, melhora da capacidade funcional e redução da dispneia por meio da telemonitoramento.

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“…The impact of the pandemic on mental health has been less studied than the COVID-19 epidemiology, transmission patterns, physical symptoms, and their treatment [18]. Furthermore, while numerous studies have been conducted to assess physician and patient satisfaction with telemedicine [19][20][21][22], to our knowledge, fewer studies have been conducted to examine physicians' perceptions of the mental health crisis and/or suggestions on how to best face the future challenges [1,[23][24][25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Mental health in Italy after two years of COVID-19 from the perspective of 1281 Italian physicians: looking back to plan forward

et al. 2022

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Background The COVID-19 pandemic has generated an unprecedented global crisis that is profoundly affecting mental health and mental health care. The aim of this study was to survey a relatively large group of Italian physicians about their perceived impact of COVID-19 on the mental health of the Italian population and about their suggestions on the best strategies to address the current and future challenges. Methods One thousand two hundred eighty-one (1,281) physicians were surveyed between November 2021 and February 2022. Results Eighty-one percent of respondents reported an increase in the number of people with mental illness presenting to their practice during the COVID-19 pandemic. Thirty-four percent reported a 26–50% increase in the number of people with mental illness in their community; approximately 33% reported a 1–25% increase; and 26.9% reported a 51–75% increase. The most commonly reported mental issues that increased because of COVID-19 were agitation, mood and anxiety disorders. Regarding the suggested strategies to address future challenges related to the COVID-19 pandemic, 34.6% of respondents recommended providing psychoeducation to the general population for early detection of mental illness and developing strategies to reduce the impact of COVID-19-related stress. In addition, 12.6% of respondents suggested improving telehealth services, while 12.3% suggested the need for increased funding for community-based care. When asked about physicians' opinion on the possibility of an increased prevalence of mental illness in the next 12 months, more than 30% of them predicted an increase in stress-related illnesses, while 25.2% were more concerned about a worsening of the ongoing clinical conditions of patients with previous psychiatric disorders. However, 21% of respondents believed that people's ability to cope with the pandemic would increase in the next 12 months. Conclusions This study confirmed a strong and negative impact on the mental health of the past 2 years of COVID-19 pandemic in the Italian population. Providing psychoeducation to the general population and improving the availability of telemedicine services could reduce the impact of future challenges related to the pandemic.

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Perceptions and Use of Telehealth Among Mental Health, Primary, and Specialty Care Clinicians During the COVID-19 Pandemic

Cited by 41 publications

References 39 publications

Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry

Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry

Análise da satisfação de pacientes Pós-COVID-19 com telemonitoramento para o treinamento da musculatura inspiratória

Mental health in Italy after two years of COVID-19 from the perspective of 1281 Italian physicians: looking back to plan forward

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