System-Level Factors Associated With Telephone and Video Visit Use: Survey of Safety-Net Clinicians During the Early Phase of the COVID-19 Pandemic

Sharma, Anjana E.; Khoong, Elaine C.; Sieera, Maribel; Rivadeneira, Natalie A.; Nijagal, Malini A.; Su, George; Lyles, Courtney R.; DeFries, Triveni; Tuot, Delphine S.; Sarkar, Urmimala

doi:10.2196/34088

Cited by 10 publications

(7 citation statements)

References 29 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Callison et al18 used interrupted time series methods to examine telemedicine use among Medicaid beneficiaries before and during the pandemic and found that the outpatient service use disparities between White and Black Louisiana Medicaid beneficiaries, but gaps in telemedicine use occurred at the same time. They also find that Latino beneficiaries had large reductions in outpatient service use and relatively small increases in telemedicine use compared with other populations, consistent with past research that highlights barriers to care due to limited English language proficiency 3,12,13…”

Section: Commentarysupporting

confidence: 80%

“…Community health centers (CHC) struggle with addressing racial-ethnic and linguistic disparities in telemedicine access 11. CHCs and other organizations serving socioeconomically vulnerable populations face barriers to implementing telemedicine due to billing challenges, required technology and workflow changes, and unstable, low-quality internet connections for some patients 12–16. Despite this, CHCs accelerated telemedicine implementation during the pandemic,17 but the rapid expansion may have not supported high-quality clinical interactions given the predominant use of audio-only visits in these settings.…”

Section: Commentarymentioning

confidence: 99%

“…11 CHCs and other organizations serving socioeconomically vulnerable populations face barriers to implementing telemedicine due to billing challenges, required technology and workflow changes, and unstable, low-quality internet connections for some patients. [12][13][14][15][16] Despite this, CHCs accelerated telemedicine implementation during the pandemic, 17 but the rapid expansion may have not supported high-quality clinical interactions given the predominant use of audio-only visits in these settings. There is limited longitudinal evidence about the impact of pandemic-era telemedicine implementation on the quality of care and utilization for Medicaid beneficiaries and CHC patients.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Assessing the Impact of Telemedicine Implementation in Diverse Health Care Systems

Rodríguez

2023

Medical Care

View full text Add to dashboard Cite

Health care organizations and systems can have a large impact on how extensively telemedicine and virtual visits are used by medical practices and individual clinicians. This supplemental issue of medical care aims to advance evidence about how health care organizations and systems can best support telemedicine and virtual visit implementation. This issue includes 10 empirical studies examining the impact of telemedicine on quality of care, utilization, and/or patient care experiences, of which 6 are studies of Kaiser Permanente patients; 3 are studies of Medicaid, Medicare, and community health center patients; and 1 is a study of PCORnet primary care practices. The Kaiser Permanente studies find that ancillary service orders resulting from telemedicine encounters were not placed as often as in-person encounters for urinary tract infections, neck, and back pain, but there were no significant changes in patient fulfillment of ordered antidepressant medications. Studies focused on diabetes care quality among community health center patients and Medicare and Medicaid beneficiaries highlight that telemedicine helped maintain continuity of primary care and diabetes care quality during the COVID-19 pandemic. The research findings collectively demonstrate high variation in telemedicine implementation across systems and the important role that telemedicine had in maintaining the quality of care and utilization for adults with chronic conditions when in-person care was less accessible.

show abstract

Section: Commentarysupporting

confidence: 80%

Section: Commentarymentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Assessing the Impact of Telemedicine Implementation in Diverse Health Care Systems

Rodríguez

2023

Medical Care

View full text Add to dashboard Cite

show abstract

“…The training issues highlighted by the doctors are important. Other studies have found that peer training is useful to introduce non-early adopter GPs to video consulting (16), and that there is a correlation between a desire for more training and the non-adoption of video consulting (17).…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

How and why are video consultations used in urgent primary care settings in the UK? A focus group study

Payne

Clarke

2023

BJGP Open

View full text Add to dashboard Cite

BackgroundVideo consulting was widely rolled out across general practice at the start of the COVID-19 pandemic. In the in-hours setting there has been a marked shift away from using the technology, but many urgent care clinicians continue to use video consulting. Little is known about the reasons behind this discrepancy.AimTo understand how and why video is used in urgent care settingsDesign and SettingFocus groups were held via Microsoft Teams with 11 General Practitioners (GPs) working in in- and out- of hours settings across the UK.MethodsGPs were recruited through a purposive sampling strategy. Meetings were recorded, auto-transcribed and checked for accuracy. A thematic analysis was performed.ResultsUrgent care GPs usedvideo as an adjunct to the telephone in the initial assessment of patients and felt it helped direct patients to the right service first time. They were confident using video for a broad range of presenting conditions. They felt it created additional trust and rapport with patients and was useful for bringing third parties into the consultation. They felt that it allowed them to maximise resources and use shielded colleagues effectively. They were more likely to have received 1–1 training and this was seen as vital for effective implementation within an organisationConclusionVideo consulting is useful in the urgent care setting as an adjunct to telephone consulting. It is particularly helpful in the initial triage of patients. 1–1 training is needed for effective implementation.

show abstract

“…Visual cues aid communication and improve the rapport between the patient and physician. Clinicians have also seen that video-enabled picking up on nonverbal cues during visits, compared with telephone contact and visual contact with patients, also reduces the risk of miscommunication (11,12).…”

Section: Introductionmentioning

confidence: 99%

Delivering urgent care services for adult patients by way of video visits at Helsinki University Hospital joint emergency care departments - retrospective observational study

Vainio

Castrèn

Kobylin³

2023

Preprint

View full text Add to dashboard Cite

Objective We aimed to study how video visits could replace in-person visits in emergency care clinics. The objective of this study was to characterise those patient groups that are suitable for receiving care via video visits. We describe our experiences with the number of visits, patient groups and how often the video visits replaced in-person visits in ED on contact day and follow-up visits in ED within 21 days after the index day. The patients in our setting were over 16 years of age. After the initial video visit, we assessed the subsequent medical follow-up visits (at ED), X-rays and laboratory tests performed as well as the antibiotics prescribed. We also present patient self-reported data on patient satisfaction and their video visit experiences. Design: A retrospective observational study Setting: Emergency departments (EDs) in the Uusimaa region of Finland. Video visits in the ED are a pilot project implemented by Helsinki University Hospital that has been financed by the development project fund that promotes the hospital’s strategic goals. Participants : A total of 601 patients registered for video visits were included in the analysis in the period 4/3/2022–29/5/2022. Interventions: The seven physicians who were hired exclusively for the project used a digital EPR platform to connect with patients through synchronous video communication. Main outcome measures: EPR data from the video visits, including patient demographics, visit characteristics and patient satisfaction. Results There were 601 patients cared for through telemedicine during the observation period. Those patients receiving care by video visits had a mean age of 38 (standard deviation 15.5). A wide range of diagnoses was given to patients during the video. Twenty-one days after the initial video visit, 83% (501) of the patients had not been seen by a medical provider in the ED. Twenty-one-day returns requiring ED admission were 9.8% (n = 59) with the same reason for the encounter as in the video visit. The patient satisfaction scores with video visits were high (NPS 80 avg. 9.3) Conclusions Telemedicine adoption in ED settings requires more evidence of telehealth benefits. Providing care via video visits for ED patients without compromising patient satisfaction can be effective if the admission is based on a carefully assessed need for ED care and patient safety is ensured during all the stages of the patients’ pathway.

show abstract

System-Level Factors Associated With Telephone and Video Visit Use: Survey of Safety-Net Clinicians During the Early Phase of the COVID-19 Pandemic

Cited by 10 publications

References 29 publications

Assessing the Impact of Telemedicine Implementation in Diverse Health Care Systems

Assessing the Impact of Telemedicine Implementation in Diverse Health Care Systems

How and why are video consultations used in urgent primary care settings in the UK? A focus group study

Delivering urgent care services for adult patients by way of video visits at Helsinki University Hospital joint emergency care departments - retrospective observational study

Contact Info

Product

Resources

About