Telemedicine in Primary Care: Lessons Learned About Implementing Health Care Innovations During the COVID-19 Pandemic

Abstract

PURPOSE During the COVID-19 pandemic, telemedicine emerged as an important tool in primary care. Technology and policy-related challenges, however, revealed barriers to adoption and implementation. This report describes the findings from weekly and monthly surveys of primary care clinicians regarding telemedicine during the first 2 years of the pandemic.METHODS From March 2020 to March 2022, we conducted electronic surveys using convenience samples obtained through social networking and crowdsourcing. Unique tokens were used to confidentially track respondents over time. A multidisciplinary team conducted quantitative and qualitative analyses to identify key concepts and trends.RESULTS A total of 36 surveys resulted in an average of 937 respondents per survey, representing clinicians from all 50 states and multiple specialties. Initial responses indicated general difficulties in implementing telemedicine due to poor infrastructure and reimbursement mechanisms. Over time, attitudes toward telemedicine improved and respondents considered video and telephone-based care important tools for their practice, though not a replacement for in-person care. CONCLUSIONSThe implementation of telemedicine during COVID-19 identified barriers and opportunities for technology adoption and highlighted steps that could support primary care clinics' ability to learn, adapt, and implement technology.

You Cannot Function in “Overwhelm”: Helping Primary Care Navigate the Slow End of the Pandemic

“…We used an exploratory design to conduct mixed-methods analyses of data from multiple waves of the survey. The methods have been detailed elsewhere (Etz et al, 2023;Sullivan et al, 2023). Briefly, in March 2020, the Green Center began surveying primary care clinicians practicing family medicine, internal medicine, pediatrics, and other specialties in primary care settings.…”

Management of Rheumatoid Arthritis in Primary Care: A Scoping Review

“…eHealth technologies include mobile devices, telemedicine, artificial intelligence, and big data analytics [ 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 ]. The application of eHealth tools in PC leads to improvements at various levels, e.g., prevention, diagnostics, therapy, patient management, homecare for the elderly, risk prediction, clinical decision support, accuracy of diagnosis, optimization of healthcare resources, patient satisfaction of healthcare, equity of care, and health cost reduction [ 61 , 80 , 81 , 82 , 83 , 84 , 85 ]. However, there are limitations to the use of eHealth, such as existing socio-cultural norms, geographic inequalities in access to technology, and disparities in digital literacy [ 70 , 86 , 87 , 88 ].…”

“…During the SARS-CoV-2 pandemic, there has been an increase in the use of eHealth solutions in rheumatology to ensure the continuity of care and the safety of patients and caregivers [ 82 , 89 , 90 ]. The retrospective study by Avouac J. et al demonstrated the effectiveness of telemedicine in the management of RA by rheumatologists [ 91 ].…”