Qualitative data provided by 87 primary care practices in New York and Florida suggest that although telehealth experiences differ based on pre-pandemic clinicians and Familiarity with virtual care platforms, various state regulations during public health emergencies, lack of formal guidance, and physician burnout affect the pace of development of telemedicine services in practice.
WHY IT IMPORTANT
To identify common facilitators and barriers to telehealth implementation, researchers assessed practice leaders’ views on 32 aspects of telemedicine. in their practice, according to a new report published in the journal Annals of Family Medicine.
Participating primary care practices, all of which are part of the Patient-Centered Outcomes Institute clinical research network, are general practice, family, emergency medicine, medicine. preventive medicine or geriatric medicine. They define their own maturity point.
Not surprisingly, ease of adoption depends on prior experience with virtual health, according to the report “Telemedicine Experiences in Primary Care Operations in the United States: Insights from practice leaders”.
Practice with established telemedicine programs do not face the same adaptation challenges as their counterparts embarking on new virtual care programs. However, the scheduled volume of visits is “a widely cited acute problem.”
Researchers say clinicians say the transition from in-person visits to telehealth and back is frustrating – and note that patients are less tolerant of waiting for an appointment virtual, the researchers said. They also said clinicians need more training on how to communicate more effectively on virtual platforms and on state regulation.
Very different regulations also affect their use of telehealth platforms. For example, according to the researchers, “Florida’s very specific emergency order restricting the prescribing of controlled drugs to pre-existing patients” was a common theme in interviews.
A primary care practice leader says Florida’s law has placed a “monkey wrench” in telemedicine. They note: “Patients taking controlled substances, such as testosterone, will have to be onsite to get supplements.
Like many other states, Florida’s law restricting payment for asynchronous visits restricted audio-only appointments, which respondents said limited access to older patients .
Licenses are also a moving target that could hinder the ability to treat pre-existing patients.
A third theme that has emerged is the trend of telemedicine visits being scheduled for too many appointments, rather than an appropriate format for specific claims.
According to the researchers, some respondents agree that a robust triage process is needed so that clinicians do not try to address a symptom such as acute chest pain during telehealth.
Respondents said patient-specific factors, such as privacy preferences, can underpin decisions about the type of visit. They also note that it is unclear when to refer a virtual patient to emergency services
“While clear guidelines are important for planning virtual visits, formal guidance is currently lacking,” the researchers said.
“These gaps are not trivial and represent an opportunity to dramatically improve virtual healthcare delivery.”
The fourth theme that emerged was that telemedicine has both positive and negative effects on both doctors and patients.
Jumping into a virtual visit is seen as a boon for mental health and chronic conditions, just as some PCP leaders oversee operations serving Medicaid and Medicare groups as a “disruptive tool.” break the disparity”.
Two study respondents noted that telehealth visits offer a “payable opportunity” to consolidate and review screening results after the initial visit.
However, some practices are concerned about “unfair access to care,” such as when they set up a patient portal as a prerequisite for booking virtual visits.
Research shows mixed opinions about how telehealth affects physician burnout.
Several practice leaders have reported that telemedicine visits are often preferred to improve access for patients with limited mobility, reducing the physician’s risk of infection. clinical practice and offers physicians more flexible scheduling opportunities.
Meanwhile, other respondents said doctors work outside of normal hours, assist with patient technical issues and are allowed to assess when a virtual visit fits the patient’s needs. core.
“[Clinicians] feeling alone when doing telemedicine [and] tell yourself ‘I never want to do that again,’ because all day telehealth is a challenge,” said one respondent.
TREND TO BIGGER WOMAN
Prior to the COVID-19 pandemic, the use of telemedicine was hampered by concerns about reimbursement and lack of regulation. But the telehealth boom during the pandemic has proven virtual primary care has inspired some valuable advertising.
Virtual care is primary care reimagined by Rob Bressler, senior vice president of Primary360 at Teladoc Health. Telemedicine is a tool that helps create vertical care plans that foster long-term relationships between patients and service providers, provide ongoing support to the care team, and can deliver a seamless experience. unity for all people.
“The promise of providing quality primary care in a more efficient and consumer-friendly way coupled with the anticipated shortage of PCPs underscore the need for primary care,” he said. virtual head will increase significantly in the next few years”. Healthcare IT News last year.
ON PROFILE
Arguably the most striking finding – and potentially modifiable – is the documented need for telemedicine triage rules, the researchers said.
Andrea Fox is the senior editor of Healthcare IT News.
Email: [email protected]
Healthcare IT News is a publication of HIMSS Media.
