Coronavirus Disease 2019’s Shake-up of Telehealth Policy: Application of Kingdon’s Multiple Streams Framework

Giese, K.

doi:10.1016/j.nurpra.2020.08.015

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…The creation of telehealth user resources is needed such as generating handouts and video tutorials of the connection process and creating mock appointments to practice online connections [21]. Despite the challenges of telehealth, uncertain future of insurance coverage of telehealth, and differing delivery systems worldwide, these study results can provide guidance for the impact, outcomes, and implementation of telehealth among older adults with cancer and changes needed in telehealth practices and policies [22,23]. Doing so can improve the telehealth experience for older adults with cancer, their caregivers, and healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

Healthcare providers’ experiences of continuing care for older adults with cancer during the COVID-19 pandemic

et al. 2023

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Purpose The COVID-19 pandemic has caused great strain on older adults with cancer and their healthcare providers. This study explored healthcare providers’ reported changes in cancer care, clinical barriers to care, patient questions, and the overall experiences of caring for older adults with cancer during the COVID-19 crisis. Methods The Advocacy Committee of the Cancer and Aging Research Group and the Association of Community Cancer Centers developed a survey for healthcare providers of adults with cancer, inquiring about their experiences during the pandemic. Responses from the survey’s four open-ended items were analyzed by four independent coders for identification of common themes using deductive and inductive methods. Results Participants ( n = 137) represented a variety of demographic and clinical experiences. Six overall themes emerged, including (1) telehealth use, (2) concerns for patient mental health, (3) patient physical and social isolation, (4) patient fear of contracting COVID-19, (5) continued disruptions to cancer care, and (6) patients seeking guidance, particularly regarding COVID-19 vaccination. Questions fielded by providers focused on the COVID-19 vaccination’s safety and efficacy during older adults’ cancer treatment. Conclusions Additional resources (e.g., technology support, established care guidelines, and sufficient staffing) are needed to support older adults with cancer and healthcare providers during the pandemic. Future research should explore universally effective in-person and virtual treatment strategies for older adults with cancer. Implications for Cancer Survivors Persistence of telehealth barriers, particularly a lack of infrastructure to support telehealth visits, social isolation, and restrictive visitor policies as a result of COVID-19, negatively impacted the mental health of older adults with cancer.

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Section: Discussionmentioning

confidence: 99%

Healthcare providers’ experiences of continuing care for older adults with cancer during the COVID-19 pandemic

et al. 2023

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“…According to Kingdon's Policy Streams Approach, the research methodology consisted of three domains [19,20]. The first was the problem stream that describes a problem or issue that needs to be resolved.…”

Section: Planning (Methodology) Of Researchmentioning

confidence: 99%

“…The process of the conceptual framework of evidence-based medicine substitution formation in Ukraine was studied based on the Policy Streams Approach [19,20]. The SWOT analysis was applied for identification of a strengths and weaknesses of conceptual framework implementation of evidence-based medicine substitution in Ukraine.…”

Section: Analysis Was Carried Out Based On the Collected Information From The Lists And Reports Of Public Procurement Of The Ministry Of mentioning

confidence: 99%

Shaping of the evidence-based substitution conceptual framework of the original medicines to generic counterparts in Ukraine

Dobrova

Popov

Зупанец

et al. 2021

SR: PS

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The aim. To develop conceptual framework of the strategy for a reasonable transition from original to generic medicines by complex implementation of proper bioequivalence studies and sufficient therapeutic drug monitoring management. Materials and methods. To conduct the study, we used the lists of medicines included in the state reimbursement program “Dostupny Liky” (Affordable Medicines), and materials of reports on medicines public procurement provided on the website of the Ministry of Health of Ukraine and the National Health Service of Ukraine, as well as information data on the results of studies of the quality and effectiveness of these drugs provided by the Rx-Index website. In the course of the study, the methods of logical analysis, SWOT analysis, and statistical evaluation of results, Kingdon’s Policy Streams Approach and the method of flowcharts construction were used. The concept of evidence-based medicine substitution formation in Ukraine was designed applying the Policy Streams Approach. Results. The analysis of public procurement programs for drugs for the period 2018–2020, as well as the analysis of drugs included in the new list under the “Dostupny Liky” (Affordable Medicines) program, carried out in the course of the study, showed that the level of evidence of data on assessing their effectiveness remains low. At the same time, more than 1.5 billion UAH (~ 50 mln USD) is spent annually on the purchase of such drugs and reimbursement of their cost, and the question of the optimal selection and monitoring of pharmacotherapy with these drugs remains open. A structural model has been developed, in which three basic levels are identified: provision of regulatory and financial components, executive and the level of implementation of the results. The SWOT-analysis of the strengths and weaknesses, as well as external opportunities and threats for the implementation of the conceptual framework made it possible to substantiate the advantages and reveal the possibilities of attracting clinical centers of universities and research institutions to the implementation of the concept. A framework for the interaction of a research center with health care institutions in the implementation of therapeutic drug monitoring was developed for low-income and low-middle income countries on the example of Ukraine. Distribution of responsibilities was proposed and the basic principles of interaction between performers of therapeutic drug monitoring were highlighted. Conclusions. Based on the results of the analysis of the evidence of the quality and effectiveness of drugs included in public procurement and in reimbursement programs, the key problems of organizing pharmaceutical provision of an appropriate level of quality for a number of chronic diseases requiring lifelong therapy were identified. The conceptual framework of evidence-based original medicines substitution to generic counterparts have been formed; and the ways of its implementation in the conditions of scarce financial resources on the example of Ukraine have been substantiated

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“…31 The MSF was used as a framework to analyze telehealth reimbursement in the human health policy arena. 33 Following that use of this framework by Giese,33 this work applies the MSF to explore telemedical policy in veterinary medicine as a tool to mitigate access disparities to veterinary care. Specifically, the establishment of a VCPR through virtual and/or remote technology is identified as the key policy area in which to apply the MSF, with the identification of a parallel policy stream hypothesized to exist in human healthcare.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Identifying policy alternatives to enable the virtual establishment of a veterinarian–client–patient relationship

Neal,

Greenberg

2024

Journal of Feline Medicine and Surgery

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Objectives This research seeks to identify an existing policy stream around the establishment of a veterinarian–client–patient relationship (VCPR) through telemedicine to provide evidence of, and advance policy alternatives for, states and countries looking to allow this practice responsibly. This is seen as an important step for access to veterinary care, particularly for cats. Methods The multiple streams policy framework requires identification of a centering event, problem stream, policy stream and politics stream in order to have the necessary conditions for policy change to occur. This research identifies that policy stream through thematic content analysis. State-level policies from across the entire USA that address the virtual establishment of a physician–patient relationship were analyzed to provide themes that could be applied to similar policies in veterinary medicine. Results Ten key themes were identified and further organized into four high-order concepts through the thematic content analysis. Detailed accounting of the specific policy alternatives is provided in the supplementary materials. Conclusions and relevance The themes and concepts presented provide evidence of a robust policy stream. This content analysis, and the supporting supplementary details, provide many options to guide states in the development of sound policies for the virtual establishment of a VCPR by drawing from the more matured field of human medicine.

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Coronavirus Disease 2019’s Shake-up of Telehealth Policy: Application of Kingdon’s Multiple Streams Framework

Cited by 5 publications

References 14 publications

Healthcare providers’ experiences of continuing care for older adults with cancer during the COVID-19 pandemic

Healthcare providers’ experiences of continuing care for older adults with cancer during the COVID-19 pandemic

Shaping of the evidence-based substitution conceptual framework of the original medicines to generic counterparts in Ukraine

Identifying policy alternatives to enable the virtual establishment of a veterinarian–client–patient relationship

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