Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people

Abstract

BackgroundAmong indigenous populations in remote locations who are at increased risk for chronic diseases such as diabetes, telemedicine has the potential to improve access to health care services and thus may reduce adverse health outcomes. Yet few studies are available on how best to use telemedicine technology in reducing ethnic and racial health care disparities.ObjectiveWe examined perspectives of patients and providers in 2 indigenous populations in Alaska and Hawai'i about the use of telemedicine in primary care chronic disease management.DesignSix focus groups with patients and providers at 2 sites (3 in Alaska and 3 in Hawai'i).ResultsThree broad themes were common to both sites: (a) benefits and barriers of using telemedicine; (b) building patient–provider relationships; and (c) elements of an acceptable telemedicine primary care encounter. Two key elements were endorsed by both patients and providers as important for an effective telemedicine encounter: (a) the initial patient–provider interaction should be face-to-face; and (b) patients must see the same provider on follow-up visits.ConclusionThe use of telemedicine in chronic disease management has potential to improve patient care in remote indigenous populations and may supplement patient–provider relationships.

Telemedicine Use in Rural Native American Communities in the Era of the ACA: a Systematic Literature Review

“…Further, where telecommunication technology does exist, there can be technical barriers preventing access to care. In one study, providers using telehealth technologies to treat Native American patients cited frustrations with the usability of technology itself as well as lack of staff knowledge of how to operate the tools [ 16 ]. Acceptance .…”

Patient Attitudes Toward Telemedicine for Diabetic Retinopathy

“…Therefore, telemedicine programs should focus on individuals who have limited access to care. 24,42 Programs could also highlight the shortened travel distances and decreased time away from work for those who already have good access to care. 39 Not surprisingly, patients with ocular comorbidities did not believe telemedicine to be more …”

Exploring Canadian Physicians' Experiences With Type 2 Diabetes Care for Adult Indigenous Patients

“…Previous research identifies multiple factors important in the delivery of high-quality care for diverse patients at high risk for diabetes (17)(18)(19), though few explore physicians' experiences with Indigenous patients. The research that does exist provides a glimpse of the barriers perceived by health practitioners; the barriers arise at the levels of the patients, the providers and the wider system (20), including health practitioners' frustrations with negative health outcomes, staff shortages and turnover, inadequate training and the fragmentation of care, in addition to community isolation and poverty.…”