Telehealth Provider Perspectives During Covid-19: Insights From an Academic Cardiology Practice

Lee, Megan; Luna, Paulina; Lynch, Shannon M.; Nagpal, Sameer; Dominguez, Yulanka Castro; Ahmed, Zain; Brice, Aaron; Arham, Ahmad Firdhaus; Smolderen, Kim G.; Hurtado, Carlos Mena

doi:10.1016/s0735-1097(21)04567-8

Cited by 3 publications

(2 citation statements)

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“…From the health care provider's perspective, the advantages of telehealth included increased usage of services [17], improved provider well-being [17,18], accommodation of patients who face challenges for in-person care [18,19], and fostering a sense of family-centered care [18]. The disadvantages from the clinician perspective include issues with technology and disparities in patient access to technology [17][18][19][20], less personal connection [19], inability to complete in-person diagnostic tests [20], reimbursement complications and out-of-state licensure restrictions [17], and a preference for in-person visits for patient populations that would benefit more from in-person care [17]. Studies exploring patient perspectives have reported that benefits, such as reduced travel time, shorter wait time, and cost savings [15,21], as well as convenience and safety [15,22], were seen as advantages, whereas internet issues, technical barriers [21,22], lack of connection with their provider, and unfamiliarity with the telehealth process [22] were seen as barriers.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Telehealth for Diabetes Management in the Deep South of the United States: Qualitative Study of Barriers and Facilitators on the Patient and Clinician Journey

Bazzano,

Patel,

Nauman

et al. 2024

J Med Internet Res

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Background The Deep South of the United States, and Louisiana in particular, bears a greater burden of obesity, diabetes, and heart disease compared with other regions in the United States. Throughout the COVID-19 pandemic, there has been a substantial increase in telehealth visits for diabetes management to protect the safety of patients. Although there have been significant advancements in telehealth and chronic disease management, little is known about patient and provider perspectives on the challenges and benefits of telehealth visits among people living with diabetes and providers who care for patients with diabetes in Louisiana. Objective This study aimed to explore barriers, facilitators, challenges, and benefits to telehealth for patients with diabetes and health care providers as they transitioned from in-person to remote care during the early COVID-19 pandemic to understand potential optimization. Methods A total of 24 semistructured qualitative interviews were conducted with 18 patients living with diabetes and 6 clinicians who served patients with diabetes to explore their experiences and perceptions of telehealth services for diabetes care. Approximately half of the participants identified as Black or African American, half as White, and 75% as female. Interviews were recorded, transcribed, and coded by experienced qualitative researchers using inductive and deductive techniques. A narrative, descriptive approach to the patient and clinician journey framed the study, including the development of internal journey maps, and reflexive thematic analysis was applied to the transcripts, with special attention to barriers and facilitators. Results In total, 5 themes illustrated barriers and facilitators for participants: convenience, safety, and comfort are the benefits of telehealth for patients and clinicians; yet telehealth and in-person visits are valued differently; the convenience of telehealth may have a downside; technology acts as a double-edged sword; and managing expectations and efficiency of the visit experience was an important factor. Individual experiences varied in relation to several factors, including comfort level and access to technology, health system protocols for providing telemedicine, and level of diabetes control among patients. Conclusions Recommendations for optimization include providing support to help guide and inform patients about what to expect and how to prepare for telehealth visits as well as allowing clinicians to schedule telehealth and in-person visits during discrete blocks of time to improve efficiency. Further research should address how hybrid models of telehealth and in-person care may differentially impact health outcomes for patients with diabetes, particularly for people with multiple chronic conditions in settings where access to technology and connectivity is not optimal.

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Section: Introductionmentioning

confidence: 99%

Optimizing Telehealth for Diabetes Management in the Deep South of the United States: Qualitative Study of Barriers and Facilitators on the Patient and Clinician Journey

Bazzano,

Patel,

Nauman

et al. 2024

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“… 2 Early research suggested the potential benefits of telehealth in increasing care access, patient satisfaction, and cost savings, 3 in addition to preserving personal protective equipment and mitigating infections. 4 , 5 , 6 Despite new guidance from cardiology publications on how to perform TH visits, 7 , 8 , 9 residual hesitancy among patients 10 and providers 11 in adopting TH stems from the paucity of evidence evaluating its impact on clinical outcomes compared with in-person visits. In this study, we sought to investigate the clinical outcomes of patients with coronary artery disease (CAD) and/or heart failure (HF) who were evaluated in cardiology clinics through TH visits during the first 6 months of the 2020 COVID-19 pandemic in comparison with prepandemic (PP) patients seen in the first 6 months of 2019.…”

mentioning

confidence: 99%

Clinical Outcomes of Telehealth in Patients With Coronary Artery Disease and Heart Failure During the COVID-19 Pandemic

Woo

Chung

Shi

et al. 2023

The American Journal of Cardiology

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Optimizing Telehealth for Diabetes Management in the Deep South of the United States: Qualitative Study of Barriers and Facilitators on the Patient and Clinician Journey (Preprint)

Bazzano,

Patel,

Nauman

et al. 2022

Preprint

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BACKGROUND The Deep South of the United States, and Louisiana in particular, bears a greater burden of obesity, diabetes, and heart disease compared with other regions in the United States. Throughout the COVID-19 pandemic, there has been a substantial increase in telehealth visits for diabetes management to protect the safety of patients. Although there have been significant advancements in telehealth and chronic disease management, little is known about patient and provider perspectives on the challenges and benefits of telehealth visits among people living with diabetes and providers who care for patients with diabetes in Louisiana. OBJECTIVE This study aimed to explore barriers, facilitators, challenges, and benefits to telehealth for patients with diabetes and health care providers as they transitioned from in-person to remote care during the early COVID-19 pandemic to understand potential optimization. METHODS A total of 24 semistructured qualitative interviews were conducted with 18 patients living with diabetes and 6 clinicians who served patients with diabetes to explore their experiences and perceptions of telehealth services for diabetes care. Approximately half of the participants identified as Black or African American, half as White, and 75% as female. Interviews were recorded, transcribed, and coded by experienced qualitative researchers using inductive and deductive techniques. A narrative, descriptive approach to the patient and clinician journey framed the study, including the development of internal journey maps, and reflexive thematic analysis was applied to the transcripts, with special attention to barriers and facilitators. RESULTS In total, 5 themes illustrated barriers and facilitators for participants: convenience, safety, and comfort are the benefits of telehealth for patients and clinicians; yet telehealth and in-person visits are valued differently; the convenience of telehealth may have a downside; technology acts as a double-edged sword; and managing expectations and efficiency of the visit experience was an important factor. Individual experiences varied in relation to several factors, including comfort level and access to technology, health system protocols for providing telemedicine, and level of diabetes control among patients. CONCLUSIONS Recommendations for optimization include providing support to help guide and inform patients about what to expect and how to prepare for telehealth visits as well as allowing clinicians to schedule telehealth and in-person visits during discrete blocks of time to improve efficiency. Further research should address how hybrid models of telehealth and in-person care may differentially impact health outcomes for patients with diabetes, particularly for people with multiple chronic conditions in settings where access to technology and connectivity is not optimal.

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Telehealth Provider Perspectives During Covid-19: Insights From an Academic Cardiology Practice

Cited by 3 publications

References 0 publications

Optimizing Telehealth for Diabetes Management in the Deep South of the United States: Qualitative Study of Barriers and Facilitators on the Patient and Clinician Journey

Optimizing Telehealth for Diabetes Management in the Deep South of the United States: Qualitative Study of Barriers and Facilitators on the Patient and Clinician Journey

Clinical Outcomes of Telehealth in Patients With Coronary Artery Disease and Heart Failure During the COVID-19 Pandemic

Optimizing Telehealth for Diabetes Management in the Deep South of the United States: Qualitative Study of Barriers and Facilitators on the Patient and Clinician Journey (Preprint)

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