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Acceptability, Usability, and Effectiveness: A Qualitative Study Evaluating a Pediatric Telemedicine Program
Hadley S Sauers-Ford1, Michelle Y Hamline1, Melissa M Gosdin2
1Department of Pediatrics, University of California Davis, Sacramento, CA.
Insights
To improve pediatric emergency telemedicine, address provider biases and adapt technology for wider use. Including patients and families in consultations enhances their experience and care.
Area of Science:
- Emergency Medicine
- Telehealth
- Pediatric Care
Background:
- Pediatric emergency telemedicine consultations support community hospitals.
- Despite recognized value, telemedicine adoption in pediatric emergency care is slow.
- A qualitative study explored reasons for underutilization of available telemedicine.
Purpose of the Study:
- Identify barriers to pediatric telemedicine use.
- Discover strategies to improve telemedicine program adoption.
- Understand clinician perspectives on telemedicine in pediatric emergencies.
Main Methods:
- Qualitative study using grounded theory methodology.
- Conducted in-depth interviews with physicians and nurses.
- Iterative data analysis and participant feedback on conceptual model.
Main Results:
- Three key themes emerged from 16 interviews.
- Addressing telemedicine biases is crucial for buy-in.
- Telemedicine processes must adapt to technological advancements and increase collaboration.
Conclusions:
- Modify processes to address provider biases and end-user concerns for better patient care.
- Adapt telemedicine for diverse technologies (e.g., smartphones) and broader user participation (e.g., nurses).
- Incorporate patients and families into telemedicine consultations to improve their experience.
Background:
Pediatric emergency telemedicine consultations have been shown to provide support to community emergency departments treating critically ill pediatric patients. However, despite the recognized value of telemedicine, adoption has been slow. To determine why clinicians frequently do not use telemedicine when it is available for pediatric patients, as well as to learn how to improve telemedicine programs, we conducted a qualitative study using stakeholder interviews.
Methods:
We conducted a qualitative study using grounded theory methodology, with in-depth interviews of referring and accepting physicians and referring, transport, and transfer center nurses. We analyzed data iteratively and adapted the interview guide based on early interviews. We solicited feedback from the participants on the conceptual model.
Results:
Sixteen interviews were conducted; all respondents had been involved in a telemedicine consultation at least five times, with some having used telemedicine more than 30 times. Analysis resulted in three themes: 1) recognizing and addressing telemedicine biases are central to gaining buy-in; 2) as technology advances, telemedicine processes need to adapt accordingly; and 3) telemedicine increases collaboration among health care providers and patients/families in the patient care process.
Conclusions:
To improve patient care through increased use of telemedicine for pediatric emergency consultations, processes need to be modified to address provider biases and end-user concerns. Processes should be adapted to allow users to utilize a variety of technologies (including smartphones) and to enable more users, such as nurses, to participate. Finally, telemedicine can be used to improve the patient and family experience by including them in consultations.
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