A framework for patient-centered telemedicine: Application and lessons learned from vulnerable populations

Area of Science:

• Digital Health
• Telemedicine Implementation
• Public Health Interventions

Background:

• Virtual technologies enhance healthcare delivery, patient monitoring, and clinician-patient interactions.
• Telemedicine facilitates patient-centered care by enabling remote communication and information transfer.
• Opioid treatment programs (OTPs) serve vulnerable populations often facing barriers to accessing care.

Purpose of the Study:

• To present a framework for implementing a comprehensive, dynamic, patient-centered telemedicine network.
• To manage hepatitis C virus (HCV) infection through telemedicine, integrating HCV and substance use medications.
• To apply the Sociotechnical System model for telemedicine deployment in vulnerable populations.

Main Methods:

• Deployment of a telemedicine network across 12 opioid treatment programs (OTPs) in New York State (NYS).
• Utilizing the Sociotechnical System model with a focus on patient-centered factors for implementation.
• Addressing challenges related to interoperability with electronic health records (EHR) and clinical information retrieval.

Main Results:

• The Sociotechnical System model provided a viable framework for telemedicine deployment to a vulnerable population.
• Identified challenges include EHR interoperability, clinical information retrieval, and ensuring system security and confidentiality.
• Valuable lessons were learned regarding the implementation of a dynamic, patient-centered telemedicine system in OTPs.

Conclusions:

• A patient-centered telemedicine framework, guided by the Sociotechnical System model, is effective for vulnerable populations.
• Addressing interoperability, data retrieval, and trust are crucial for successful telemedicine implementation in OTPs.
• Findings offer generalizable insights for extending telemedicine to other hard-to-reach populations.