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Understanding Provider's Experiences With Telehealth at an Urban Pediatric Health Care System
Debra Lajoie1, Jean Anne Connor, Terry Saia
1Author Affiliations: Nursing Research Medical, Surgical, Behavioral Health & Emergency Patient Services (Dr Lajoie), Nursing Research Cardiovascular, Critical Care & Perioperative Patient Services (Dr Connor), Nursing and Patient Care Operations-Ambulatory Cardiology, APRN Professional Development for Cardiovascular, Perioperative and Critical Care Programs (Dr Saia), Boston Operations for Ambulatory Cardiology (Dr Saleeb), Ambulatory Cardiology (Dr DeFerranti), Ambulatory Medicine (Dr Morgan-Gorman), Cardiovascular and Critical Care Services (Ms Cole), Cardiovascular, Critical Care and Perioperative, Patient Services (Mr DiPasquale), Cardiovascular, Critical Care and Perioperative Services (Dr Hickey), Boston Children's Hospital, Boston, Massachusetts; and Department of Pediatrics, Harvard Medical School (Dr Saleeb, Dr DeFerranti, Dr Hickey), Boston, Massachusetts.
None:
The purpose of this three-part, mixed-methods study is to mitigate patient risk by understanding and describing the current and future state of pediatric telehealth (TH) care delivery. As the COVID-19 pandemic emerged, an unprepared clinical workforce mobilized to quickly transition patients to TH to mitigate the risk of infection and maintain access to care. Optimizing digital health care delivery requires an understanding of the current models of care, the identification of best practices, and opportunities for improvement to mitigate patient/family, provider, and institutional risk. Aim 1 used descriptive, qualitative inquiry to understand and explore the experience of cardiology providers utilizing TH through structured interviews. From the 6 providers interviews conducted, 6 themes emerged: the experience of TH Care Delivery, Conflicting Expectations of Parents/Patients vs. Providers, Regulatory, Ethical, and Legal Concerns, Knowledge Gaps, Data Burden, and Moral Distress. Hearing providers' voices and experiences can guide the integration of TH and digital technologies into health care. These findings describe the need to develop evidence describing the significance and inter-relatedness of TH and the concepts of psychological safety, the healthy work environment, and thriving.
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