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Using Implementation Science to Understand Barriers to Telemedicine Use for Burn Care During a Crisis.
Amanda P Bettencourt1, Theresa M Davis2, Subhash Aryal3
1Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, United States.
Summary
Telemedicine technology (TT) can improve burn care during crises, but its use is limited. Clinician perceptions of feasibility and intention to use TT are positive, yet actual usage remains low, indicating a need for targeted interventions.
Area of Science:
- Implementation Science
- Health Services Research
- Burn Care Management
Background:
- Limited burn care expertise among clinicians and hospitals creates significant challenges during crises.
- Patients with extensive burns (up to 40% TBSA) often face delays in receiving definitive care due to capacity limitations.
- Telemedicine technology (TT) offers a solution to connect remote caregivers with expert burn clinicians but is underutilized.
Purpose of the Study:
- To investigate clinician perceptions of telemedicine technology (TT) for burn care.
- To identify factors influencing the adoption and utilization of TT in emergency and burn settings.
- To explore the relationship between clinician perceptions and actual TT usage rates.
Main Methods:
- A questionnaire assessed burn center (BC) and emergency department (ED) clinician perceptions of TT feasibility, acceptability, and intention to use.
- Data were collected from 24 hospitals across four American Burn Association (ABA) disaster response regions.
- Monthly teleconsultation referral usage rates were tracked and correlated with clinician perceptions.
Main Results:
- Clinician ratings for TT acceptability, feasibility, and intention to use were generally neutral to agreeable (3.04-4.01).
- No significant relationship was found between clinician perceptions and the actual use of teleconsultation.
- Strong correlations existed between feasibility and intention to use TT, while weaker correlations were noted between ease of use and perceived usefulness.
Conclusions:
- While clinicians find TT feasible and intend to use it, its actual adoption in burn care is hindered by factors not fully captured by current perceptions.
- Interventions should focus on enhancing the perceived usefulness and ease of use of TT to improve its uptake.
- Optimizing TT implementation is crucial for enhancing the quality of initial and ongoing burn care during both crisis and routine situations.
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