Clinician Perspectives on Implementing Video Visits in Home-Based Palliative Care.

Autor:	Osuji TA; Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, California, USA., Macias M; Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, California, USA., McMullen C; Kaiser Permanente Northwest, Center for Health Research, Portland, Oregon, USA., Haupt E; Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, California, USA., Mittman B; Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, California, USA., Mularski RA; Kaiser Permanente Northwest, Center for Health Research, Portland, Oregon, USA., Wang SE; Kaiser Permanente Southern California, West Los Angeles Medical Center, Los Angeles, California, USA., Werch H; Kaiser Permanente Northwest, Member-Caregiver, Stakeholder Advisory Committee, Portland, Oregon, USA., Nguyen HQ; Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, California, USA.
Jazyk:	angličtina
Zdroj:	Palliative medicine reports [Palliat Med Rep] 2020 Oct 06; Vol. 1 (1), pp. 221-226. Date of Electronic Publication: 2020 Oct 06 (Print Publication: 2020).
DOI:	10.1089/pmr.2020.0074
Abstrakt:	Background: Despite the increasing use and acceptance of technology in health care, there is limited evidence on the usefulness and appropriate use of telehealth in home-based palliative care (HBPC). As part of the process evaluation of a pragmatic trial of video visits in HBPC, we assessed clinician experience with video visit implementation. Methods: We assessed clinicians' experiences with and perception of the usefulness and appropriateness of video visits using anonymous surveys and brief qualitative interviews with a subset of survey participants. Qualitative analyses were guided by sociotechnical frameworks that emphasize technology's "value proposition" for its end users as being key to adoption. Results: Clinicians (36 physicians and 48 registered nurses) generally had favorable attitudes toward video visits and telehealth. Respondents felt confident in the skills needed to make their role in video visits successful. Clinicians were neutral on whether video visits were useful for their practice or enhanced the patient-caregiver experience. Clinicians found video visits to be most appropriate for follow-up care (as opposed to start of care). The interviews yielded two themes that complemented the survey findings: (1) factors enhancing the value proposition (positive responses from patients and families and convenience) and (2) factors diminishing the value proposition (issues related to the technology and scheduling). Discussion: Our findings provide insights into clinicians' experiences with implementing remote video physician consultations, facilitated by a nurse in the patient's home in the pre-COVID-19 era. Clinician views about video visits may have shifted with the pandemic, which occurred after our data collection was complete. Clinical Trials Registration No. NCT#03694431. Competing Interests: No competing financial interests exist. (© Thearis A. Osuji et al. 2020; Published by Mary Ann Liebert, Inc.)
Databáze:	MEDLINE
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