The life rafts sailed; Now let's take stock and set the course ahead (Commentary)
| Autor: | Jane Davies |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
CFF
Cystic Fibrosis Foundation Pulmonary and Respiratory Medicine Facilitators Cystic Fibrosis education SoC State of Care COVID-19 Telemedicine Article CFIR Consolidated framework for implementation research Membrane Microdomains Telehealth CF Cystic fibrosis Implementation Pediatrics Perinatology and Child Health Humans health care economics and organizations Barriers PwCF people living with cystic fibrosis |
| Zdroj: | Journal of Cystic Fibrosis |
| ISSN: | 1569-1993 |
| DOI: | 10.1016/j.jcf.2021.08.022 |
| Popis: | Background The COVID-19 pandemic forced cystic fibrosis (CF) care programs to rapidly shift from in-person care delivery to telehealth. Our objective was to provide a qualitative exploration of facilitators and barriers to: 1) implementing high-quality telehealth and 2) navigating reimbursement for telehealth services. Methods We used data from the 2020 State of Care CF Program Survey (n=286 U.S. care programs) administered in August-September to identify two cohorts of programs, with variation in telehealth quality (n=12 programs) and reimbursement (n=8 programs). We conducted focus groups and semi-structured interviews with CF program directors and coordinators in December 2020, approximately 9 months from onset of the pandemic. We used the Consolidated Framework for Implementation Research to identify facilitators and barriers of implementation, and inductive thematic analysis to identify facilitators and barriers of reimbursement. Results Factors differentiating programs with greater and lower perceived telehealth quality included telehealth characteristics (perceived advantage over in-person care, cost, platform quality); external influences (needs and resources of those served by the CF program), characteristics of the CF program (compatibility with workflows, relative priority, available resources); characteristics of team members (individual stage of change), and processes for implementation (engaging patients and teams). Reimbursement barriers included documentation to optimize billing; reimbursement of multi-disciplinary team members, remote monitoring, and telephone-only telehealth; and lower volume of patients. Conclusions A number of factors are associated with successful implementation and reimbursement of telehealth. Future efforts should provide guidance and incentives that support telehealth delivery and infrastructure, share best practices across CF programs, and remove barriers. |
| Databáze: | OpenAIRE |
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