Telehealth for Pediatric Patients: Facilitators, Barriers, and Impact on Disparities

IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES

Joint Commission journal on quality and patient safety Pub Date : 2025-07-20 DOI:10.1016/j.jcjq.2025.07.006

Courtney Sump MD, MSc (Assistant Professor, Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine.), Hadley Sauers-Ford MPH, CCRP (is Senior Clinical Research Coordinator, Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center.), Sinem Toraman Turk PhD (is Associate Research Scientist, Yale Global Health Leadership Initiative, Department of Health Policy and Management, Yale School of Public Health.), Kylee Denker MSN, RN, NE-BC (is Clinical Director, Home Care Agency and Remote Patient Monitoring, Cincinnati Children’s Hospital Medical Center.), Carlos Casillas MD, MPH (is Assistant Professor, Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine.), Joanna Thomson MD, MPH (is Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, and Professor, Department of Pediatrics, University of Cincinnati College of Medicine. Please send correspondence to Courtney Sump)

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引用次数: 0

Abstract

Background

Although telehealth has potential to improve access to care by eliminating barriers such as transportation and childcare, it also may result in disparate access for certain populations. The aim of this study was to gain an in-depth understanding of telehealth access at a large quaternary care children’s hospital.

Methods

This qualitative study employed purposive sampling and semistructured interviews of key personnel across our institution, including caregivers, clinical providers, and telehealth operational leads and staff. Interviews targeting access to telehealth were recorded and transcribed verbatim. Using an inductive, thematic approach, each interview was coded independently by two study team members. The authors identified preliminary themes and iteratively reviewed interviews and codes to finalize themes with illustrative quotes.

Results

The authors interviewed 25 participants and identified four themes: (1) Telehealth may perpetuate health disparities, including provider reluctance to offer telehealth to patients with a preferred language other than English; (2) Telehealth can help patients receive the right care, at the right place and time; (3) There are numerous facilitators to telehealth’s uptake, including provider and caregiver buy-in and optimal physical workspace; and (4) There are challenges in its execution that lead to decreased uptake.

Conclusion

Telehealth has many challenges to successful execution but is an integral component to providing the right care at the right place and time. This study was unique in capturing perspectives of multidisciplinary members of the healthcare team in addition to patient caregivers to provide a wide variety of perspectives on access to telehealth. The findings in this single-site, qualitative study identify that real and perceived assumptions about who is best suited for telehealth care may perpetuate health disparities and exacerbate gaps in access to care.

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儿科患者远程医疗：促进者、障碍和对差异的影响。

背景：虽然远程保健有可能通过消除交通和儿童保育等障碍来改善获得保健的机会，但它也可能导致某些人群获得不同的机会。本研究的目的是深入了解远程医疗访问在一家大型四级护理儿童医院。方法：本定性研究采用有目的抽样和半结构化访谈的主要人员在我们的机构，包括护理人员，临床提供者，远程医疗业务主管和工作人员。记录和逐字抄录了针对获取远程保健的访谈。采用归纳、主题的方法，每次访谈都由两名研究小组成员独立编码。作者确定了初步主题，并反复审查访谈和代码，以说明性引用最终确定主题。结果：作者采访了25名参与者，并确定了四个主题：(1)远程医疗可能会使健康差距长期存在，包括提供者不愿以英语以外的首选语言向患者提供远程医疗；(2)远程医疗可以帮助患者在正确的时间和地点获得正确的护理；(3)有许多促进远程医疗的因素，包括提供者和护理人员的支持和最佳的物理工作空间；(4)在执行过程中存在挑战，导致使用率下降。结论：远程医疗在成功实施方面面临许多挑战，但它是在正确的地点和时间提供正确护理的重要组成部分。这项研究的独特之处在于，除了患者护理人员之外，还捕获了医疗团队多学科成员的观点，以提供关于远程医疗的各种观点。这项单点定性研究的结果表明，关于谁最适合远程保健的真实和可感知的假设可能使健康差距永久化，并加剧获得保健的差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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