Telehealth Adoption During COVID-19: Lessons Learned from Obstetric Providers in the Rocky Mountain West.

Carly Holman, Annie Glover, Kimber McKay, Courtney Gerard
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引用次数: 1

Abstract

Introduction: Obstetric providers have used telemedicine to manage gestational diabetes, mental health, and prenatal care. However, the uptake of telemedicine in this field has not been universal. The COVID-19 pandemic catalyzed the adoption of telehealth in obstetric care, which will have lasting effects, especially for rural communities. We sought to understand the experience of adapting to telehealth among obstetric providers in the Rocky Mountain West to identify implications for policy and practice.

Methods: This study included 20 semi-structured interviews with obstetric providers in Montana, Idaho, and Wyoming. The interviews followed a moderator's guide based on the Aday & Andersen Framework for the Study of Access to Medical Care, exploring domains of health policy, the health system, the utilization of health services, and the population at risk. All the interviews were recorded, transcribed, and analyzed using thematic analysis.

Results: Findings indicate that participants view telehealth as a useful tool during prenatal and postpartum care; many participants intend to continue telehealth practices after the pandemic. Participants shared that their patients reported benefits to telehealth beyond COVID-19 safety, including limiting travel time, reducing time off work, and alleviating childcare needs. Participants expressed concern that expanding telehealth will not equally benefit all patients and could widen existing health inequities.

Discussion: Success moving forward will require a telehealth infrastructure, adaptive telehealth models, and provider and patient training. As obstetric telehealth expands, efforts must prioritize equitable access for rural and low-income communities, so all patients can benefit from the technological advancements to support health.

COVID-19期间远程医疗的采用:从落基山脉西部产科提供者那里吸取的经验教训。
产科提供者已经使用远程医疗来管理妊娠糖尿病、心理健康和产前护理。然而,远程医疗在这一领域的应用尚未普及。2019冠状病毒病大流行促使在产科护理中采用远程医疗,这将产生持久影响,特别是对农村社区。我们试图了解西部落基山脉产科服务提供者适应远程医疗的经验,以确定对政策和实践的影响。方法:本研究包括对蒙大拿州、爱达荷州和怀俄明州的产科医生进行的20次半结构化访谈。访谈遵循主持人的指导,该指导基于Aday & Andersen医疗保健可及性研究框架,探索卫生政策、卫生系统、卫生服务利用和风险人群等领域。所有访谈都被记录、转录,并使用主题分析进行分析。结果:研究结果表明,参与者认为远程保健是产前和产后护理的有用工具;许多与会者打算在大流行之后继续采用远程保健做法。与会者分享说,他们的患者报告了远程医疗的好处,除了COVID-19安全之外,包括限制旅行时间、减少下班时间和减轻儿童保育需求。与会者表示关切的是,扩大远程保健不会平等地惠及所有患者,并可能扩大现有的保健不公平现象。讨论:成功地向前推进将需要远程医疗基础设施、适应性远程医疗模式以及提供者和患者培训。随着产科远程保健的扩大,必须优先考虑为农村和低收入社区提供公平的机会,使所有患者都能从技术进步中受益,从而支持健康。
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