Kristin N. Ray , James C. Bohnhoff , Kelsey Schweiberger , Gina M. Sequeira , Janel Hanmer , Jeremy M. Kahn
{"title":"远程医疗在初次门诊专科会诊中的应用:一项针对普通儿科医生和儿科专科医生的全国性调查","authors":"Kristin N. Ray , James C. Bohnhoff , Kelsey Schweiberger , Gina M. Sequeira , Janel Hanmer , Jeremy M. Kahn","doi":"10.1016/j.hjdsi.2021.100600","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Evidence-based strategies are needed to support appropriate use of telemedicine<span> for initial outpatient subspecialty consultative visits. To inform such strategies we performed a survey of general pediatricians and pediatric subspecialists about use of telemedicine for patients newly referred for pediatric subspecialty care.</span></p></div><div><h3>Methods</h3><p>We developed and fielded an e-mail and postal survey of a national sample of 840 general pediatricians and 840 pediatric subspecialists in May and June 2020.</p></div><div><h3>Results</h3><p>Of 266 completed surveys (17% response rate), 204 (76%) thought telemedicine should be offered for some and 29 (11%) thought telemedicine should be offered for all initial subspecialist visits. Most respondents who indicated telemedicine should be offered for some initial consultations believed this decision should be made by subspecialty attendings (176/204, 86%). Respondents prioritized several data elements to inform this decision, including clinical information and family-based contextual information (e.g., barriers to in-person care, interest in telemedicine, potential communication barriers). Factors perceived to reduce appropriateness of telemedicine for subspecialty consultation included need for interpreter services and prior history of frequent no-shows. Responses from generalists and subspecialists rarely differed significantly.</p></div><div><h3>Conclusions</h3><p>Survey results suggest potential opportunities to support the appropriate use of telemedicine for initial outpatient pediatric subspecialty visits through structured transfer of specific clinical and contextual information at the time of referral and through strategies to mitigate perceived communication or engagement barriers.</p></div><div><h3>Implication</h3><p>Pediatric physician beliefs about telemedicine for initial outpatient subspecialty consultative visits may inform future interventions to support appropriate telemedicine use.</p></div><div><h3>Level of evidence</h3><p>Survey of a national sample of clinicians.</p></div>","PeriodicalId":29963,"journal":{"name":"Healthcare-The Journal of Delivery Science and Innovation","volume":"10 1","pages":"Article 100600"},"PeriodicalIF":2.0000,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"Use of telemedicine for initial outpatient subspecialist consultative visit: A national survey of general pediatricians and pediatric subspecialists\",\"authors\":\"Kristin N. Ray , James C. Bohnhoff , Kelsey Schweiberger , Gina M. Sequeira , Janel Hanmer , Jeremy M. Kahn\",\"doi\":\"10.1016/j.hjdsi.2021.100600\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Evidence-based strategies are needed to support appropriate use of telemedicine<span> for initial outpatient subspecialty consultative visits. To inform such strategies we performed a survey of general pediatricians and pediatric subspecialists about use of telemedicine for patients newly referred for pediatric subspecialty care.</span></p></div><div><h3>Methods</h3><p>We developed and fielded an e-mail and postal survey of a national sample of 840 general pediatricians and 840 pediatric subspecialists in May and June 2020.</p></div><div><h3>Results</h3><p>Of 266 completed surveys (17% response rate), 204 (76%) thought telemedicine should be offered for some and 29 (11%) thought telemedicine should be offered for all initial subspecialist visits. Most respondents who indicated telemedicine should be offered for some initial consultations believed this decision should be made by subspecialty attendings (176/204, 86%). Respondents prioritized several data elements to inform this decision, including clinical information and family-based contextual information (e.g., barriers to in-person care, interest in telemedicine, potential communication barriers). Factors perceived to reduce appropriateness of telemedicine for subspecialty consultation included need for interpreter services and prior history of frequent no-shows. Responses from generalists and subspecialists rarely differed significantly.</p></div><div><h3>Conclusions</h3><p>Survey results suggest potential opportunities to support the appropriate use of telemedicine for initial outpatient pediatric subspecialty visits through structured transfer of specific clinical and contextual information at the time of referral and through strategies to mitigate perceived communication or engagement barriers.</p></div><div><h3>Implication</h3><p>Pediatric physician beliefs about telemedicine for initial outpatient subspecialty consultative visits may inform future interventions to support appropriate telemedicine use.</p></div><div><h3>Level of evidence</h3><p>Survey of a national sample of clinicians.</p></div>\",\"PeriodicalId\":29963,\"journal\":{\"name\":\"Healthcare-The Journal of Delivery Science and Innovation\",\"volume\":\"10 1\",\"pages\":\"Article 100600\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2022-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Healthcare-The Journal of Delivery Science and Innovation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S221307642100083X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Healthcare-The Journal of Delivery Science and Innovation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S221307642100083X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
Use of telemedicine for initial outpatient subspecialist consultative visit: A national survey of general pediatricians and pediatric subspecialists
Background
Evidence-based strategies are needed to support appropriate use of telemedicine for initial outpatient subspecialty consultative visits. To inform such strategies we performed a survey of general pediatricians and pediatric subspecialists about use of telemedicine for patients newly referred for pediatric subspecialty care.
Methods
We developed and fielded an e-mail and postal survey of a national sample of 840 general pediatricians and 840 pediatric subspecialists in May and June 2020.
Results
Of 266 completed surveys (17% response rate), 204 (76%) thought telemedicine should be offered for some and 29 (11%) thought telemedicine should be offered for all initial subspecialist visits. Most respondents who indicated telemedicine should be offered for some initial consultations believed this decision should be made by subspecialty attendings (176/204, 86%). Respondents prioritized several data elements to inform this decision, including clinical information and family-based contextual information (e.g., barriers to in-person care, interest in telemedicine, potential communication barriers). Factors perceived to reduce appropriateness of telemedicine for subspecialty consultation included need for interpreter services and prior history of frequent no-shows. Responses from generalists and subspecialists rarely differed significantly.
Conclusions
Survey results suggest potential opportunities to support the appropriate use of telemedicine for initial outpatient pediatric subspecialty visits through structured transfer of specific clinical and contextual information at the time of referral and through strategies to mitigate perceived communication or engagement barriers.
Implication
Pediatric physician beliefs about telemedicine for initial outpatient subspecialty consultative visits may inform future interventions to support appropriate telemedicine use.
期刊介绍：
HealthCare: The Journal of Delivery Science and Innovation is a quarterly journal. The journal promotes cutting edge research on innovation in healthcare delivery, including improvements in systems, processes, management, and applied information technology.
The journal welcomes submissions of original research articles, case studies capturing "policy to practice" or "implementation of best practices", commentaries, and critical reviews of relevant novel programs and products. The scope of the journal includes topics directly related to delivering healthcare, such as:
● Care redesign
● Applied health IT
● Payment innovation
● Managerial innovation
● Quality improvement (QI) research
● New training and education models
● Comparative delivery innovation
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