远程医疗转型:私立医疗机构组织变革过程与结果的混合方法研究

IF 2.5 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Masab A Mansoor DBA, MBA, ¸BS
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引用次数: 0

摘要

目的这项混合方法案例研究调查了在两个私立儿科诊所系统中实施远程医疗服务的相关影响、成本、障碍和促进因素。方法在采用企业级远程医疗前后,对儿科和心脏病诊所的 34 名临床医生、管理人员和员工进行了访谈,以考察这一创新中的变革过程。对实施前后 12 个月的财务记录进行了统计分析,以评估收入和成本动态。定量结果测量包括支出、收入和远程医疗访问利用率,而对访谈和焦点小组的定性分析则通过对参与者的叙述进行严格的归纳编码来揭示关键的实施主题。每个医疗服务提供者每月的远程医疗访问量在各医疗点成倍增加了 450%。从定性角度看,83% 的医疗服务提供者对灵活安排时间的好处表示赞赏,但 68% 的员工表示工作流程受到干扰。结论解释性地讲,研究结果表明,在预约容量明显扩大的情况下,催化了财务和生产力的转变,以及细微的干扰感知。建议包括更新护理协调协议、加强培训和支持资源、激励医疗服务提供者使用,以及在大规模组织创新过程中根据用户反馈调整实施进度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Telehealth Transformation: A Mixed-Methods Study on Organizational Change Processes and Outcomes in Private Medical Practices

Purpose

This mixed-methods case study investigated the impacts, costs, barriers, and facilitators associated with implementing telehealth services across two private pediatric clinic systems. The research examined the effects of telehealth on provider engagement and financial performance.

Methods

Thirty-four clinicians, administrators, and staff across the pediatric and cardiology clinics were interviewed before and after enterprise-level telehealth adoption to examine change processes amid this innovation. Twelve months of pre- and post-implementation financial records underwent statistical analysis to assess revenue and cost dynamics. Quantitative outcome measures encompassed expenses, revenues, and telehealth visit utilization rates, while qualitative analysis of interviews and focus groups revealed key implementation themes through rigorous inductive coding of participant narratives.

Results

Results showed significantly increased costs (44-75%) and revenues (21-47%) at both clinics following virtual care expansion. Monthly telehealth visits per provider exponentially rose over 450% across sites. Qualitatively, 83% of providers appreciated scheduling flexibility benefits, but 68% of staff cited workflow disruptions. Interpretatively, findings demonstrated catalyzed financial and productivity transformations and nuanced perceived disruption amid pronounced appointment capacity expansions.

Conclusions

Interpretatively, findings demonstrated catalyzed financial and productivity transformations and nuanced perceived disruption amid pronounced appointment capacity expansions. Recommendations encompass updated care coordination protocols, enhanced training and support resources, incentivizing provider usage, and modulating implementation pacing responding to user feedback during large-scale organizational innovation.

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来源期刊
CiteScore
4.80
自引率
3.00%
发文量
139
审稿时长
98 days
期刊介绍: Journal of the National Medical Association, the official journal of the National Medical Association, is a peer-reviewed publication whose purpose is to address medical care disparities of persons of African descent. The Journal of the National Medical Association is focused on specialized clinical research activities related to the health problems of African Americans and other minority groups. Special emphasis is placed on the application of medical science to improve the healthcare of underserved populations both in the United States and abroad. The Journal has the following objectives: (1) to expand the base of original peer-reviewed literature and the quality of that research on the topic of minority health; (2) to provide greater dissemination of this research; (3) to offer appropriate and timely recognition of the significant contributions of physicians who serve these populations; and (4) to promote engagement by member and non-member physicians in the overall goals and objectives of the National Medical Association.
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