{"title":"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","authors":"Masab A Mansoor DBA, MBA, ¸BS","doi":"10.1016/j.jnma.2024.07.087","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 449"},"PeriodicalIF":2.5000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Telehealth Transformation: A Mixed-Methods Study on Organizational Change Processes and Outcomes in Private Medical Practices\",\"authors\":\"Masab A Mansoor DBA, MBA, ¸BS\",\"doi\":\"10.1016/j.jnma.2024.07.087\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusions</h3><p>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.</p></div>\",\"PeriodicalId\":17369,\"journal\":{\"name\":\"Journal of the National Medical Association\",\"volume\":\"116 4\",\"pages\":\"Page 449\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the National Medical Association\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0027968424001688\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the National Medical Association","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0027968424001688","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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.
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.