scholarly journals Clinician and staff perspectives on potential disparities introduced by the rapid implementation of telehealth services during COVID-19: a mixed-methods analysis

2021 ◽  
Author(s):  
P Phimphasone-Brady ◽  
J Chiao ◽  
L Karamsetti ◽  
A Sieja ◽  
R Johnson ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Health Care ◽  
Mixed Methods ◽  
Health Care Access ◽  
Care Delivery ◽  
Geriatric Medicine ◽  
Implementation Strategies ◽  
Care Access ◽  
Set Up ◽  
Survey Responses

Abstract The COVID-19 pandemic has rapidly altered ambulatory health care delivery and may have worsened disparities in health care access. To assess the telehealth implementation experiences of ambulatory personnel in different disciplines and their perspectives on potential telehealth disparities, and to make recommendations for more equitable telehealth delivery. We used a convergent parallel mixed-methods design. Clinic managers from geriatric medicine, internal medicine, and psychiatry e-mailed a survey to clinicians and staff regarding experiences with telehealth care delivery. Quantitative survey responses were analyzed with Fisher’s Exact tests. Qualitative responses were coded thematically. Recommendations were categorized by type of implementation strategy. Quantitative and qualitative findings on telehealth disparities were merged in a joint data display. Respondents (n = 147, 57% response rate) were distributed across three specialties: 66% internal medicine, 19% psychiatry, and 14% geriatric medicine. Prior to 2020, 77% of clinicians had never delivered telehealth services. By Spring 2020, 78% reported conducting more than half of clinic visits by telehealth. Among clinicians, 52% agreed/strongly agreed that rapid telehealth implementation exacerbated access to care disparities to: older adult patients, those with limited internet access, and those needing interpretation services. Staff expressed similar difficulties with telehealth set-up especially for these patients. To improve telehealth equity, clinicians recommended to: (i) change infrastructure; (ii) train and educate stakeholders; and (iii) support clinicians. Clinicians and staff reported specific subpopulations had challenges in accessing telehealth visits. To avoid perpetuating telehealth access disparities, further co-discovery of equitable implementation strategies with patients and clinics are urgently needed.

The Philippine Health Care Delivery System and Health Expenditure

2016 ◽  
pp. 457-470
Author(s):  
Abdulkadir Işık ◽  
Abdulhamid Mauyag Gunda ◽  
Birol Topçu
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Human Resources For Health ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
The Philippines ◽  
Human Right ◽  
Care Access ◽  
Out Of Pocket Payments

Health is recognized by the Philippine constitution as a basic human right. The Philippines, compared to most Asian countries, produces more and better human resources for health. However, the Philippines are challenged by attracting and retaining staff in the under-served areas of the country. Philippine allotted 4.2-4.4% of its GDP to health from 2009 to 2011. Furthermore, considerable inequities in health care access and outcomes between Socio-economic groups remain. The Phil Health's limited breadth and depth of coverage has resulted in high levels of out of pocket payments. The implementation of the reforms in financing, service delivery and regulation which are aimed to tackle the inefficiencies and inequalities in the health system has been challenged by the decentralized environment and the presence of private sector, often creating fragmentation and variation in the quality of health services across the country.

scholarly journals Telehealth in the COVID-19 Era: A Balancing Act to Avoid Harm (Preprint)

2020 ◽  
Author(s):  
J. Jeffery Reeves ◽  
John W. Ayers ◽  
Christopher A. Longhurst
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Patient Characteristics ◽  
Virtual Patient ◽  
Unintended Consequences ◽  
Disease States ◽  
Care Access

UNSTRUCTURED The telehealth revolution has been heralded for its potential to improve health care access and improve the efficiency of health care delivery. However, virtual patient care can bring unintended consequences that eclipse the benefits including potentially limiting the patient-provider relationship, the quality of the examination, the efficiency of healthcare delivery, and the overall quality of care. Facing the most rapidly adopted medical trend in modern history, clinicians are beginning to grasp its possibilities, but we also need to understand its boundaries. As outcomes are studied and federal regulations reconsidered, it is important to be precise in the approach to the virtual patient encounter. We offer some simple guidelines to assist providers in determining the appropriateness of a telehealth visit, considering visit types, chief complaint or disease states, and patient characteristics.

A Multidisciplinary Remote Healthcare Delivery System to Increase Health Care Access, Pathology Screening, and Treatment in Developing Countries

2019 ◽  
pp. 1376-1409
Author(s):  
Thierry Oscar Edoh ◽  
Pravin Amrut Pawar ◽  
Bernd Brügge ◽  
Gunnar Teege
Keyword(s):  
Health Care ◽  
Delivery System ◽  
Health Care Access ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Access To Healthcare ◽  
Healthcare Delivery System ◽  
Care Access ◽  
Traditional Practitioners ◽  
Remote Care

In this paper, the authors describe a case study of the poor access to healthcare in developing world, case of Benin, a West African developing country. The authors identify problems and the existing obstacles for applying standard Telemedicine and eHealth solutions. The authors particularly describe an adapted multidisciplinary remote care delivery system approach for improving and increasing the use of existing health services as well as the access to healthcare by overcoming some cultural, social, financial, and at least linguistic barriers. The multidisciplinary remote care delivery system integrates traditional practitioners, because most people are more confident with the traditional medicine. The authors further present a practical test which has shown that their approach has the potential to improve the quality and effectiveness of health care in rural and other concerned regions and also increase the accessibility to health care system.

Opportunities and Challenges of Telehealth in Disease Management during COVID-19 Pandemic: A Scoping Review

2021 ◽  
Vol 12 (04) ◽  
pp. 864-876
Author(s):  
Jahanpour Alipour ◽  
Mohammad Hosein Hayavi-Haghighi
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Access ◽  
Care Delivery ◽  
Meta Analysis ◽  
The Novel ◽  
Public Health Emergencies ◽  
Care Access ◽  
Legal Challenges ◽  
Novel Coronavirus

Abstract Objective The novel coronavirus disease 2019 (COVID-19) pandemic is an unexpected universal problem that has changed health care access across the world. Telehealth is an effective solution for health care delivery during disasters and public health emergencies. This study was conducted to summarize the opportunities and challenges of using telehealth in health care delivery during the COVID-19 pandemic. Methods A structured search was performed in the Web of Science, PubMed, Science Direct, and Scopus databases, as well as the Google Scholar search engine, for studies published until November 4, 2020. The reviewers analyzed 112 studies and identified opportunities and challenges. This review followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) protocols. Quality appraisal was done according to the Mixed Methods Appraisal Tool (MMAT) version 2018. Thematic analysis was applied for data analysis. Results A total of 112 unique opportunities of telehealth application during the pandemic were categorized into 4 key themes, such as (1) clinical, (2) organizational, (3) technical, and (4) social, which were further divided into 11 initial themes and 26 unique concepts. Furthermore, 106 unique challenges were categorized into 6 key themes, such as (1) legal, (2) clinical, (3) organizational, (40 technical, (5) socioeconomic, and (6) data quality, which were divided into 16 initial themes and 37 unique concepts altogether. The clinical opportunities and legal challenges were the most frequent opportunities and challenges, respectively. Conclusion The COVID-19 pandemic significantly accelerated the use of telehealth. This study could offer useful information to policymakers about the opportunities and challenges of implementing telehealth for providing accessible, safe, and efficient health care delivery to the patient population during and after COVID-19. Furthermore, it can assist policymakers to make informed decisions on implementing telehealth in response to the COVID-19 pandemic by addressing the obstacles ahead.

scholarly journals The experience of delayed health care access during the COVID 19 pandemic in Australian women: A mixed methods exploration

2021 ◽  
Author(s):  
Jennifer White ◽  
Dominic Cavenagh ◽  
Julie Byles ◽  
Gita Mishra ◽  
Leigh Tooth ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Access ◽  
Care Access

A Multidisciplinary Remote Healthcare Delivery System to Increase Health Care Access, Pathology Screening, and Treatment in Developing Countries

2017 ◽  
pp. 269-302
Author(s):  
Thierry Oscar Edoh ◽  
Pravin Amrut Pawar ◽  
Bernd Brügge ◽  
Gunnar Teege
Keyword(s):  
Health Care ◽  
Delivery System ◽  
Health Care Access ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Access To Healthcare ◽  
Healthcare Delivery System ◽  
Care Access ◽  
Traditional Practitioners ◽  
Remote Care

In this paper, the authors describe a case study of the poor access to healthcare in developing world, case of Benin, a West African developing country. The authors identify problems and the existing obstacles for applying standard Telemedicine and eHealth solutions. The authors particularly describe an adapted multidisciplinary remote care delivery system approach for improving and increasing the use of existing health services as well as the access to healthcare by overcoming some cultural, social, financial, and at least linguistic barriers. The multidisciplinary remote care delivery system integrates traditional practitioners, because most people are more confident with the traditional medicine. The authors further present a practical test which has shown that their approach has the potential to improve the quality and effectiveness of health care in rural and other concerned regions and also increase the accessibility to health care system.

scholarly journals Health care access for rural youth on equal terms? A mixed methods study protocol in northern Sweden

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Isabel Goicolea ◽  
Dean Carson ◽  
Miguel San Sebastian ◽  
Monica Christianson ◽  
Maria Wiklund ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Study Protocol ◽  
Health Care Access ◽  
Rural Youth ◽  
Mixed Methods Study ◽  
Northern Sweden ◽  
Care Access

scholarly journals Telehealth in the COVID-19 Era: A Balancing Act to Avoid Harm

10.2196/24785 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e24785
Author(s):  
J Jeffery Reeves ◽  
John W Ayers ◽  
Christopher A Longhurst
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Access ◽  
Care Delivery ◽  
Patient Characteristics ◽  
Virtual Patient ◽  
Care Providers ◽  
Health Crisis ◽  
Care Access

The telehealth revolution in response to COVID-19 has increased essential health care access during an unprecedented public health crisis. However, virtual patient care can also limit the patient-provider relationship, quality of examination, efficiency of health care delivery, and overall quality of care. As we witness the most rapidly adopted medical trend in modern history, clinicians are beginning to comprehend the many possibilities of telehealth, but its limitations also need to be understood. As outcomes are studied and federal regulations reconsidered, it is important to be precise in the virtual patient encounter approach. Herein, we offer some simple guidelines that could assist health care providers and clinic schedulers in determining the appropriateness of a telehealth visit by considering visit types, patient characteristics, and chief complaint or disease states.

Health care access and the Americans with Disabilities Act: A mixed methods study

2021 ◽  
Vol 14 (1) ◽  
pp. 100967 ◽  
Author(s):  
Anne Ordway ◽  
Chris Garbaccio ◽  
Michael Richardson ◽  
Kathe Matrone ◽  
Kurt L. Johnson
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Access ◽  
Americans With Disabilities Act ◽  
Mixed Methods Study ◽  
Care Access
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