Associations Between Telemedicine Use Barriers, Organizational Factors, and Physician Perceptions of Care Quality

被引:1
作者
Wiley, Kevin [1 ]
Pugh, Ashley [2 ]
Brown-Podgorski, Brittany L. [3 ]
Jackson, Joanna R. [4 ]
McSwain, David [5 ]
机构
[1] Med Univ South Carolina, Dept Healthcare Leadership & Management, Charleston, SC 29425 USA
[2] Natl Comm Qual Assurance, Washington, DC USA
[3] Univ Pittsburgh, Sch Publ Hlth, Dept Hlth Policy & Management, Pittsburgh, PA USA
[4] Winthrop Univ, Coll Business Adm, Dept Management & Mkt, Rock Hill, SC USA
[5] Univ N Carolina, UNC Sch Med, Dept Pediat, Chapel Hill, NC USA
基金
美国国家卫生研究院;
关键词
telemedicine; health care quality; experience; HEALTH INFORMATION-TECHNOLOGY; TELEHEALTH; ADOPTION;
D O I
10.1089/tmj.2024.0249
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Introduction: Evaluating physician perceptions of telemedicine use and its impact on care quality among physician providers is critical to sustaining telemedicine programs, given the uncertainty of reimbursement policy, preferences, inadequate training, and technical difficulties. Physicians reported technical barriers to effectively practicing integrated medicine using telemedicine as patient volumes increased during the pandemic. The objective of this work was to examine whether perceived practice barriers and facilitators were associated with physician respondents' perceptions of telemedicine care quality compared with in-person care. Methods: This cross-sectional study analyzed the 2021 National Electronic Health Record Survey. The sample comprised 1,857 nonfederally employed physicians (weighted n = 403,013) delivering integrated patient care. Of those physicians, 1,630 (weighted n = 346,646) reported providing care through telemedicine. We reported frequencies and percentages of reported practice characteristics. Generalized ordinal logistic regressions examined relationships between practice factors and care quality for telemedicine care. Results: Most of the sample (n = 1,630) were male (66.1%), >50 years of age (66.1%), and worked in a single location (73.5%). A total of 70% of respondents reported that patients had difficulty using telemedicine platforms, and 64% reported limitations in patients' access to technology. Most respondents indicated having provided quality care to some extent (45%) and to a great extent (26%) during telemedicine visits compared to in-person visits. Associations between barriers, facilitators, and care quality perceptions were positive, underscoring resiliency in telemedicine programs among practices. Conclusion: Care modalities and the organizational, environmental, and personal facilitators drive quality perceptions among physicians. Perceived fit and usability determine perceptions of care quality for providers integrating telemedicine into their practice.
引用
收藏
页码:2883 / 2889
页数:7
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