远程医疗导航计划对基层医疗机构视频就诊安排和完成情况的影响》(Effect of a Telehealth Navigator Program on Video Visit Scheduling and Completion in Primary Care)。

IF 3 Q1 PRIMARY HEALTH CARE Journal of Primary Care and Community Health Pub Date : 2024-01-01 DOI:10.1177/21501319231225997
Kevin Chen, Kenan Katranji, Khera Bailey, Michele Rains, Helena Mirzoyan, Christine Zhang, Shivali Choxi, Hannah B Jackson
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引用次数: 0

摘要

导言:患者和临床医生在参与视频远程保健就诊时面临挑战。在其他情况下,患者导航能有效提高患者参与临床项目的积极性。我们的目标是评估实施远程医疗导航计划以支持患者和临床医生是否会影响视频就诊安排、视频使用和不就诊情况:这是一个采用差分法的准实验性质量改进项目。我们纳入了一个大型城市公共医疗系统的 17 个成人初级医疗点从 2021 年 10 月 1 日到 2022 年 10 月 31 日的数据。其中 6 个医疗点接受了远程医疗导航,11 个医疗点作为比较对象。导航员(通过电话)联系即将进行视频就诊的患者,以评估和解决成功完成视频就诊的潜在障碍。他们还为患者和临床医生提供远程医疗就诊和电子患者门户网站使用方面的现场支持。研究的主要结果是远程医疗计划就诊比例的差异,以及分别完成视频就诊和未参加计划视频就诊的比例:干预地点和非干预地点分别有 65 488 次和 71 504 次预定的远程保健就诊。经调整后,以视频方式预约的远程保健就诊比例的差异为-9.1%[95%置信区间为-26.1%,8.0%],以视频方式完成的远程保健就诊比例为1.3%[-4.9%,7.4%],未参加以视频方式预约的就诊比例为-3.7%[-6.0%,-1.4%]:有远程医疗导航员的医疗点的视频就诊缺勤率相对较低,但视频就诊的安排或完成率并无明显差异。尽管如此,导航员的实地考察有助于发现改进护理设计的机会。
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Effect of a Telehealth Navigator Program on Video Visit Scheduling and Completion in Primary Care.

Introduction: Patients and clinicians face challenges in participating in video telehealth visits. Patient navigation has been effective in other settings in enhancing patients' engagement with clinical programs. Our objective was to assess whether implementing a telehealth navigator program to support patients and clinicians affected video visit scheduling, video usage, and non-attendance.

Methods: This was a quasi-experimental quality improvement project using difference-in-differences. We included data from 17 adult primary care sites at a large, urban public healthcare system from October 1, 2021 to October 31, 2022. Six sites received telehealth navigators and 11 sites were used as comparators. Navigators contacted patients (by phone) with upcoming video visits to assess and address potential barriers to successful video visit completion. They also provided on-site support to patients and clinicians regarding telehealth visits and usage of an electronic patient portal. The primary outcomes were difference-in-differences for the proportion of telehealth visits scheduled and, separately, completed as video visits and non-attendance for visits scheduled as video visits.

Results: There were 65 488 and 71 504 scheduled telehealth appointments at intervention and non-intervention sites, respectively. The adjusted difference-in-differences for the proportion of telehealth visits scheduled as video was -9.1% [95% confidence interval -26.1%, 8.0%], the proportion of telehealth visits completed as video visits 1.3% [-4.9%, 7.4%], and non-attendance for visits scheduled as video visits -3.7% [-6.0%, -1.4%].

Conclusions: Sites with telehealth navigators had comparatively lower video visit non-attendance but did not have comparatively different video visit scheduling or completion rates. Despite this, navigators' on-the-ground presence can help identify opportunities for improvements in care design.

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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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