通过大学生导航员弥合远程医疗数字鸿沟:服务学习型健康差异课程的混合方法评估研究。

IF 3.2 Q1 EDUCATION, SCIENTIFIC DISCIPLINES JMIR Medical Education Pub Date : 2024-10-01 DOI:10.2196/57077
Zakaria Nadeem Doueiri, Rika Bajra, Malathi Srinivasan, Erika Schillinger, Nancy Cuan
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引用次数: 0

摘要

背景有限的数字知识是弱势患者获得医疗服务的障碍:斯坦福大学技术访问资源小组(START)是一门为弥合远程医疗数字鸿沟而开设的服务学习课程,它培训本科生和研究生为患者提供实践支持,以改善电子病历(EMR)和视频访问的访问,同时学习健康的社会决定因素:START 学生接触了 1185 名患者(其中 711 人,60% 来自大型学术医疗中心的初级保健诊所;474 人,40% 来自联邦合格保健中心)。登记包括没有 EMR 账户的患者(初级保健诊所)或已安排远程医疗就诊的患者(联邦合格医疗中心)。通过成功注册 EMR 和设置视频访问来评估患者的治疗效果。学生的成果通过对主题内容进行编码的反思进行评估:在 6 个学季中,57 名学生接触了 1185 名登记患者。在联系的 229 名患者中,有 141 人需要技术支持。START 学生成功建立了 EMR 账户,并为 78.7% 的患者(111/141)建立了视频访问。计划完成后,我们联系了 13.5%(19/141)的患者,收集他们对计划效用的看法。大多数患者(18/19,94.7%)表示 START 学生提供了帮助,73.7%(14/19)的患者表示他们在数字就诊中成功地与医疗服务提供者建立了联系。无法建立连接的原因包括缺乏 Wi-Fi 或设备连接、没有口译员以及残疾导致无法使用视频访问。对学生反思的定性分析显示,这对学生未来的职业目标产生了影响,并提高了他们对技术接入的健康差异的认识:结论:在希望获得远程医疗服务的患者中,START 改善了 78.7%(111/141)的患者获得远程医疗服务的机会。学生们发现,START 拓宽了他们对健康差距和健康的社会决定因素的理解,并影响了他们未来的职业目标。
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Bridging the Telehealth Digital Divide With Collegiate Navigators: Mixed Methods Evaluation Study of a Service-Learning Health Disparities Course.

Background: Limited digital literacy is a barrier for vulnerable patients accessing health care.

Objective: The Stanford Technology Access Resource Team (START), a service-learning course created to bridge the telehealth digital divide, trained undergraduate and graduate students to provide hands-on patient support to improve access to electronic medical records (EMRs) and video visits while learning about social determinants of health.

Methods: START students reached out to 1185 patients (n=711, 60% from primary care clinics of a large academic medical center and n=474, 40% from a federally qualified health center). Registries consisted of patients without an EMR account (at primary care clinics) or patients with a scheduled telehealth visit (at a federally qualified health center). Patient outcomes were evaluated by successful EMR enrollments and video visit setups. Student outcomes were assessed by reflections coded for thematic content.

Results: Over 6 academic quarters, 57 students reached out to 1185 registry patients. Of the 229 patients contacted, 141 desired technical support. START students successfully established EMR accounts and set up video visits for 78.7% (111/141) of patients. After program completion, we reached out to 13.5% (19/141) of patients to collect perspectives on program utility. The majority (18/19, 94.7%) reported that START students were helpful, and 73.7% (14/19) reported that they had successfully connected with their health care provider in a digital visit. Inability to establish access included a lack of Wi-Fi or device access, the absence of an interpreter, and a disability that precluded the use of video visits. Qualitative analysis of student reflections showed an impact on future career goals and improved awareness of health disparities of technology access.

Conclusions: Of the patients who desired telehealth access, START improved access for 78.7% (111/141) of patients. Students found that START broadened their understanding of health disparities and social determinants of health and influenced their future career goals.

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来源期刊
JMIR Medical Education
JMIR Medical Education Social Sciences-Education
CiteScore
6.90
自引率
5.60%
发文量
54
审稿时长
8 weeks
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