TY - JOUR AU - Sharma, Anjana E AU - Khoong, Elaine C AU - Sierra, Maribel AU - Rivadeneira, Natalie A AU - Nijagal, Malini A AU - Su, George AU - Lyles, Courtney R AU - DeFries, Triveni AU - Tuot, Delphine S AU - Sarkar, Urmimala PY - 2022 DA - 2022/3/10 TI -与电话和视频访问使用相关的系统级因素:安全网的调查临床医生在早期阶段的COVID-19流行乔- Res JMIR形式SP - e34088六世- 6 - 3 KW -远程医疗KW -安全网医院KW -医疗保健交付KW -门诊千瓦弱势群体KW - COVID-19 KW -调查KW -脆弱KW -远程医疗千瓦医院KW -安全KW -交付KW -视频KW -实现千瓦卫生系统AB -背景:COVID-19大流行促使安全网卫生保健系统在几乎没有经验的情况下迅速实施远程医疗服务，造成了虚拟就诊机会的差异。虽然对患者障碍给予了很多关注，但对影响电话与视频就诊采用的系统级因素知之甚少。由于远程医疗仍然是患者和医疗提供者首选的服务，而音频访问的报销平价将不会继续，卫生系统必须评估如何支持更高质量的视频访问。目的:本研究旨在评估卫生系统层面的因素及其对电话和视频访问采用的影响，为门诊安全网站点远程医疗的可持续性提供信息。方法:我们在2020年5月28日至7月14日期间，在一个与医院相关的流动诊所网络中，对为多样化的、公共保险的患者群体服务的流动护理临床医生进行了横断面调查。我们进行了双变量分析，评估与以下因素相关的医疗保健系统层面的因素:(1)电话使用率高(平均每次会议4次或以上就诊);(2)采用视频访问(平均每节课至少1次视频访问)。结果:我们从643名符合条件的临床医生中收集了311份回应，回应率为48.4%。 Clinician respondents (N=311) included 34.7% (n=108) primary or urgent care, 35.1% (n=109) medical, and 7.4% (n=23) surgical specialties. Our sample included 178 (57.2%) high telephone adopters and 81 (26.05%) video adopters. Among high telephone adopters, 72.2% utilized personal devices for telemedicine (vs 59.0% of low telephone adopters, P=.04). Video nonadopters requested more training in technical aspects than adopters (49.6% vs 27.2%, P<.001). Primary or urgent care had the highest proportion of high telephone adoption (84.3%, compared to 50.4% of medical and 37.5% of surgical specialties, P<.001). Medical specialties had the highest proportion of video adoption (39.1%, compared to 14.8% of primary care and 12.5% of surgical specialties, P<.001). Conclusions: Personal device access and department specialty were major factors associated with high telephone and video visit adoption among safety-net clinicians. Desire for training was associated with lower video visit use. Secure device access, clinician technical trainings, and department-wide assessments are priorities for safety-net systems implementing telemedicine. SN - 2561-326X UR - https://formative.www.mybigtv.com/2022/3/e34088 UR - https://doi.org/10.2196/34088 UR - http://www.ncbi.nlm.nih.gov/pubmed/35148271 DO - 10.2196/34088 ID - info:doi/10.2196/34088 ER -