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. 2024 May;30(6 Spec No.):SP437-SP444.
doi: 10.37765/ajmc.2024.89550.

Implementing team-based telemedicine workflows in safety-net primary care

Marianna Kong  1 , Rachel Willard-Grace, Elaine Khoong, Anjana Sharma, Monjori Mukerjee, George Su, Delphine Tuot
Affiliations

Implementing team-based telemedicine workflows in safety-net primary care

Marianna Kong et al. Am J Manag Care. 2024 May.

Abstract

Objectives: Challenges in implementing telemedicine disproportionately affect patients served in safety-net settings. Few studies have elucidated pragmatic, team-based strategies for successful telemedicine implementation in primary care, especially with a safety-net population.

Study design: We conducted in-depth, semistructured qualitative interviews with primary care clinicians and staff in a large urban safety-net health care system on the facilitators, challenges, and impact of implementing team workflows for synchronous telemedicine video and audio-only visits.

Methods: Interviews were analyzed using modified grounded theory with multistage coding. Common themes were identified and reviewed to describe within-group and between-group variations. We used the Practical, Robust Implementation Sustainability Model framework to organize the final themes with an implementation science lens.

Results: Four themes emerged from 11 interviews: (1) having a dedicated individual preparing patients for video visits is a prerequisite for the successful introduction of video visits to patients with limited digital literacy; (2) health care maintenance during video and audio-only visits benefits from standardized workflows and communication; (3) the increased flexibility and accessibility of telemedicine visits were perceived benefits to patient care, despite barriers for subsets of patients; and (4) telemedicine visits generally have a positive impact on work experience for clinicians and staff due to increased efficiency, despite audio-only visits feeling less engaging.

Conclusions: Understanding how to strategically use team-based workflows to expand video visit access while ensuring care quality of all telemedicine visits will allow primary care practices to maximize telemedicine's benefits to patients in the safety-net setting.

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Figures

Figure 1.
Figure 1.
Thematic areas mapped to the The Practical Robust Implementation Sustainability Model (PRISM).–
See this image and copyright information in PMC

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