Tristen L. Hall, MPH; Lauri Connelly, MPH; Elizabeth W. Staton, MSTC; Jodi Summers Holtrop, PhD, MCHES; Amber Sieja, MD; Kyle Knierim, MD; Heather Holmstrom, MD, FAAFP
Corresponding Author: Jodi Summers Holtrop, PhD, MCHES; University of Colorado - Department of Family Medicine.
Contact Email: Jodi.Holtrop@ucdenver.edu
Section: Original Research
Published: www.jabfm.org/content/35/3/517
INTRODUCTION: Health systems undertook a rapid transition to increase the use of telehealth care in the wake of the COVID-19 pandemic. A continued need for telehealth services in the coming years is likely, both during the pandemic and beyond. We need to understand the factors that facilitate or hinder implementation of effective telehealth care. The purpose of this paper is to examine telehealth from multiple stakeholders’ perspectives considering RE-AIM outcomes.
METHODS: Semi-structured interviews were conducted with primary care practice team members and patients. Rapid qualitative analysis was used to identify themes in experiences and perceptions related to telehealth implementation. The RE-AIM implementation framework was applied to thematic findings to understand influences on implementation outcomes.
RESULTS: Twenty-four practice members and 17 patients across five clinics participated. All stakeholder groups reported that technological capabilities influenced patients’ access to telehealth and that certain patients and reasons for visits were not appropriate for telehealth. Limited non-verbal communication over video or phone negatively affects visit effectiveness. All groups felt that telehealth was a good option for some patients, some of the time, but not all patients all of the time.
DISCUSSION: Telehealth works well if it is used for the appropriate visits and patient types and with needed technological elements. Older age may limit the feasibility of telehealth for some patients, supporting the need for research and resources to ensure equitable access to telehealth when appropriate. Added administrative work and associated costs support systematic screening to determine visit appropriateness for telehealth.