PT  - JOURNAL ARTICLE
AU  - Nkodo, Amelie Foumena
AU  - Gonzalez, Martha M.
AU  - Reves, Sarah
AU  - Etz, Rebecca S.
TI  - Telemedicine Adoption During COVID-19 Pandemic: Perspectives from Primary Care Clinicians in Safety-Net Settings
AID  - 10.3122/jabfm.2023.230339R1
DP  - 2024 May 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 409--417
VI  - 37
IP  - 3
4099  - http://www.jabfm.org/content/37/3/409.short
4100  - http://www.jabfm.org/content/37/3/409.full
SO  - J Am Board Fam Med2024 May 01; 37
AB  - Objective: The objective of this study is to describe the facilitators and barriers of telemedicine during the COVID-19 pandemic for primary care clinicians in safety-net settings.Methods: We selected 5 surveys fielded between September 2020 and March 2023 from the national “Quick COVID-19 Primary Care Survey” by the Larry A. Green Center, with the Primary Care Collaborative. We used an explanatory sequential mixed method approach. We compared safety-net practices (free & charitable organization, federally qualified health center (FQHC), clinics with a 50% or greater Medicaid) to all other settings. We discuss: 1) telemedicine services provided; 2) clinician motivations; 3) and telemedicine access.Results: All clinicians were similarly motivated to implement telemedicine. Safety-net clinicians were more likely to report use of phone visits. These clinicians felt less “confident in my use of telemedicine” (covariate-adjusted OR = 0.611, 95% CI 0.43 - 0.87) and were more likely to report struggles with televisits in March 2023 (covariate-adjusted OR = 1.73, 95% CI 1.16 - 2.57), particularly with physical examinations. Safety-net clinicians were more likely to endorse reductions in no-shows (covariate-adjusted OR = 1.77, 95% CI 1.17 - 2.68). Telemedicine increased access and new patient-facing demands including portal communications.Conclusions: This study enhances our understanding of the use of telemedicine within the safety-net setting. Clinician perceptions are important for identifying barriers to telemedicine following the end of the Federal COVID-19 Public Health Emergency. Clinicians highlighted significant limitations to its use including clinical appropriateness, quality of physical examinations, and added patient-facing workload.