The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital
Evaluating the use and impact of telemedicine in nursing homes is necessary to promote improvements in the quality of this practice. Even though challenges and opportunities of telemedicine are increasingly becoming well documented for geriatrics (such as improving access to healthcare, patient mana...
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2021
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oai:doaj.org-article:62caa05048d74e55a62d9346127860df2021-11-11T16:17:50ZThe Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital10.3390/ijerph1821111481660-46011661-7827https://doaj.org/article/62caa05048d74e55a62d9346127860df2021-10-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11148https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601Evaluating the use and impact of telemedicine in nursing homes is necessary to promote improvements in the quality of this practice. Even though challenges and opportunities of telemedicine are increasingly becoming well documented for geriatrics (such as improving access to healthcare, patient management, and education while reducing costs), there is still limited knowledge on how to better implement it in an inter-organizational context, especially when considering nursing homes. In this regard, this study aimed first to describe the telemedicine activity of nursing homes when cooperating with a general hospital; and then understand the behavioral differences amongst nursing homes while identifying critical factors when implementing a telemedicine project. We conducted a sequential, explanatory mixed-method study using quantitative then qualitative methods to better understand the results. Three years of teleconsultation data of twenty-six nursing homes (15 rural and 11 urban) conducting teleconsultations with a general hospital (Troyes Hospital, France) were included for the quantitative analysis, and eleven telemedicine project managers for the qualitative analysis. Between April 2018 and April 2021, 590 teleconsultations were conducted: 45% (<i>n</i> = 265) were conducted for general practice, 29% (<i>n</i> = 172) for wound care, 11% (<i>n</i> = 62) for diabetes management, 8% (<i>n</i> = 47) with gerontologist and 6% (<i>n</i> = 38) for dermatology. Rural nursing homes conducted more teleconsultations overall than urban ones (RR: 2.484; 95% CI: 1.083 to 5.518; <i>p</i> = 0.03) and included more teleconsultations for general practice (RR: 16.305; 95% CI: 3.505 to 73.523; <i>p</i> = 0.001). Our qualitative study showed that three critical factors are required for the implementation of a telemedicine project in nursing homes: (1) the motivation to perform teleconsultations (in other words, improving access to care and cooperation between professionals); (2) building a relevant telemedicine medical offer based on patients’ and treating physicians’ needs; and (3) it’s specific organization in terms of time and space. Our study showed different uses of teleconsultations according to the rural or urban localization of nursing homes and that telemedicine projects should be designed to consider this aspect. Triggered by the COVID-19 pandemic, telemedicine projects in nursing homes are increasing, and observing the three critical factors presented above could be necessary to limit the failure of such projects.Clément CormiJan ChruscielAntoine FayolMichel Van RechemKhuloud Abou-AmshaMatthieu TixierMyriam LewkowiczDavid LaplancheStéphane SanchezMDPI AGarticletelemedicinenursing homesrural healthurban healthhealth servicesMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11148, p 11148 (2021) |
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telemedicine nursing homes rural health urban health health services Medicine R |
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telemedicine nursing homes rural health urban health health services Medicine R Clément Cormi Jan Chrusciel Antoine Fayol Michel Van Rechem Khuloud Abou-Amsha Matthieu Tixier Myriam Lewkowicz David Laplanche Stéphane Sanchez The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital |
| description |
Evaluating the use and impact of telemedicine in nursing homes is necessary to promote improvements in the quality of this practice. Even though challenges and opportunities of telemedicine are increasingly becoming well documented for geriatrics (such as improving access to healthcare, patient management, and education while reducing costs), there is still limited knowledge on how to better implement it in an inter-organizational context, especially when considering nursing homes. In this regard, this study aimed first to describe the telemedicine activity of nursing homes when cooperating with a general hospital; and then understand the behavioral differences amongst nursing homes while identifying critical factors when implementing a telemedicine project. We conducted a sequential, explanatory mixed-method study using quantitative then qualitative methods to better understand the results. Three years of teleconsultation data of twenty-six nursing homes (15 rural and 11 urban) conducting teleconsultations with a general hospital (Troyes Hospital, France) were included for the quantitative analysis, and eleven telemedicine project managers for the qualitative analysis. Between April 2018 and April 2021, 590 teleconsultations were conducted: 45% (<i>n</i> = 265) were conducted for general practice, 29% (<i>n</i> = 172) for wound care, 11% (<i>n</i> = 62) for diabetes management, 8% (<i>n</i> = 47) with gerontologist and 6% (<i>n</i> = 38) for dermatology. Rural nursing homes conducted more teleconsultations overall than urban ones (RR: 2.484; 95% CI: 1.083 to 5.518; <i>p</i> = 0.03) and included more teleconsultations for general practice (RR: 16.305; 95% CI: 3.505 to 73.523; <i>p</i> = 0.001). Our qualitative study showed that three critical factors are required for the implementation of a telemedicine project in nursing homes: (1) the motivation to perform teleconsultations (in other words, improving access to care and cooperation between professionals); (2) building a relevant telemedicine medical offer based on patients’ and treating physicians’ needs; and (3) it’s specific organization in terms of time and space. Our study showed different uses of teleconsultations according to the rural or urban localization of nursing homes and that telemedicine projects should be designed to consider this aspect. Triggered by the COVID-19 pandemic, telemedicine projects in nursing homes are increasing, and observing the three critical factors presented above could be necessary to limit the failure of such projects. |
| format |
article |
| author |
Clément Cormi Jan Chrusciel Antoine Fayol Michel Van Rechem Khuloud Abou-Amsha Matthieu Tixier Myriam Lewkowicz David Laplanche Stéphane Sanchez |
| author_facet |
Clément Cormi Jan Chrusciel Antoine Fayol Michel Van Rechem Khuloud Abou-Amsha Matthieu Tixier Myriam Lewkowicz David Laplanche Stéphane Sanchez |
| author_sort |
Clément Cormi |
| title |
The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital |
| title_short |
The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital |
| title_full |
The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital |
| title_fullStr |
The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital |
| title_full_unstemmed |
The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital |
| title_sort |
use of telemedicine in nursing homes: a mixed-method study to identify critical factors when connecting with a general hospital |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/62caa05048d74e55a62d9346127860df |
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