"Telehealth implementation as a solution to improving access to care fo" by Adrienne Barrett

Date of Award

2023

Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chair

Susan Alexander

Committee Member

Jeffery Sano

Subject(s)

Medical telematics, Health services accessibility, Chronic diseases--Treatment

Abstract

Chronic disease affects millions worldwide, causing increased disease burden and death rates for this population. Telehealth is a viable approach to managing chronic illness. In response to the COVID-19 pandemic, a research hospital facility implemented telehealth in April 2020. An evaluation of the telehealth program was needed to explore the facility’s strengths and opportunities for improvement. Using the Centers for Disease Control and Prevention’s Framework for Program Evaluation, the telehealth program was evaluated to determine whether telehealth implementation improved access to care, efficiency, and provider experience. Visit duration, missed and canceled visits, and visit wait times between April 2020 and June 2023 were analyzed for those 19 years and older with chronic illnesses identified by ICD-10 codes. The provider experience was measured with the Telehealth Usability Questionnaire. More substantive data was available when the facility transitioned from Microsoft Teams to the Andor telehealth platform in March 2023. Descriptive analyses revealed improved completed visits, decreased patient abandoned visits, and varied canceled and duration percentages. Providers missed visits less frequently than patients. Run charts for telehealth total visits versus chronic visits did not reveal special cause variations. The provider experience was favorable, except for below-average telehealth reliability and interface quality scores. Recommendations include continued user training, assessing the patient experience, exploring telehealth’s impact on research participant recruitment, and standardizing evaluation processes through policy development.

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