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Presentation

Human Factors and Telehealth: Opportunities for Research, Design, and Implementation
Event Type
Discussion Panel
TimeThursday, April 1511:00am - 12:00pm EDT
LocationPatient Safety Research and Initiatives
DescriptionThe widespread adoption of telehealth during the COVID-19 pandemic has brought about considerations for Human Factors/Ergonomics (HFE) to be integrated into telehealth design and implementation. As telehealth is predicted to remain highly utilized after the pandemic has subsided, there is a long-term need to incorporate HFE into the telehealth domain. Presenters in this panel will share experiences recommendations for clinical integration, patient safety, patient experience, and inclusive design.

Ram Dixit, MS: As organizations look to the long-term use of telehealth, it is critical that telehealth programs are integrated into healthcare infrastructure so they can be effectively measured and optimized to support high-quality care for all. In this panel, I will present some of my experiences analyzing telehealth technology, clinical, and administrative data at MedStar Health and highlight important Human Factors challenges to using telehealth data and developing operational analytics. Additionally, I will touch on ongoing research into population-level analyses of telehealth that present important questions about care patterns in response to the COVID-19 pandemic. These perspectives provide practical guidance for Human Factors practitioners aiming to use operational data to gain insight into telehealth programs. They also point to research areas important to the sustained use of telehealth, such as developing models and measures to evaluate telehealth programs and integrating telehealth platforms with other information systems to support a new paradigm of virtual care.

Kylie M. Gomes, PhD: The COVID-19 pandemic has resulted in a dramatic increase in the adoption and use of telehealth across the United States (Galewitz, 2020; Wosik et al., 2020) and emphasized the benefits that telehealth offers like increased access and reducing barriers to care (Ko et al., 2020; Marcin, Shaikh, & Steinhorn, 2016). However, there are likely new patient safety risks associated with delivering care remotely as many patients and providers are interacting through a new and unfamiliar modality of care while also managing a new disease - COVID-19. The extent and nature of patient safety risks that may be associated with telehealth remains largely unknown and extend beyond COVID-19 to other diseases. Dr. Gomes will discuss the implications for human factors practitioners to address this largely unexplored area of patient safety research in telehealth and will pose questions that have yet to be answered in this space such as: (a) When telehealth is unable to provide definitive care, how do we ensure patients successfully navigate to the level of care they need? and (b) Can we operationalize telehealth quality measures to provide early indicators of patient safety risks and what should those measures be? She will also share ongoing research efforts she is leading to begin to understand and address patient safety risks associated with telehealth. She invites the audience members to share insights and perspectives to spark collaborative discussion about how human factors practitioners can begin to address the research gap of patient safety risks in telehealth.

Peter Hoonakker, PhD: The Coronavirus pandemic has brought many changes to our world. The social distancing and wearing of personal protection equipment (PPE) that is required to prevent infection has had a major impact on how we look and how we behave. In healthcare, clinicians have to deal with the many different aspects of the virus, and one of the consequences is that many activities now are performed via tele-health. The good thing is that tele-health has been around for a while, and many studies have been conducted to examine the effects. However, until recently it has not been implemented on a large scale. Two main reasons why tele-health has not been implemented was that the insurance companies would not pay for it, and that clinicians could not cope with the large impact it would have on their workflow. The COVID-19 pandemic has changed all of that overnight and tele-health applications have been implemented massively. One of the tele-health applications that has been implemented on a large scale is Vidyo. Vidyo is software that makes it possible to do secure consultations (in primary care but also in emergency departments and hospitals) online, using a video connection and tablet or a smartphone. Evidently, implementation of tele-health applications has a major impact on the whole healthcare socio-technical system. In this presentation, we examine the impact that implementation of Vidyo software for rounding on the Pediatric Intensive Care Unit (PICU) has on patients and their families.

Courtney Rogers, MPH: Though telehealth can be a way to expand access to health care, its increased use could potentially exacerbate health disparities and further marginalize certain populations, especially those affected by the digital divide. Those impacted by the digital divide include those who live in rural areas, older adults, people of color, those with low socioeconomic status (SES), and individuals with disabilities. This talk will focus on considerations for inclusive design of telehealth as well as strategies for implementation and policy recommendations.

References
Galewitz, P. (2020). Telemedicine surges, fueled by coronavirus fears and shift in payment rules. Kaiser Health News.
Ko, K., Kurliand, M. M., Curtis, K. M., Palmer, C. M., Naimer, M. S., Rodi, S. W., & Agha, Z. (2020). Launching an Emergency Department Telehealth Program During COVID-19. JGEM, 1(7), 1-7.

Marcin, J. P., Shaikh, U., & Steinhorn, R. H. (2016). Addressing health disparities in rural communities using telehealth. Pediatric Research, 79(1), 169-176.

Wosik, J., Fudim, M., Cameron, B., Gellad, Z. F., Cho, A., Phinney, D., ... & Tcheng, J. (2020). Telehealth transformation: COVID-19 and the rise of virtual care. Journal of the American Medical Informatics Association, 27(6), 957-962.
Authors
Human Factors Specialist
Post-Doctoral Research Fellow