A University of Connecticut study recently published in the Journal of Medical Internet Research concluded that front-line staff’s resistance to telemedicine technology causes failure of implementation of the program.
January 8, 2021 – A telehealth program implemented in 2017 at a California independent living facility didn’t help reduce hospitalizations due to staff’s opposition to using the technology.
The study highlights that an overlooked barrier to telehealth adoption is the adverse response of staff tasked with using it in the healthcare setting. According to the study, led by Kelsi Carolan, PhD, of UConn’s School of Social Work, front-line staff viewed telemedicine technology as complex and a barrier to their decision-making. Carolan and her colleagues also reported that reducing resident transports to the Emergency Department (ED) was not a goal embraced by safety staff.
The study shows that the problem lies not only in educating staff how to incorporate technology in their work, but also letting them understand its capacity and limitation. If they are not utilizing connected health technology because they do not understand the benefits, those benefits won’t be seen.
Moreover, it is said that actively involving staff in the planning process of the management is vital in order to get their commitment to use a telehealth program.
In the study, the group of researchers analyzed call logs from a 950-patient senior living community in California in 2017-18, and compared that to two other sites run by the same company. One of them had started telemedicine in 2017 with the purpose to help care providers triage patients and to give them a virtual access to an emergency medicine physician to identify those needing transport. This would give on-site staff more resources to treat patients and reduce costly hospitalizations.
Staff, however, did not see the benefits of the platform. According to the researchers, staff felt they could still make their own triage decisions, that telehealth only make the process more complicated and does not contribute to the results.
“Safety staff felt that the program’s goal to deter ED visits was the wrong goal and that telemedicine would better address minor medical concerns at the on-site clinic,” the study noted.
The residents, in contrast, have more positive feedback on telehealth. According to the Carolan, “Residents expressed a strong interest in avoiding trips to the ED whenever possible, mentioning the long wait times, financial costs, and potential health risks of ED visits. Residents interviewed identified avoiding an ED visit as a primary benefit of using the telemedicine intervention.”
In conclusion, the study shows that the failure to see the benefits of telehealth is not directly attributed to the technology alone but how staff reacted to it. Carolan and her colleagues wrote, “EMTs embracing reduced ED transport as a goal would require a significant shift in professional mentality and culture.”
“Staff may have benefitted from further education on identifying potentially avoidable transfers, the harm to residents of unnecessary transfers, and the opportunity to work and learn in cooperation with remote physicians,” Carolan and her group concluded.