Download PDF
CC BY-NC-ND 4.0 · Appl Clin Inform 2022; 13(01): 230-241
DOI: 10.1055/s-0042-1742627
Research Article

Associations of Telehealth Care Delivery with Pediatric Health Care Provider Well-Being

Richelle deMayo
1   Division of Clinical Informatics, Connecticut Children's Medical Center, Hartford, Connecticut, United States
2   Division of Pain and Palliative Medicine, Connecticut Children's Medical Center, Hartford, Connecticut, United States
3   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, United States
,
Yungui Huang
4   Research Information Solutions and Innovation, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, United States
,
En-Ju D. Lin
4   Research Information Solutions and Innovation, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, United States
,
Jennifer A. Lee
5   Division of Clinical Informatics, Nationwide Children's Hospital, Columbus, Ohio, United States
6   Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, United States
7   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Andrew Heggland
1   Division of Clinical Informatics, Connecticut Children's Medical Center, Hartford, Connecticut, United States
3   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, United States
8   Division of Pediatric Emergency Medicine, Connecticut Children's Medical Center, Hartford, Connecticut, United States
,
Jane Im
1   Division of Clinical Informatics, Connecticut Children's Medical Center, Hartford, Connecticut, United States
3   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, United States
9   Division of Pediatric Hospital Medicine, Connecticut Children's Medical Center, Hartford, Connecticut, United States
,
Christopher Grindle
1   Division of Clinical Informatics, Connecticut Children's Medical Center, Hartford, Connecticut, United States
10   Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, United States
11   Division of Otolaryngology, Connecticut Children's Medical Center, Hartford, Connecticut, United States
,
Aarti Chandawarkar
5   Division of Clinical Informatics, Nationwide Children's Hospital, Columbus, Ohio, United States
7   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background The rapid, large-scale deployment of new health technologies can introduce challenges to clinicians who are already under stress. The novel coronavirus disease 19 (COVID-19) pandemic transformed health care in the United States to include a telehealth model of care delivery. Clarifying paths through which telehealth technology use is associated with change in provider well-being and interest in sustaining virtual care delivery can inform planning and optimization efforts.

Objective This study aimed to characterize provider-reported changes in well-being and daily work associated with the pandemic-accelerated expansion of telehealth and assess the relationship of provider perceptions of telehealth effectiveness, efficiency, and work–life balance with desire for future telehealth.

Methods A cross-sectional survey study was conducted October through November 2020, 6 months after the outbreak of COVID-19 at three children's hospitals. Factor analysis and structural equation modeling (SEM) were used to examine telehealth factors associated with reported change in well-being and desire for future telehealth.

Results A total of 947 nontrainee physicians, advanced practice providers, and psychologists were surveyed. Of them, 502 (53.0%) providers responded and 467 (49.3%) met inclusion criteria of telehealth use during the study period. Of these, 325 (69.6%) were female, 301 (65.6%) were physicians, and 220 (47.1%) were medical subspecialists. Providers were 4.77 times as likely (95% confidence interval [CI]: 3.29–7.06) to report improved versus worsened well-being associated with telehealth. Also, 95.5% of providers (95% CI: 93.2–97.2%) wish to continue performing telehealth postpandemic. Our model explains 66% of the variance in telehealth-attributed provider well-being and 59% of the variance for future telehealth preference and suggests telehealth resources significantly influence provider-perceived telehealth care effectiveness which in turn significantly influences provider well-being and desire to perform telehealth.

Conclusion Telehealth has potential to promote provider well-being; telehealth-related changes in provider well-being are associated with both provider-perceived effectiveness of telemedicine for patients and adequacy of telehealth resources.

Keywords

telemedicine and telehealth - burnout, professional - efficiency - clinical effectiveness - personal satisfaction

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed by the Institutional Review Boards of all participating organizations: Connecticut Children's (registration no.: IRB00000703), Nationwide Children's Hospital (registration no.: IRB00000568), and East Tennessee Children's Hospital (registration no.: IRB00002221).




Publication History

Received: 10 July 2021

Accepted: 14 December 2021

Article published online:
16 February 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany