Hospital-Level Implementation Barriers, Facilitators, and Willingness to Use a New Regional Disaster Teleconsultation System : Cross-Sectional Survey Study
©Tehnaz Boyle, Krislyn Boggs, Jingya Gao, Maureen McMahon, Rachel Bedenbaugh, Lauren Schmidt, Kori Sauser Zachrison, Eric Goralnick, Paul Biddinger, Carlos A Camargo Jr. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 27.06.2023..
BACKGROUND: The Region 1 Disaster Health Response System project is developing new telehealth capabilities to provide rapid, temporary access to clinical experts across US jurisdictions to support regional disaster health response.
OBJECTIVE: To guide future implementation, we identified hospital-level barriers, facilitators, and willingness to use a novel regional peer-to-peer disaster teleconsultation system for disaster health response.
METHODS: We used the National Emergency Department Inventory-USA database to identify all 189 hospital-based and freestanding emergency departments (EDs) in New England states. We digitally or telephonically surveyed emergency managers regarding notification systems used for large-scale no-notice emergency events, access to consultants in 6 disaster-relevant specialties, disaster credentialing requirements before system use, reliability and redundancy of internet or cellular service, and willingness to use a disaster teleconsultation system. We examined state-wise hospital and ED disaster response capability.
RESULTS: Overall, 164 (87%) hospitals and EDs responded-126 (77%) completed telephone surveys. Most (n=148, 90%) receive emergency notifications from state-based systems. Forty (24%) hospitals and EDs lacked access to burn specialists; toxicologists, 30 (18%); radiation specialists, 25 (15%); and trauma specialists, 20 (12%). Among critical access hospitals (CAHs) or EDs with <10,000 annual visits (n=36), 92% received routine nondisaster telehealth services but lacked toxicologist (25%), burn (22%), and radiation (17%) specialist access. Most hospitals and EDs (n=115, 70%) require disaster credentialing of teleconsultants before system use. Among 113 hospitals and EDs with written disaster credentialing procedures, 28% expected completing disaster credentialing within 24 hours, and 55% within 25-72 hours, which varied by state. Most (n=154, 94%) reported adequate internet or cellular service for video-streaming; 81% maintained cellular service despite internet disruption. Fewer rural hospitals and EDs reported reliable internet or cellular service (19/22, 86% vs 135/142, 95%) and ability to maintain cellular service with internet disruption (11/19, 58% vs 113/135, 84%) than urban hospitals and EDs. Overall, 133 (81%) were somewhat or very likely to use a regional disaster teleconsultation system. Large-volume EDs (annual visits ≥40,000) were less likely to use the service than smaller ones; all CAHs and nearly all rural hospitals or freestanding EDs were likely to use disaster consultation services. Among hospitals and EDs somewhat or very unlikely to use the system (n=26), sufficient consultant access (69%) and reluctance to use new technology or systems (27%) were common barriers. Potential delays (19%), liability (19%), privacy (15%), and hospital information system security restrictions (15%) were infrequent concerns.
CONCLUSIONS: Most New England hospitals and EDs have access to state emergency notification systems, telecommunication infrastructure, and willingness to use a new regional disaster teleconsultation system. System developers should focus on ways to improve telecommunication redundancy in rural areas and use low-bandwidth technology to maintain service availability to CAHs and rural hospitals and EDs. Policies and procedures to accelerate and standardize disaster credentialing are needed for implementation across jurisdictions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
JMIR public health and surveillance - 9(2023) vom: 27. Juni, Seite e44164 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Boyle, Tehnaz [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 29.06.2023 Date Revised 14.07.2023 published: Electronic Citation Status MEDLINE |
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| doi: |
10.2196/44164 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358698219 |
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| 100 | 1 | |a Boyle, Tehnaz |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hospital-Level Implementation Barriers, Facilitators, and Willingness to Use a New Regional Disaster Teleconsultation System |b Cross-Sectional Survey Study |
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| 500 | |a Date Completed 29.06.2023 | ||
| 500 | |a Date Revised 14.07.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a ©Tehnaz Boyle, Krislyn Boggs, Jingya Gao, Maureen McMahon, Rachel Bedenbaugh, Lauren Schmidt, Kori Sauser Zachrison, Eric Goralnick, Paul Biddinger, Carlos A Camargo Jr. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 27.06.2023. | ||
| 520 | |a BACKGROUND: The Region 1 Disaster Health Response System project is developing new telehealth capabilities to provide rapid, temporary access to clinical experts across US jurisdictions to support regional disaster health response | ||
| 520 | |a OBJECTIVE: To guide future implementation, we identified hospital-level barriers, facilitators, and willingness to use a novel regional peer-to-peer disaster teleconsultation system for disaster health response | ||
| 520 | |a METHODS: We used the National Emergency Department Inventory-USA database to identify all 189 hospital-based and freestanding emergency departments (EDs) in New England states. We digitally or telephonically surveyed emergency managers regarding notification systems used for large-scale no-notice emergency events, access to consultants in 6 disaster-relevant specialties, disaster credentialing requirements before system use, reliability and redundancy of internet or cellular service, and willingness to use a disaster teleconsultation system. We examined state-wise hospital and ED disaster response capability | ||
| 520 | |a RESULTS: Overall, 164 (87%) hospitals and EDs responded-126 (77%) completed telephone surveys. Most (n=148, 90%) receive emergency notifications from state-based systems. Forty (24%) hospitals and EDs lacked access to burn specialists; toxicologists, 30 (18%); radiation specialists, 25 (15%); and trauma specialists, 20 (12%). Among critical access hospitals (CAHs) or EDs with <10,000 annual visits (n=36), 92% received routine nondisaster telehealth services but lacked toxicologist (25%), burn (22%), and radiation (17%) specialist access. Most hospitals and EDs (n=115, 70%) require disaster credentialing of teleconsultants before system use. Among 113 hospitals and EDs with written disaster credentialing procedures, 28% expected completing disaster credentialing within 24 hours, and 55% within 25-72 hours, which varied by state. Most (n=154, 94%) reported adequate internet or cellular service for video-streaming; 81% maintained cellular service despite internet disruption. Fewer rural hospitals and EDs reported reliable internet or cellular service (19/22, 86% vs 135/142, 95%) and ability to maintain cellular service with internet disruption (11/19, 58% vs 113/135, 84%) than urban hospitals and EDs. Overall, 133 (81%) were somewhat or very likely to use a regional disaster teleconsultation system. Large-volume EDs (annual visits ≥40,000) were less likely to use the service than smaller ones; all CAHs and nearly all rural hospitals or freestanding EDs were likely to use disaster consultation services. Among hospitals and EDs somewhat or very unlikely to use the system (n=26), sufficient consultant access (69%) and reluctance to use new technology or systems (27%) were common barriers. Potential delays (19%), liability (19%), privacy (15%), and hospital information system security restrictions (15%) were infrequent concerns | ||
| 520 | |a CONCLUSIONS: Most New England hospitals and EDs have access to state emergency notification systems, telecommunication infrastructure, and willingness to use a new regional disaster teleconsultation system. System developers should focus on ways to improve telecommunication redundancy in rural areas and use low-bandwidth technology to maintain service availability to CAHs and rural hospitals and EDs. Policies and procedures to accelerate and standardize disaster credentialing are needed for implementation across jurisdictions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a alert | |
| 650 | 4 | |a disaster | |
| 650 | 4 | |a disaster medicine | |
| 650 | 4 | |a e-consult | |
| 650 | 4 | |a eHealth | |
| 650 | 4 | |a emergency | |
| 650 | 4 | |a health care delivery | |
| 650 | 4 | |a health system | |
| 650 | 4 | |a hospital management | |
| 650 | 4 | |a notification | |
| 650 | 4 | |a remote consultation | |
| 650 | 4 | |a teleconsultation | |
| 650 | 4 | |a telehealth | |
| 650 | 4 | |a telemedicine | |
| 700 | 1 | |a Boggs, Krislyn |e verfasserin |4 aut | |
| 700 | 1 | |a Gao, Jingya |e verfasserin |4 aut | |
| 700 | 1 | |a McMahon, Maureen |e verfasserin |4 aut | |
| 700 | 1 | |a Bedenbaugh, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Schmidt, Lauren |e verfasserin |4 aut | |
| 700 | 1 | |a Zachrison, Kori Sauser |e verfasserin |4 aut | |
| 700 | 1 | |a Goralnick, Eric |e verfasserin |4 aut | |
| 700 | 1 | |a Biddinger, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Camargo, Carlos A |c Jr |e verfasserin |4 aut | |
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| 773 | 1 | 8 | |g volume:9 |g year:2023 |g day:27 |g month:06 |g pages:e44164 |
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