Jarvis-Selinger S et al. 2008 "Clinical telehealth across the disciplines: lessons learned."

Reference
Jarvis-Selinger S, Chan E, Payne R, et al. Clinical telehealth across the disciplines: lessons learned. Telemed J E Health 2008;14(7):720-725.
Abstract
"Videoconferencing technologies can vastly expand the reach of healthcare practitioners by providing patients (particularly those in rural/remote areas) with unprecedented access to services. While this represents a fundamental shift in the way that healthcare professionals care for their patients, very little is known about the impact of these technologies on clinical workflow practices and interprofessional collaboration. In order to better understand this, we have conducted a focused literature review, with the aim of providing policymakers, administrators, and healthcare professionals with an evidence-based foundation for decision-making. A total of 397 articles focused on videoconferencing in clinical contexts were retrieved, with 225 used to produce this literature review. Literature in the fields of medicine (including general and family practitioners and specialists in neurology, dermatology, radiology, orthopedics, rheumatology, surgery, cardiology, pediatrics, pathology, renal care, genetics, and psychiatry), nursing (including hospital-based, community-based, nursing homes, and home-based care), pharmacy, the rehabilitation sciences (including occupational and physical therapy), social work, and speech pathology were included in the review. Full utilization of the capacity of videoconferencing tools in clinical contexts requires some basic necessary technical conditions to be in place (including basic technological infrastructure, site-to-site technological compatibility, and available technical support). The available literature also elucidates key strategies for organizational readiness and technology adoption (including the development of a change management and user training plan, understanding program cost and remuneration issues, development of organizational protocols for system use, and strategies to promote interprofessional collaboration)."
Objective
"To understand the impact of videoconferencing technologies on clinical workflow practices and interprofessional collaboration."
Size
not applicable
Type of Health IT
Telemedicine
Type of Health IT Functions
The functions varied across the articles reviewed.
Workflow-Related Findings
Results point out several barriers against the introduction of technology, in this case videoconferencing (VC), in the workplace, such as a lack of technological compatibility, lack of (ongoing) technical support, the need for training and the need for organizational readiness and system adaption. Results of the review showed that, in general, equity of care (between clinical videoconferencing vs. face-to-face encounters) is possible. Especially referring providers were positive about the potential to reduce unnecessary patient transfers and maintain care within the home community. Results also show that introducing videoconferencing in health care has consequences for clinical workflow. For example, VC has an impact on how health care teams work together. Especially the coordination required between the different health care providers can create temporal and logistical challenges. However, VC can also create a new context for team-based management, enabling team members to better communicate, and can result in more effective case management and decreased treatment time for patients.
Study Design
Systematic literature review
Study Participants
In a focused literature review on the impact of video-conferencing on clinical workflow practices and inter-professional collaboration the authors reviewed 225 studies.