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Wu J, Bolton RE, Anwar C, Bokhour BG, Khanna A, Mullur RS, Taylor SL, Hyde J. Modifying Whole Health Services for Successful Telehealth Delivery: Lessons from Veterans Health Administration's Rapid Transition During the COVID-19 Pandemic. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:792-804. [PMID: 37668607 DOI: 10.1089/jicm.2023.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Introduction: The Veterans Health Administration (VHA) is shifting care from a disease-oriented to health-creating approach that aims to provide whole person care. This Whole Health (WH) system combines person-centered care with delivery of WH services (e.g., health coaching, well-being education and skill-building classes, and evidence-based complementary and integrative health therapies), alongside conventional medical services. During the COVID-19 pandemic, WH services were modified for delivery through telehealth (teleWH). This article characterizes modifications to WH services made to maintain continuity during the transition to telehealth formats. Materials and methods: We conducted semistructured qualitative interviews with a purposive sample of 51 providers delivering teleWH services at 10 VHA medical centers. We examined WH service modifications as well as facilitators and barriers to those modifications using rapid coding and directed content analysis. Results: Modifications were driven by (1) preparing for teleWH service delivery and (2) improving teleWH service delivery. To prepare for teleWH services, modifications were prompted by access, readiness, and setting and resources. Modifications to improve the delivery of teleWH services were motivated by engagement, community-building, safety, and content for a teleWH environment. One-on-one teleWH services required the fewest modifications, while more significant modifications were needed for well-being, skill-building, and movement-based groups, and reconfiguration of manual therapies. Discussion: Findings highlighted the need for modifications to ensure that teleWH services are accessible and safe and support interpersonal relationships between patients and providers, as well as in group-based classes. Successfully delivering teleWH services requires proactive preparation that considers access, readiness, and the availability of resources to engage in teleWH services. Tailoring strategies and considering the unique needs of different teleWH services are critical. Conclusions: The COVID-19 pandemic catalyzed teleWH service implementation, utilization, and sustainment. The challenges faced and modifications made during this transition provide lessons learned for other health care systems as they attempt to implement teleWH services.
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Affiliation(s)
- Juliet Wu
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Rendelle E Bolton
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Chitra Anwar
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Barbara G Bokhour
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Aishwarya Khanna
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Rashmi S Mullur
- U.S. Department of Veterans Affairs, Center for the Study of Health Care Innovation, Implementation & Policy (CSHIIP), Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
- Department of Medicine, Division of Diabetes, Endocrinology & Metabolism, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Integrative Medicine Collaborative, University of California Los Angeles Health, Los Angeles, CA, USA
| | - Stephanie L Taylor
- U.S. Department of Veterans Affairs, Center for the Study of Health Care Innovation, Implementation & Policy (CSHIIP), Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Health Policy and Management, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Justeen Hyde
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
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Building and Realizing the Obstetrics and Gynecology Nursing Management Platform by Computer Information Technology under the Concept of Mindfulness Intervention. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6297934. [PMID: 35356622 PMCID: PMC8959969 DOI: 10.1155/2022/6297934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 11/17/2022]
Abstract
Nursing management of the gynecology department is one of the challenging issues and needed to be resolved through effective utilization of the available technology. In this paper, we are going to address this issue and try to establish an obstetrics and gynecology nursing management platform used to monitor and evaluate the mental health of pregnant women. Firstly, computer information technology is adopted, and the obstetrics and gynecology nursing management system is established. Secondly, after adopting the system to intervene in the mental state of patients with mindfulness, the system timely monitors the pregnant women's physical health indicators and mental health level data. With the help of the computer data analysis system, the obstetrics and gynecology management platform is built to carry out timely mindfulness interventions for pregnant women. The established system can reach high accuracy in identifying negative emotions of pregnant women, and the accuracy can reach 89.7%. It shows that the established system can timely and accurately intervene and regulate the pregnant woman's bad psychological state, effectively improve the pregnant woman's sleep quality during pregnancy, and enhance the pregnant woman's sleep effect. The effectiveness and feasibility of Internet mindfulness interventions for improving sleep quality during pregnancy has been confirmed. This has important practical significance for the digital and intelligent development of the medical care management platform.
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