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Wong D, Cross IH, Ramers CB, Imtiaz F, Scott JD, Dezan AM, Armistad AJ, Manteuffel ME, Wagner D, Hunt RC, England WL, Kwong MW, Dizon RA, Lamers V, Plotkin I, Jolly BT, Jones W, Daly DD, Yeager M, Riley JA, Krupinski EA, Solomon AP, Wibberly KH, Struminger BB. Large-Scale Telemedicine Implementation for Outpatient Clinicians: Results From a Pandemic-Adapted Learning Collaborative. J Ambul Care Manage 2024; 47:51-63. [PMID: 38441558 DOI: 10.1097/jac.0000000000000491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Learning collaboratives are seldom used outside of health care quality improvement. We describe a condensed, 10-week learning collaborative ("Telemedicine Hack") that facilitated telemedicine implementation for outpatient clinicians early in the COVID-19 pandemic. Live attendance averaged 1688 participants per session. Of 1005 baseline survey respondents, 57% were clinicians with one-third identifying as from a racial/ethnic minoritized group. Practice characteristics included primary care (71%), rural settings (51%), and community health centers (28%). Of three surveys, a high of 438 (81%) of 540 clinicians had billed ≥1 video-based telemedicine visit. Our learning collaborative "sprint" is a promising model for scaling knowledge during emergencies and addressing health inequities.
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Affiliation(s)
- David Wong
- Author Affiliations: Healthcare Resilience Working Group, U.S. National COVID-19 Response, Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services, Washington, District of Columbia (Drs Wong, Cross, Manteuffel, Hunt, England, and Jolly, and Ms Imtiaz, and Mr Jones, Mr Daly, Ms Yeager, and Ms Riley); Commissioned Corps of the U.S. Public Health Service (Drs Wong, Cross, and Manteuffel, Mr Daly, and Ms Riley); Laura Rodriguez Research Institute - Family Health Centers of San Diego, San Diego, California (Dr Ramers); ECHO Institute, University of New Mexico Health Sciences Center, Albuquerque, New Mexico (Drs Ramers and Struminger, Ms Dezan, and Ms Armistad); Deloitte Consulting, LLP, Arlington, Virginia (Ms Imtiaz and Ms Yeager); Digital Health, University of Washington, Seattle, Washington (Dr Scott); Yes And Leadership, LLC, Alexandria, Virginia (Mr Wagner); Center for Connected Health Policy, Sacramento, California (Ms Kwong and Mr Dizon); Public Health Foundation, Washington, District of Columbia (Ms Lamers and Mr Plotkin); Telehealth Consultant, Aveshka, Inc., Vienna, Virginia (Dr Jolly); Southwest Telehealth Resource Center, Tucson, Arizona (Dr Krupinski); Northeast Telehealth Resource Center, Augusta, Maine (Mr Solomon); Mid-Atlantic Telehealth Resource Center, Charlottesville, Virginia (Dr Wibberly)
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Noar AP, Jeffery HE, Subbiah Ponniah H, Jaffer U. The aims and effectiveness of communities of practice in healthcare: A systematic review. PLoS One 2023; 18:e0292343. [PMID: 37815986 PMCID: PMC10564133 DOI: 10.1371/journal.pone.0292343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/18/2023] [Indexed: 10/12/2023] Open
Abstract
Communities of practice (CoPs) are defined as "groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis". They are an effective form of knowledge management that have been successfully used in the business sector and increasingly so in healthcare. In May 2023 the electronic databases MEDLINE and EMBASE were systematically searched for primary research studies on CoPs published between 1st January 1950 and 31st December 2022. PRISMA guidelines were followed. The following search terms were used: community/communities of practice AND (healthcare OR medicine OR patient/s). The database search picked up 2009 studies for screening. Of these, 50 papers met the inclusion criteria. The most common aim of CoPs was to directly improve a clinical outcome, with 19 studies aiming to achieve this. In terms of outcomes, qualitative outcomes were the most common measure used in 21 studies. Only 11 of the studies with a quantitative element had the appropriate statistical methodology to report significance. Of the 9 studies that showed a statistically significant effect, 5 showed improvements in hospital-based provision of services such as discharge planning or rehabilitation services. 2 of the studies showed improvements in primary-care, such as management of hepatitis C, and 2 studies showed improvements in direct clinical outcomes, such as central line infections. CoPs in healthcare are aimed at improving clinical outcomes and have been shown to be effective. There is still progress to be made and a need for further studies with more rigorous methodologies, such as RCTs, to provide further support of the causality of CoPs on outcomes.
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Affiliation(s)
- Alexander P. Noar
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
- Highgate Mental Health Centre, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Hannah E. Jeffery
- Department of General Surgery, East and North Hertfordshire NHS Trust, Stevenage, United Kingdom
| | - Hariharan Subbiah Ponniah
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Usman Jaffer
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Vascular Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom
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Costa-Cordella S, Grasso-Cladera A, Rossi A, Duarte J, Guiñazu F, Cortes CP. Internet-based peer support interventions for people living with HIV: A scoping review. PLoS One 2022; 17:e0269332. [PMID: 36040950 PMCID: PMC9426879 DOI: 10.1371/journal.pone.0269332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
Peer support interventions for people living with HIV and AIDS (PLWHA) are effective, but their associated time and material costs for the recipient and the health system make them reachable for only a small proportion of PLWHA. Internet-based interventions are an effective alternative for delivering psychosocial interventions for PLWHA as they are more accessible. Currently, no reviews are focusing on internet-based interventions with peer support components. This scoping review aims to map the existing literature on psychosocial interventions for PLWHA based on peer support and delivered through the internet. We conducted a systematic scoping review of academic literature following methodological guidelines for scoping reviews, and 28 articles met our criteria. We summarized the main characteristics of the digital peer support interventions for PLWHA and how they implemented peer support in a virtual environment. Overall the reported outcomes appeared promising, but more robust evidence is needed.
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Affiliation(s)
- Stefanella Costa-Cordella
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Instituto Milenio Depresión y Personalidad (MIDAP), Santiago, Chile
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Aitana Grasso-Cladera
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Alejandra Rossi
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Javiera Duarte
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Instituto Milenio Depresión y Personalidad (MIDAP), Santiago, Chile
| | - Flavia Guiñazu
- Web Intelligence Centre, Facultad de Ingeniería Industrial, Universidad de Chile, Santiago, Chile
| | - Claudia P. Cortes
- Hospital Clínico San Borja Arriarán & Fundación Arriarán, Santiago, Chile
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- * E-mail:
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