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Baratta LR, Lew D, Kannampallil T, Lou SS. Contributors to Electronic Health Record-Integrated Secure Messaging Use: A Study of Over 33,000 Health Care Professionals. Appl Clin Inform 2024; 15:612-619. [PMID: 39048085 PMCID: PMC11268985 DOI: 10.1055/s-0044-1787756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/22/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES Electronic health record (EHR)-integrated secure messaging is extensively used for communication between clinicians. We investigated the factors contributing to secure messaging use in a large health care system. METHODS This was a cross-sectional study that included 14 hospitals and 263 outpatient clinic locations. Data on EHR-integrated secure messaging use over a 1-month period (February 1, 2023, through February 28, 2023) were collected. A multilevel mixed effects model was used to assess the contribution of clinical role, clinical unit (i.e., specific inpatient ward or outpatient clinic), hospital or clinic location (i.e., Hospital X or Outpatient Clinic Building Y), and inpatient versus outpatient setting toward secure messaging use. RESULTS Of the 33,195 health care professionals who worked during the study period, 20,576 (62%) were secure messaging users. In total, 25.3% of the variability in messaging use was attributable to the clinical unit and 30.5% was attributable to the hospital or clinic location. Compared with nurses, advanced practice providers, pharmacists, and physicians were more likely to use secure messaging, whereas medical assistants, social workers, and therapists were less likely (p < 0.001). After adjusting for other factors, inpatient versus outpatient setting was not associated with secure messaging use. CONCLUSION Secure messaging was widely used; however, there was substantial variation by clinical role, clinical unit, and hospital or clinic location. Our results suggest that interventions and policies for managing secure messaging behaviors are likely to be most effective if they are not only set at the organizational level but also communicated and tailored toward individual clinical units and clinician workflows.
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Affiliation(s)
- Laura R. Baratta
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, St Louis, Missouri, United States
| | - Daphne Lew
- Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St Louis, Missouri, United States
| | - Thomas Kannampallil
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, St Louis, Missouri, United States
- Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St Louis, Missouri, United States
- Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, United States
| | - Sunny S. Lou
- Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St Louis, Missouri, United States
- Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, United States
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McCrimmon T, Collins LF, Perez-Brumer A, Bazzi AR, Shaffer VA, Kerrigan D, Alcaide ML, Philbin MM. Long-Acting Injectable Antiretrovirals for HIV Treatment: A Multi-Site Qualitative Study of Clinic-Level Barriers to Implementation in the United States. AIDS Patient Care STDS 2024; 38:61-69. [PMID: 38381949 PMCID: PMC11250840 DOI: 10.1089/apc.2023.0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Long-acting injectable antiretroviral therapy (LAI ART) has the potential to address adherence obstacles associated with daily oral ART, leading to enhanced treatment uptake, adherence, and viral suppression among people living with HIV (PLWH). Yet, its potential may be limited due to ongoing disparities in availability and accessibility. We need a better understanding of the organizational context surrounding the implementation of LAI ART, and to inform its widespread rollout, we conducted 38 in-depth interviews with medical and social service providers who offer HIV care at private and hospital-based clinics across six US cities. Our findings highlight real-world implementation barriers outside of clinical trial settings. Providers described ongoing and anticipated barriers across three stages of LAI ART implementation: (1) Patient enrollment (challenges registering patients and limited insurance coverage), (2) medication delivery (insufficient personnel and resources), and (3) leadership and management (lack of interprofessional coordination and a lack of programming guidelines). Providers described how these barriers would have a disproportionate impact on under-resourced clinics, potentially exacerbating existing disparities in LAI ART access and adherence. Our findings suggest strategies that clinic leadership, policymakers, and other stakeholders can pursue to promote rapid and equitable LAI ART implementation in clinics across the United States. Resource and staffing investments could support clinics to begin, sustain, and scale up LAI ART delivery; additionally, the establishment of guidelines and tools could facilitate wider adoption of LAI ART across clinical settings. These efforts are crucial to promote resourced, standardized, and equitable implementation of LAI ART and maximize its potential to help end the HIV epidemic.
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Affiliation(s)
- Tara McCrimmon
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Lauren F. Collins
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Amaya Perez-Brumer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Angela R. Bazzi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Victoria A. Shaffer
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri, USA
| | - Deanna Kerrigan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Maria L. Alcaide
- Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Morgan M. Philbin
- Division of Vulnerable Populations, Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Robertson ST, Rosbergen ICM, Brauer SG, Grimley RS, Burton-Jones A. Addressing complexity when developing an education program for the implementation of a stroke Electronic Medical Record (EMR) enhancement. BMC Health Serv Res 2023; 23:1301. [PMID: 38001487 PMCID: PMC10675965 DOI: 10.1186/s12913-023-10314-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Digital interventions in health services often fail due to an underappreciation of the complexity of the implementation. This study develops an approach to address complexity through an evidenced-based, theory-driven education and implementation program for an Electronic Medical Record (EMR) digital enhancement for acute stroke care. METHODS An action research approach was used to design, develop, and execute the education and implementation program over several phases, with iterative changes over time. The study involved collaboration with multiple statewide and local key stakeholders and was conducted across two tertiary teaching hospitals and a regional hospital in Australia. RESULTS Insights were gained over five phases. Phase 1 involved a review of evidence that supported blended learning strategies for the education and training of staff end-users. In Phase 2, contextual assessment was conducted via observation of study sites, providing awareness of local context variability and insight into key implementation considerations. The Non-adoption, Abandonment, Scale-Up, Spread and Sustainability (NASSS) framework assisted in Phase 3 to identify and manage the key domains of complexity. Phase 4 involved the design of the program which included group-based training and an e-learning package, endorsed and evaluated by key leaders. Throughout implementation in Phase 5, further barriers were identified, and iterative changes were tailored to each context. CONCLUSIONS The NASSS framework, combined with a multi-phased approach employing blended learning techniques, context evaluations, and iterative modifications, can serve as a model for generating theory-driven and evidence-based education strategies that adresss the complexity of the implementation process and context.
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Affiliation(s)
- Samantha T Robertson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
- Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia.
- Digital Health CRC, Sydney, NSW, Australia.
| | - Ingrid C M Rosbergen
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
- Department of Physical Therapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Sandra G Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Rohan S Grimley
- Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Birtinya, Australia
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Kotsis F, Bächle H, Altenbuchinger M, Dönitz J, Njipouombe Nsangou YA, Meiselbach H, Kosch R, Salloch S, Bratan T, Zacharias HU, Schultheiss UT. Expectation of clinical decision support systems: a survey study among nephrologist end-users. BMC Med Inform Decis Mak 2023; 23:239. [PMID: 37884906 PMCID: PMC10605935 DOI: 10.1186/s12911-023-02317-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD), a major public health problem with differing disease etiologies, leads to complications, comorbidities, polypharmacy, and mortality. Monitoring disease progression and personalized treatment efforts are crucial for long-term patient outcomes. Physicians need to integrate different data levels, e.g., clinical parameters, biomarkers, and drug information, with medical knowledge. Clinical decision support systems (CDSS) can tackle these issues and improve patient management. Knowledge about the awareness and implementation of CDSS in Germany within the field of nephrology is scarce. PURPOSE Nephrologists' attitude towards any CDSS and potential CDSS features of interest, like adverse event prediction algorithms, is important for a successful implementation. This survey investigates nephrologists' experiences with and expectations towards a useful CDSS for daily medical routine in the outpatient setting. METHODS The 38-item questionnaire survey was conducted either by telephone or as a do-it-yourself online interview amongst nephrologists across all of Germany. Answers were collected and analysed using the Electronic Data Capture System REDCap, as well as Stata SE 15.1, and Excel. The survey consisted of four modules: experiences with CDSS (M1), expectations towards a helpful CDSS (M2), evaluation of adverse event prediction algorithms (M3), and ethical aspects of CDSS (M4). Descriptive statistical analyses of all questions were conducted. RESULTS The study population comprised 54 physicians, with a response rate of about 80-100% per question. Most participants were aged between 51-60 years (45.1%), 64% were male, and most participants had been working in nephrology out-patient clinics for a median of 10.5 years. Overall, CDSS use was poor (81.2%), often due to lack of knowledge about existing CDSS. Most participants (79%) believed CDSS to be helpful in the management of CKD patients with a high willingness to try out a CDSS. Of all adverse event prediction algorithms, prediction of CKD progression (97.8%) and in-silico simulations of disease progression when changing, e. g., lifestyle or medication (97.7%) were rated most important. The spectrum of answers on ethical aspects of CDSS was diverse. CONCLUSION This survey provides insights into experience with and expectations of out-patient nephrologists on CDSS. Despite the current lack of knowledge on CDSS, the willingness to integrate CDSS into daily patient care, and the need for adverse event prediction algorithms was high.
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Affiliation(s)
- Fruzsina Kotsis
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany
- Department of Medicine IV - Nephrology and Primary Care, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany
| | - Helena Bächle
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany
| | - Michael Altenbuchinger
- Department of Medical Bioinformatics, University Medical Center Göttingen, Göttingen, Germany
| | - Jürgen Dönitz
- Department of Medical Bioinformatics, University Medical Center Göttingen, Göttingen, Germany
- Institute of Computational Biology, Helmholtz Zentrum München, Munich, Germany
| | | | - Heike Meiselbach
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Robin Kosch
- Department of Medical Bioinformatics, University Medical Center Göttingen, Göttingen, Germany
| | - Sabine Salloch
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Hanover, Germany
| | - Tanja Bratan
- Competence Center Emerging Technologies, Fraunhofer Institute for Systems and Innovation Research ISI, Karlsruhe, Germany
| | - Helena U Zacharias
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hanover, Germany
| | - Ulla T Schultheiss
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.
- Department of Medicine IV - Nephrology and Primary Care, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.
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Barbara A, Villani L, Lombardo P, Parente P, Gemma A, Angeletti D, Chiriaco T, Mastromattei A, Akselrod S, Goletti M, Rosa ED, De Vito C. The "Lazio ADVICE" telemedicine platform: First results of general practitioners' usage, facilitators and barriers in the Local Health Authority Roma 1. Digit Health 2023; 9:20552076231174099. [PMID: 37256007 PMCID: PMC10226167 DOI: 10.1177/20552076231174099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/19/2023] [Indexed: 06/01/2023] Open
Abstract
Background Telemedical approaches represent a valuable tool for the management of coronavirus disease 2019 patients, allowing daily clinical assessment, monitoring of vital parameters, remote visits, and prescription of treatment or hospitalization in case of clinical worsening. This cross-sectional study aims to evaluate the use, barriers and facilitators of the "Lazio ADVICE" telemedical platform, a regional system for remote assistance for coronavirus disease 2019 patients at home, according to General Practitioners and Family Pediatricians of the Local Health Authority Roma 1, during the coronavirus disease 2019 pandemic. Methods An interview-based survey was performed between December 2020 and January 2021. The survey investigated the demographic information of General Practitioner and Family Pediatricians, the knowledge of the platform, frequency of utilization, usefulness, strengths and weaknesses, and hypothesis of future implementation proposed. Results We interviewed 214 physicians and 89 (41.6%) were classified as users and 125 (58.4%) as non-users. Older age and working in District 1, 14 and 15 (vs. District 13) significantly reduced the probability of using the platform physician. Among the 89 users, 19 (21.3%) used the platform every day or even several times a day, 40 (44.9%) several times a week but less than one access per day, 30 (33.7%) used the platform several times a month up to one entry per week. Most of them (92.3%) consider the platform useful. Barriers were poor integration with software and work routine (76.4%), and usability issues (53.9%). Among the 125 non-users, 14 (11.2%) didn't know the existence of the platform, 60 (48.0%) never tried it and 51 (40.8%) tried to use it. Reported reasons for the interruption of use were not very user-friendly (45.1%), perceived useless (37.3%), non-optimal functioning (23.5%), and lack of time (19.6%). Conclusion The pandemic accelerated the implementation of telemedicine services around Lazio Region, starting a positive and continuous exchange of experiences, activities and best practices among physicians.
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Affiliation(s)
- Andrea Barbara
- Department of Public Health and
Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Local Health Authority Roma
1, Rome, Italy
| | - Leonardo Villani
- Local Health Authority Roma
1, Rome, Italy
- Section of Hygiene - University
Department of Life Sciences and Public Health, Università Cattolica Del Sacro
Cuore, Rome, Italy
| | - Paolo Lombardo
- Department of Public Health and
Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | | | | | | | - Antonio Mastromattei
- Integrated Territorial Network Area of
the Regional Health and Social Health Integration Directorate, Regione Lazio,
Italy
| | | | | | | | - Corrado De Vito
- Department of Public Health and
Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Moll C, Arndt F, Arvanitis TN, Gonzàlez N, Groene O, Ortega-Gil A, Verdoy D, Bloemeke J. "It depends on the people!" - A qualitative analysis of contextual factors, prior to the implementation of digital health innovations for chronic condition management, in a German integrated care network. Digit Health 2023; 9:20552076231222100. [PMID: 38162835 PMCID: PMC10756073 DOI: 10.1177/20552076231222100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024] Open
Abstract
Objective Integrated care and digital health technology interventions are promising approaches to coordinate services for people living with chronic conditions, across different care settings and providers. The EU-funded ADLIFE project intends to provide digitally integrated personalized care to improve and maintain patients' health with advanced chronic conditions. This study conducted a qualitative assessment of contextual factors prior to the implementation of the ADLIFE digital health platforms at the German pilot site. The results of the assessment are then used to derive recommendations for action for the subsequent implementation, and for evaluation of the other pilot sites. Methods Qualitative interviews with healthcare professionals and IT experts were conducted at the German pilot site. The interviews followed a semi-structured interview guideline, based on the HOT-fit framework, focusing on organizational, technological, and human factors. All interviews were audio recorded, transcribed, and subsequently analysed following qualitative content analysis. Results The results of the 18 interviews show the interviewees' high openness and motivation to use new innovative digital solutions, as well as an apparent willingness of cooperation between different healthcare professionals. Challenges include limited technical infrastructure and large variability of software to record health data, lacking standards and interfaces. Conclusions Considering contextual factors on different levels is critical for the success of implementing innovations in healthcare and the transfer into other settings. In our study, the HOT-fit framework proved suitable for assessing contextual factors, when implementing IT innovations in healthcare. In a next step, the methodological approach will be transferred to the six other European pilot sites, participating in the project, for a cross-national assessment of contextual factors.
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Affiliation(s)
- Clemens Moll
- Research and Innovation, OptiMedis AG, Hamburg, Germany
| | - Fritz Arndt
- Gesunder Werra-Meißner Kreis GmbH, Eschwege, Germany
| | - Theodoros N. Arvanitis
- Institute of Digital Healthcare, University of Warwick, Coventry, UK
- School of Engineering, University of Birmingham, Birmingham, UK
| | - Nerea Gonzàlez
- Kronikgune Institute for Health Service Research, Basque Country, Spain
| | - Oliver Groene
- Research and Innovation, OptiMedis AG, Hamburg, Germany
- Faculty of Management and Economics, University of Witten/Herdecke, Witten, Germany
| | - Ana Ortega-Gil
- Kronikgune Institute for Health Service Research, Basque Country, Spain
| | - Dolores Verdoy
- Kronikgune Institute for Health Service Research, Basque Country, Spain
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Gabutti I. Designing the role of middle managers: An empirical perspective in the hospital sector. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2125021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Irene Gabutti
- Department of Management, Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy
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"Long COVID" results after hospitalization for SARS-CoV-2 infection. Sci Rep 2022; 12:9581. [PMID: 35688830 PMCID: PMC9185134 DOI: 10.1038/s41598-022-13077-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 05/20/2022] [Indexed: 11/21/2022] Open
Abstract
Long-term sequelae of symptomatic infection caused by SARS-CoV-2 are largely undiscovered. We performed a prospective cohort study on consecutively hospitalized Sars-CoV-2 patients (March–May 2020) for evaluating COVID-19 outcomes at 6 and 12 months. After hospital discharge, patients were addressed to two follow-up pathways based on respiratory support needed during hospitalization. Outcomes were assessed by telephone consultation or ambulatory visit. Among 471 patients, 80.9% received no respiratory support during hospitalization; 19.1% received non-invasive ventilation (NIV) or invasive mechanical ventilation (IMV). 58 patients died during hospitalization, therefore 413 were enrolled for follow-up. At 6 months, among 355 patients, the 30.3% had any symptoms, 18.0% dyspnea, 6.2% neurological symptoms. Fifty-two out of 105 had major damages in interstitial computed tomography images. NIV/IMV patients had higher probability to suffer of symptoms (aOR = 4.00, 95%CI:1.99–8.05), dyspnea (aOR = 2.80, 95%CI:1.28–6.16), neurological symptoms (aOR = 9.72, 95%CI:2.78–34.00). At 12 months, among 344, the 25.3% suffered on any symptoms, 12.2% dyspnea, 10.1% neurological symptoms. Severe interstitial lesions were present in 37 out of 47 investigated patients. NIV/IMV patients in respect to no respiratory support, had higher probability of experiencing symptoms (aOR = 3.66, 95%CI:1.73–7.74), neurological symptoms (aOR = 8.96, 95%CI:3.22–24.90). COVID-19 patients showed prolonged sequelae up to 12 months, highlighting the need of follow-up pathways for post-COVID-19 syndrome.
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Hansen RN, Saour BM, Serafini B, Hannaford B, Kim L, Kohno T, James R, Monsky W, Seslar SP. Opportunities and Barriers to Rural Telerobotic Surgical Health Care in 2021: Report and Research Agenda from a Stakeholder Workshop. Telemed J E Health 2021; 28:1050-1057. [PMID: 34797741 PMCID: PMC9293678 DOI: 10.1089/tmj.2021.0378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background: There are well-recognized challenges to delivering specialty health care in rural settings. These challenges are particularly evident for specialized surgical health care due to the lack of trained operators in rural communities. Telerobotic surgery could have a significant impact on the rural-urban health care gap, but thus far, the promise of this method of health care delivery has gone unrealized. With the increasing adoption of telehealth over the past year, along with the maturation of telecommunication and robotic technologies over the past 2 decades, a reappraisal of the opportunities and barriers to widespread implementation of telerobotic surgery is warranted. Here we report the outcome of a rural telerobotic stakeholder workshop to explore modern-day issues critical to the advancement of telerobotic surgical health care. Materials and Methods: We assembled a multidisciplinary stakeholder panel to participate in a 2-day Rural Telerobotic Surgery Stakeholder Workshop. Participants had diverse expertise, including specialty surgeons, technology experts, and representatives of the broader telerobotic health care ecosystem, including economists, lawyers, regulatory consultants, public health advocates, rural hospital administrators, nurses, and payers. The research team reviewed transcripts from the workshop with themes identified and research questions generated based on stakeholder comments and feedback. Results: Stakeholder discussions fell into four general themes, including (1) operating room team interactions, (2) education and training, (3) network and security, and (4) economic issues. The research team then identified several research questions within each of these themes and provided specific research strategies to address these questions. Conclusions: There are still important unanswered questions regarding the implementation and adoption of rural telerobotic surgery. Based on stakeholder feedback, we have developed a research agenda along with suggested strategies to address outstanding research questions. The successful execution of these research opportunities will fill critical gaps in our understanding of how to advance the widespread adoption of rural telerobotic health care.
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Affiliation(s)
- Ryan N Hansen
- The Comparative Health Outcomes, Policy, and Economics Institute, University of Washington, Seattle, Washington, USA
| | | | - Brian Serafini
- Sociology Department, University of Washington, Seattle, Washington, USA
| | - Blake Hannaford
- Department of Electrical Engineering, University of Washington, Seattle, Washington, USA
| | - Lanu Kim
- School of Humanities and Social Sciences, Korea Advance Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Takayoshi Kohno
- Paul G. Allen School of Computer Science & Engineering University of Washington, Seattle, Washington, USA
| | - Ryan James
- Telerobotics, LLC, Seattle, Washington, USA
| | - Wayne Monsky
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Stephen P Seslar
- Department of Cardiology, University of Washington, Seattle, Washington, USA
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