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Leslie K, Myles S, Schiller CJ, Alraja AA, Nelson S, Adams TL. Protecting the public interest while regulating health professionals providing virtual care: A scoping review. PLOS DIGITAL HEALTH 2023; 2:e0000163. [PMID: 37115785 PMCID: PMC10146454 DOI: 10.1371/journal.pdig.0000163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/20/2023] [Indexed: 04/29/2023]
Abstract
Technology is transforming service delivery in many health professions, particularly with the rapid shift to virtual care during the COVID-19 pandemic. Health profession regulators must navigate legal and ethical complexities to facilitate virtual care while upholding their mandate to protect the public interest. The objectives of this scoping review were to examine how the public interest is protected when regulating health professionals who provide virtual care, discuss policy and practice implications of virtual care, and make recommendations for future research. We searched six multidisciplinary databases for academic literature published in English between January 2015 and May 2021. We also searched specific databases and websites for relevant grey literature. After screening, 59 academic articles and 18 grey literature sources were included for analysis. We identified five key findings: the public interest when regulating health professionals providing virtual care was only implicitly considered in most of the literature; when the public interest was discussed, the dimension of access was emphasized; criticism in the literature focused on social ideologies driving regulation that may inhibit more widespread use of virtual care; subnational licensure was viewed as a barrier; and the demand for virtual care during COVID-19 catalyzed licensure and scope of practice changes. Overall, virtual care introduces new areas of risk, potential harm, and inequity that health profession regulators need to address as technology continues to evolve. Regulators have an essential role in providing clear standards and guidelines around virtual care, including what is required for competent practice. There are indications that the public interest concept is evolving in relation to virtual care as regulators continue to balance public safety, equitable access to services, and economic competitiveness.
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Affiliation(s)
| | - Sophia Myles
- Athabasca University, Athabasca, Alberta, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Catharine J Schiller
- University of Northern British Columbia, Prince George, British Columbia, Canada
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Alemneh ET, Tesfaye BH, Teka EC, Ayalew F, Wolde EG, Ashena WD, Melese TA, Biset FD, Degefu BW, Kebede BB, Asemu YM, Gebreyes MY, Shewatatek WT, Mengistu S, Dagnew T, Abebe YE, Aliyu MA, Endris FA, Sahlemariam EW, Weldesemayat GK. Health professionals' licensing: the practice and its predictors among health professional hiring bodies in Ethiopia. HUMAN RESOURCES FOR HEALTH 2022; 20:62. [PMID: 35986356 PMCID: PMC9389689 DOI: 10.1186/s12960-022-00757-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence suggests that not all human resource departments have hired their facility staff based on federal licensing standards, with some hiring without an active license. This is common in some, if not all, parts of the country. The paucity of healthcare experts, high turnover rates, employee burnout, and challenges in training and development issues were all key recruiting challenges globally. OBJECTIVE To assess the practice of health professionals' licensing and its predictors among hiring bodies in Ethiopia, March 24/2021-May 23/2021. METHODS A cross-sectional study was conducted in privately and publicly funded health facilities throughout Ethiopia. For each region, a stratified sampling strategy was utilized, followed by a simple random sampling method. Documents from the recruiting bodies for health professionals were reviewed. A pretested structured questionnaire and document review tool were used to extract data confidentially. A descriptive analysis of the basic hiring body characteristics was conducted. Hiring body characteristics were analyzed in bivariate and multivariate logistic regression to identify factors associated with best health professionals licensing practice. Data management and analysis were conducted with Epi-Data version 4.4.3.1 and SPSS version 23, respectively. RESULTS The analysis included 365 hiring bodies and 4991 files of health professionals (1581 from private and 3410 from public health organizations). Out of 365 hiring bodies studied, 66.3% practiced health professional licensing. A total of 1645 (33%) of the 4991 professionals whose files were reviewed were found to be working without any professional license at all. Furthermore, about 2733 (55%) have an active professional license, and about 603 (12%) were found to work with an expired license. Being a private facility (adjustedOR = 21.6; 95% CI = 8.85-52.55), obtaining supervision from a higher organ (adjustedOR = 19.7; 95%CI: 2.3-169.1), and conducting an internal audit (adjustedOR = 2.7; 95% CI: 1.15-6.34) were predictors of good licensing practice. CONCLUSIONS The licensing of health practitioners was poorly practiced in Ethiopia as compared to the expected proclamation of the country. A system for detecting fake licenses and controlling revoked licenses does not exist in all regions of the country.
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Affiliation(s)
- Endalkachew Tsedal Alemneh
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Biruk Hailu Tesfaye
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia.
| | - Eshetu Cherinet Teka
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Firew Ayalew
- Johns Hopkins Program for International Education in Gynecology and Obstetrics, Addis Ababa, Ethiopia
| | - Ermias Gebreyohannes Wolde
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Wondimu Daniel Ashena
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Tewodros Abebaw Melese
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Fikadie Dagnew Biset
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Bezawit Worku Degefu
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Bethlehem Bizuayew Kebede
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Yohannes Molla Asemu
- Johns Hopkins Program for International Education in Gynecology and Obstetrics, Addis Ababa, Ethiopia
| | - Meron Yakob Gebreyes
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Wudasie Teshome Shewatatek
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | | | - Tangut Dagnew
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Yeshiwork Eshetu Abebe
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Matias Azanaw Aliyu
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Fatuma Ahmed Endris
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Eden Workineh Sahlemariam
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Genet Kifle Weldesemayat
- Health Professionals' Competency Assessment and Licensing Directorate, Ministry of Health Ethiopia, Addis Ababa, Ethiopia
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