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Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry

The hub-and-spoke telehealth model leverages centrally located providers who utilize telehealth technology to bring specialized care to medically underserved areas. This model has the potential to promote equitable access to healthcare. However, few studies address how to facilitate the adoption and...

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Autores principales: Subramaniam, Soumya, Chen, Jessica, Wilkerson, Tai-Lyn, Stevenson, Lauren, Kincaid, Carrie, Firestone, Christine, Ball, Sherry L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9734451/
https://www.ncbi.nlm.nih.gov/pubmed/36530381
http://dx.doi.org/10.1007/s41347-022-00288-w
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author Subramaniam, Soumya
Chen, Jessica
Wilkerson, Tai-Lyn
Stevenson, Lauren
Kincaid, Carrie
Firestone, Christine
Ball, Sherry L.
author_facet Subramaniam, Soumya
Chen, Jessica
Wilkerson, Tai-Lyn
Stevenson, Lauren
Kincaid, Carrie
Firestone, Christine
Ball, Sherry L.
author_sort Subramaniam, Soumya
collection PubMed
description The hub-and-spoke telehealth model leverages centrally located providers who utilize telehealth technology to bring specialized care to medically underserved areas. This model has the potential to promote equitable access to healthcare. However, few studies address how to facilitate the adoption and implementation of hub-and-spoke telehealth. We examined spoke site providers’ experiences with TelePain, a national hub-and-spoke model of interdisciplinary chronic pain care, with a focus on improving future implementation. We conducted semi-structured individual interviews (20–45 min) with 27 VA spoke site providers via teleconferencing between August 2020 and February 2021. Interview transcripts were coded in Atlas.ti 8.0 using deductive (identified a priori and used to build the interview guide) and inductive (emerging) codes. Our analysis identified the following themes stressed by the spoke sites: (1) spoke sites needed to envision how TelePain services would work at their site before deciding to adopt; (2) TelePain implementation needed to fit into local existing care processes; (3) hub sites needed to understand spoke sites’ context (e.g., via needs assessment) to tailor the services accordingly, and (4) hub-and-spoke sites needed to establish bidirectional communication. Our findings provide a practical guide to improve future rollout of hub-and-spoke telehealth models. Recommendations focus on the role of the hub site in promoting program adoption by (1) developing a clear and detailed marketing plan and (2) considering how the program can be adapted to fit the local spoke site context. To improve implementation, hub-and-spoke sites must establish ongoing and consistent bidirectional communication; this is particularly critical in the everchanging post-peak pandemic healthcare system. An important next step is the development of recommendations and guidelines for implementing hub-and-spoke telehealth, as well as examining pain outcomes for patients touched by this program.
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spelling pubmed-97344512022-12-12 Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry Subramaniam, Soumya Chen, Jessica Wilkerson, Tai-Lyn Stevenson, Lauren Kincaid, Carrie Firestone, Christine Ball, Sherry L. J Technol Behav Sci Article The hub-and-spoke telehealth model leverages centrally located providers who utilize telehealth technology to bring specialized care to medically underserved areas. This model has the potential to promote equitable access to healthcare. However, few studies address how to facilitate the adoption and implementation of hub-and-spoke telehealth. We examined spoke site providers’ experiences with TelePain, a national hub-and-spoke model of interdisciplinary chronic pain care, with a focus on improving future implementation. We conducted semi-structured individual interviews (20–45 min) with 27 VA spoke site providers via teleconferencing between August 2020 and February 2021. Interview transcripts were coded in Atlas.ti 8.0 using deductive (identified a priori and used to build the interview guide) and inductive (emerging) codes. Our analysis identified the following themes stressed by the spoke sites: (1) spoke sites needed to envision how TelePain services would work at their site before deciding to adopt; (2) TelePain implementation needed to fit into local existing care processes; (3) hub sites needed to understand spoke sites’ context (e.g., via needs assessment) to tailor the services accordingly, and (4) hub-and-spoke sites needed to establish bidirectional communication. Our findings provide a practical guide to improve future rollout of hub-and-spoke telehealth models. Recommendations focus on the role of the hub site in promoting program adoption by (1) developing a clear and detailed marketing plan and (2) considering how the program can be adapted to fit the local spoke site context. To improve implementation, hub-and-spoke sites must establish ongoing and consistent bidirectional communication; this is particularly critical in the everchanging post-peak pandemic healthcare system. An important next step is the development of recommendations and guidelines for implementing hub-and-spoke telehealth, as well as examining pain outcomes for patients touched by this program. Springer International Publishing 2022-12-06 /pmc/articles/PMC9734451/ /pubmed/36530381 http://dx.doi.org/10.1007/s41347-022-00288-w Text en © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Subramaniam, Soumya
Chen, Jessica
Wilkerson, Tai-Lyn
Stevenson, Lauren
Kincaid, Carrie
Firestone, Christine
Ball, Sherry L.
Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry
title Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry
title_full Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry
title_fullStr Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry
title_full_unstemmed Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry
title_short Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry
title_sort refining the implementation of a hub-and-spoke model for telepain through qualitative inquiry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9734451/
https://www.ncbi.nlm.nih.gov/pubmed/36530381
http://dx.doi.org/10.1007/s41347-022-00288-w
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