J Am Board Fam Med
-
Telemedicine has been implemented in many health systems by necessity, yet evidence is sparse about its appropriate use for the delivery of primary care. We sought to understand what clinicians and patients consider to be appropriate use of telemedicine in primary care to inform future development of a framework that should be valuable to diverse stakeholders. ⋯ These key concepts and themes are expected to be a valuable starting point for the development of a framework to inform appropriate use of telemedicine in primary care.
-
One of the most vulnerable groups is older persons who seek medical care (patients), especially those who are cognitively impaired with limited access to technology or knowledge of its use. ⋯ Physicians working collaboratively with community agencies for in-home technology-enhanced visits led to positive outcomes for this vulnerable older population.
-
Family physicians who are self-identified members of Black, Hispanic, and American Indian/Alaska Native racial groups are more likely to practice in disadvantaged areas but also tend to have narrower scopes of practice when compared with White family physicians, despite holding the same certification. Considering the established benefits of comprehensive primary care, these results suggest the need for policies incentivizing and supporting broader scopes of practice in disadvantaged areas.
-
Given the absence of guidelines for use of virtual visits for primary care delivery, a framework is needed to inform the most appropriate use of virtual visits. ⋯ After further validation, we expect that this framework may guide future research and practice: it may be valuable for clinical practice redesign, for designing evaluations of the outcomes of virtual visits, for outcomes research, for patient education, for triage, and possibly for reimbursement considerations.
-
Family physicians who self-identify as Black, Hispanic, and American Indian/Alaska Native (AIAN) are more likely to provide care to historically marginalized patients and provide care in disadvantaged areas compared with their White counterparts. However, these physicians also tend to have a narrower scope of practice. ⋯ Therefore, historically marginalized patients and those in disadvantaged areas would greatly benefit from a physician workforce with a broad scope of practice to help combat long standing and pervasive health inequities. This commentary will visit the context of this issue and provide suggestions to equip and support a diverse physician workforce to deliver trusted and comprehensive health care.