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A Sociotechnical Framework for Telehealth Integration into Clinical Workflow
Abstract
Telehealth, which involves the use of telecommunication technologies to provide virtual care, has received special attention in the recent years for improving access to healthcare and for supporting integrated care for chronic diseases. Constraints that the COVID-19 pandemic imposed over in-person care caused healthcare providers in clinical settings transition rapidly from in-person care to virtual care, causing changes in their clinical workflow. Considering that telehealth integration can alter healthcare providers’ practice patterns, impacting efficiency, quality of care, and patient safety, it is timely to identify and account for system-level components and considerations to improve the efficiency of telehealth integrations with healthcare providers’ daily activities. Despite isolated efforts to identify such considerations, a comprehensive framework for telehealth integration is largely absent.
To address this gap, this research applied a mixed methods approach with the objective of developing a sociotechnical framework for telehealth integration into clinical workflow. This framework, based on findings from the literature (Chapter 2) and insights from three case studies at different levels of telehealth integration and different telehealth modalities (Chapters 3-5), provides a set of components that must be considered to achieve successful integration of a telehealth system in clinics, hospitals, and other healthcare settings. The resulting framework, titled the System Adoption and Integration of New Telehealth Systems (SAINTS) framework (Chapter 6), account for components specific to the context of telehealth and the main temporal stages in the integration of telehealth into clinical workflow: (1) System Preparation, (2) Patient Enrollment, and (3) System Implementation. In addition, the developed framework is influenced by socio-technical system models with application in complex healthcare systems and use Systems Modeling Language (SysML) as a reference to define the components of the telehealth system integration and model the structural relationships with other components. Despite the publication of models that includes aspects of the implementation of health information technologies into complex healthcare systems, this is one of the first efforts in establishing a framework in the context of the integration of telehealth systems into clinicians’ work.
Subject
telehealthtelemedicine
workflow modeling
sociotechnical framework
technology adoption
implementation science
process improvement
Citation
Bonet Olivencia, Samuel A (2022). A Sociotechnical Framework for Telehealth Integration into Clinical Workflow. Doctoral dissertation, Texas A&M University. Available electronically from https : / /hdl .handle .net /1969 .1 /198489.