Photo by Robina Weermeijer | Unsplash
While the future of telemedicine beyond
the pandemic is unclear, it is highly likely that its use will continue to
evolve, and the six essential elements of safe, equitable, and person-centered
telemedicine — access, privacy, diagnostic accuracy, communication, psychological
and emotional safety, and human factors and system design — will require
continued attention. The following is an excerpt from the Telemedicine: Ensuring Safe, Equitable, Person-Centered Virtual Care white paper
focused on human factors and system design.
It is essential for telemedicine services
to be fully integrated into the existing system, not just added on — and
this might require fundamentally reimagining the entire system. The design of
telemedicine services must ensure that the system is reliable, safe, efficient,
and person-centered. The IHI white paper, A Framework for Safe, Reliable, and Effective Care, presents two components that provide the
foundation for creating systems of safety: culture and the learning system.
Foundational principles that make systems and processes more reliable include
standardization, simplification, reduction of autonomy when standardized
processes exists, and highlighting deviations from standard practice.
Human factors are also an
important consideration for system design, that is, “the interaction of human
abilities, expectations, and limitations, with work environments and system
design.” The most foundational human factors consideration is that the patient
needs to be prepared to use telemedicine technology and the methods involved in
virtual care. Providers must also be comfortable with and adept at utilizing
telemedicine technology. Innovation may be required to ensure both access to
and the ability to use the required technology.
Another important human factors element is
responsiveness to important cues that might be missed when care is provided
virtually. Missed cues may lead to diagnostic errors and decrease
trust between provider and patient.
Telemedicine also requires providers to
learn new or adapted approaches to manage data and health systems must ensure
that the technology is integrated and interoperable with the existing IT
infrastructure. Telemedicine services must be designed to ensure coordination
and continuity of care.
Through user-centered co-design, active
learning, and feedback loops, organizations need to continuously monitor,
assess, and adapt every aspect of telemedicine as needed. This process may
include collaboration within the organizational learning system and with
community partners, particularly when community resources are included in the
design of telemedicine services. In addition, health care delivery systems need
opportunities to participate in open forums to share lessons learned and best
practices among organizations. As telemedicine design and implementation takes
shape, assess whether the desired outcomes are being met and mitigate potential
risks as they are identified.
Human factors and system design are
elements of the framework for ensuring safe, equitable, person-centered
telemedicine. To learn more, download the free Telemedicine: Ensuring Safe, Equitable, Person-Centered Virtual Care white paper.
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