Implementation of a telemedicine, stroke evaluation service; a qualitative study

Abstract Background Acute ischemic stroke requires early medical imaging with a computed tomography (CT) scan and immediate thrombolysis treatment. In rural areas, the long distance to the nearest hospital reduce the patients’ probability of receiving medical assistance within the 4.5-h period. The...

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Main Authors: Elin Kjelle, Aud Mette Myklebust
Format: Article
Language:English
Published: BMC 2022-08-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-022-08428-x
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author Elin Kjelle
Aud Mette Myklebust
author_facet Elin Kjelle
Aud Mette Myklebust
author_sort Elin Kjelle
collection DOAJ
description Abstract Background Acute ischemic stroke requires early medical imaging with a computed tomography (CT) scan and immediate thrombolysis treatment. In rural areas, the long distance to the nearest hospital reduce the patients’ probability of receiving medical assistance within the 4.5-h period. The aim of this study was to assess how the service was set-up, and how managers and personnel experience the organisation and value of a rural telemedicine, remote controlled CT stroke service. Methods Ten semi-structured individual interviews and one semi-structured focus group interview were conducted. The sample included 15 participants involved in the telemedicine service in Hallingdal, Norway. The interview guide consisted of questions on the service, experience of working with the service, value and quality, management, and challenges. Interviews were recorded and transcribed verbatim. Thematic content analysis was used to develop a narrative of the findings. Results Findings were categorised into three main categories; value of the service, organisation of the project, and from project to permanent service. Participants perceived the service to be valuable for patients and the local community. The service included task shifting from radiographers and junior doctors to the local paramedics. To enable long- term operation of the service the participants suggested management, coordination, and continuous training as important factors. Conclusions The service was perceived as valuable to the local community, providing a sense of healthcare security and equitability. Management’s involvement, flexibility, and coordination appears to be a key factor for successful implementation and long-term sustainability of the service.
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spelling doaj.art-3dff4ae55305448f800d99ecbbe481ce2022-12-22T01:35:44ZengBMCBMC Health Services Research1472-69632022-08-0122111010.1186/s12913-022-08428-xImplementation of a telemedicine, stroke evaluation service; a qualitative studyElin Kjelle0Aud Mette Myklebust1Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern NorwayDepartment of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern NorwayAbstract Background Acute ischemic stroke requires early medical imaging with a computed tomography (CT) scan and immediate thrombolysis treatment. In rural areas, the long distance to the nearest hospital reduce the patients’ probability of receiving medical assistance within the 4.5-h period. The aim of this study was to assess how the service was set-up, and how managers and personnel experience the organisation and value of a rural telemedicine, remote controlled CT stroke service. Methods Ten semi-structured individual interviews and one semi-structured focus group interview were conducted. The sample included 15 participants involved in the telemedicine service in Hallingdal, Norway. The interview guide consisted of questions on the service, experience of working with the service, value and quality, management, and challenges. Interviews were recorded and transcribed verbatim. Thematic content analysis was used to develop a narrative of the findings. Results Findings were categorised into three main categories; value of the service, organisation of the project, and from project to permanent service. Participants perceived the service to be valuable for patients and the local community. The service included task shifting from radiographers and junior doctors to the local paramedics. To enable long- term operation of the service the participants suggested management, coordination, and continuous training as important factors. Conclusions The service was perceived as valuable to the local community, providing a sense of healthcare security and equitability. Management’s involvement, flexibility, and coordination appears to be a key factor for successful implementation and long-term sustainability of the service.https://doi.org/10.1186/s12913-022-08428-xComputed tomographyStroke evaluationTelemedicineOrganization of health servicesImplementation
spellingShingle Elin Kjelle
Aud Mette Myklebust
Implementation of a telemedicine, stroke evaluation service; a qualitative study
BMC Health Services Research
Computed tomography
Stroke evaluation
Telemedicine
Organization of health services
Implementation
title Implementation of a telemedicine, stroke evaluation service; a qualitative study
title_full Implementation of a telemedicine, stroke evaluation service; a qualitative study
title_fullStr Implementation of a telemedicine, stroke evaluation service; a qualitative study
title_full_unstemmed Implementation of a telemedicine, stroke evaluation service; a qualitative study
title_short Implementation of a telemedicine, stroke evaluation service; a qualitative study
title_sort implementation of a telemedicine stroke evaluation service a qualitative study
topic Computed tomography
Stroke evaluation
Telemedicine
Organization of health services
Implementation
url https://doi.org/10.1186/s12913-022-08428-x
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