Evaluating barriers to and promoters of telehealth during the COVID-19 pandemic at U.S. cystic fibrosis programs

https://doi.org/10.1016/j.jcf.2021.08.034Get rights and content
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Highlights

  • During the COVID-19 pandemic, 97% of U.S. cystic fibrosis care programs used telehealth.

  • As the pandemic progressed, in-person visits supplanted telehealth visits.

  • Programs thought that lack of internet access was a major barrier to patient and family engagement with telehealth.

  • Programs reported that the quality of telehealth could be improved by expanded provision of remote monitoring devices and better access to technology.

  • Pediatric programs were less likely than adult programs to recommend telehealth.

Abstract

Background

Cystic fibrosis (CF) care programs in the United States rapidly adopted telehealth during the COVID-19 pandemic. Understanding factors that promote or impede telehealth will inform planning for future telehealth-enabled care models.

Methods

Adult, pediatric, and affiliate CF care programs in the United States (n = 287) were surveyed twice eight months apart in 2020-2021 about telehealth use. Programs were asked to describe barriers to and promoters of telehealth.

Results

Ninety-seven percent of programs provided telehealth services. In the first CF Care Program State of Care Survey (SoC1), programs estimated that 57% of patients exclusively received in-person care, 36% of patients received telehealth by phone/computer with video, and 8% of patients received telephone-only care. In the second CF Care Program State of Care Survey (SoC2), programs estimated that 80% of visits were in-person and 15% were via audio and video telehealth. Pediatric programs (21%) were less likely than adult (37%) or affiliate (41%) programs to recommend telehealth (p = 0.007). All programs ranked lack of internet access as the highest barrier to patient engagement with telehealth. Promoters of telehealth were increased accessibility and avoidance of infection transmission. Top ranked changes to improve telehealth were expanded provision of remote monitoring devices and technology access. Similar proportions of program types anticipated institutional telehealth expansion.

Conclusion

During the COVID-19 pandemic, CF programs in the United States identified factors to improve future care delivery via telehealth. Targeting specific barriers and promoters will improve the use and quality of telehealth throughout the care center network.

Keywords

Cystic fibrosis
Telehealth
COVID-19
Pandemic

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This paper is part of a Supplement supported by the Cystic Fibrosis Foundation.