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Physician Experiences With Implementing a Virtual Observation Unit in Emergency Medicine - 01/01/25

Doi : 10.1016/j.annemergmed.2024.11.013 
Olivia S. Jung, PhD a, , Xi Zhu, PhD a, Lauren M. Nentwich, MD b, Benjamin A. White, MD b, Emily M. Hayden, MD, MHPE b
a Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA 
b Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 

Corresponding Author.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 01 January 2025

Abstract

Study objective

Physician experiences with new care models like the virtual observation unit in emergency departments (EDs) can offer important insights. Virtual observation unit leverages telehealth, remote monitoring, and mobile integrated health to enable home-based ED-level care. We explored physicians’ experience with delivering care in the virtual observation unit and perceived effect of this new model.

Methods

We conducted semistructured in-depth interviews with 10 emergency physicians who staffed the newly launched virtual observation unit in an academic hospital. We conducted a thematic analysis, which involved identifying and examining codes that describe important themes in the data.

Results

Three themes emerged in terms of emergency physicians’ experience with the virtual observation unit: (1) forming a deeper connection with patients as the virtual observation unit allowed them to spend more time with patients and care for patients in the patients’ home environment; (2) increased appreciation for interprofessional and interspecialty care as the virtual observation unit presented opportunities to work closely with nurses, paramedics, and primary care physicians; and (3) (surmountable) programmatic challenges related to dealing with multipronged technology and finding the right patient with an appropriate clinical condition and acceptance of home-based care. These experiences then contributed to positive perceptions of patient-physician interactions and increased job satisfaction among physicians who participated in the virtual observation unit.

Conclusion

Physicians who staffed the virtual observation unit in our context reported largely positive experiences. Policymakers and administrators should consider benefits to physician wellbeing and cultivating interprofessional and interspecialty care when making decisions about funding telehealth and care models like the virtual observation unit.

Le texte complet de cet article est disponible en PDF.

Keywords : Community care, Physician satisfaction, Virtual observation unit


Plan


 Please see page XX for the Editor’s Capsule Summary of this article.
 Supervising editor: Stephen Schenkel, MD, MPP. Specific detailed information about possible conflict of interest for individual editors is available at editors.
 Author contributions: OSJ and EMH developed study concept and design. OSJ collected the data. OSJ, XZ, and EMH analyzed and interpreted the data. OSJ drafted the manuscript. OSJ, XZ, LMN, BAH, and EMH critically revised the manuscript for important intellectual content. OSJ takes responsibility for the manuscript as a whole.
 Data sharing statement: The deidentified data are available from authors upon request, in compliance with the institution’s data sharing policy and requirement for a data use agreement.
 All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
 Funding and support: By Annals' policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have declared that no competing interests exist.
 Disclaimer: The views expressed in this article are the authors’ own and not an official position of our institutions.


© 2024  American College of Emergency Physicians. Publié par Elsevier Masson SAS. Tous droits réservés.
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