"Laying second eyes" : Qualitative Assessment of Physician Experience in Pediatric Telemedicine Programs

Purpose: Telemedicine preformed through physician-to-physician consults provides a higher level of care to patients at hospitals in remote or rural settings. Current research focuses on patient satisfaction and delivery of care. Yet, physician experience in telemedicine programs is less understood despite the potential advantage of reduced physician burnout. This study aimed to create a holistic understanding of the physician experience in relation to telemedicine and program utilization. Methods: This study examined a TeleNICU and a TeleER program at a large metropolitan pediatric specialty hospital with a Level IV NICU that provides telemedicine consults to 16 remote sites across Texas. 24 semi structured interviews were conducted with physicians and nurses at 5 of the remote hospitals, physicians who provide consultations from the pediatric specialty hospital, and managers of the telemedicine programs. Interviews were coded into program strengths and weaknesses and reviewed to make recommendations for future program development. Results: Remote site participants reported that the programs are useful when they are in need of a second opinion and providing reassurance to patient's families. Weaknesses of program use included issues with the tele-carts, access to subspecialties, and the amount of physician time taken for the consults. Findings also revealed other measures for success could be used for evaluating the programs instead of volume of consults. Conclusion: Telemedicine programs can be used to minimize physician burnout but likewise can be a stressor for burnout if physician time is not respected. Research findings will guide future conversations of telemedicine program design.