Implementation of telemedicine for HIV Care in the public health system of Buenos Aires, Argentina: a qualitative study based on surveys among health workers to asses acceptability of this strategy

Title

Implementation of telemedicine for HIV Care in the public health system of Buenos Aires, Argentina: a qualitative study based on surveys among health workers to asses acceptability of this strategy

Presenter

Manuela Bullo

Authors

M. Bullo * (1), T. Kierszenowicz (2), M.C. Acosta (1), M.J. Rolon (3), M. Cabrini (3), D. Cecchini (4), C.G. Rodriguez (4), P.G. Scapellato (5), E.G. Bottaro (5), M.H. Losso (1)

Institutions

(1) Servicio de Inmunocomprometidos, Hospital J.M. Ramos Mejía, Buenos Aires, Argentina, (2) Buenos Aires University / National Scientific and Technical Research Council, Buenos Aires, Argentina, (3) Servicio de Infectología, Hospital Dr. Juan A. Fernández, Buenos Aires, Argentina, (4) Servicio de Infectología, Hospital Dr. Cosme Argerich, Buenos Aires, Argentina, (5) Servicio de Infectología, Hospital Donación F. Santojanni, Buenos Aires, Argentina

BACKGROUND: In October 2020, a research consortium by four HIV and infectious diseases units of general acute public hospitals of Buenos Aires city began an implementation study aimed to analyze obstacles and facilitators of telemedicine in the care of people living with HIV(PLHIV).
METHODS: This research aims to analyze changes and continuities in the perceptions of physicians on telemedicine when caring for PLHIV after 6 months of implementation of this strategy. We prospectively collected quantitative and qualitative data through an electronic semi-structured survey delivered at and 6 months after the implementation of telemedicine. The population studied consisted of medical doctors from four public hospitals in the city of Buenos Aires involved in telemedicine care for PLHIV. Instruments collected data on perceptions about:
1) the future use of telemedicine;
2) the obstacles and benefits of this strategy.
The surveys were anonymous and self-administered. The data was stored on Redcap® platform.
RESULTS: 30 physicians completed a questionnaire at baseline and 6 months after the implementation of the telemedicine. 20 (66.7%) were female physicians. Median age was 51 years old (IQR: 44-60).In both periods, all physicians surveyed (100%) stated that telemedicine would remain in the future as a parallel strategy to face-to-face consultations. 15 (50%) supported that it should be offered to specific groups of patients, such as those who are asymptomatic.
The perception on the use of computer equipment as an obstacle decreased from 15 (50%) (baseline) to 4 (13%) (month 6). Internet connection in hospitals remained as one of the main barriers (baseline: 23 (77%); month 6: 21 (70%)). Lower rates of spontaneous demand consultations were the only perceived benefit that increased after 6 months (baseline: 15 (50%); month 6: 18 (60%)). Physical examination was the most affected medical practice by tele-care (baseline: 100%; month 6: 80%).
CONCLUSIONS: The use of computer equipment and connectivity was a challenge but clearly by the end of the 6 months, still perceived as a valuable tool for physician-patient interaction. All practitioners believed that telemedicine would continue to be provided in the future. Its offer to specific groups of patients could be associated with the acceptability of this strategy.

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