Creating Opportunities for Telehealth Education, Assessment, and Care Through Hotspotting (CO-TEACH): Student-Led Development of a Telehealth Access Screener
Background: CO-TEACH is a compact telehealth curriculum delivered to 36 interprofessional students across ten health professions from Duke University and the University of North Carolina at Chapel Hill during the 2020-21 academic year. Student leaders and faculty collaborators from both universities partnered to create this novel curriculum. Course objectives included conducting effective, multidisciplinary telehealth consultations and recognizing issues of access and equity in telehealth utilization. Many CO-TEACH students also participated in Hotspotting, a program that partners health professions students with patients identified as “high utilizers” of healthcare resources to address social barriers to health and reduce emergency department overutilization. Motivated by concerns for telehealth equity, our team of CO-TEACH participants and student leaders developed a telehealth access screener to assess and address barriers to telehealth utilization among Hotspotting patients.
Methods: We performed a detailed review of five existing validated surveys evaluating telehealth utilization, digital literacy, and views on telehealth. Using this information, we: 1. Identified key domains related to telehealth access, 2. Developed specific questions to screen for barriers related to that domain, and 3. Identified potential resources to address these barriers. We then used an iterative approach for survey development involving clinical review by medical professionals and questionnaire review by survey methodologists from Duke University’s Social Science Research Institute.
Results: Our interprofessional team, including medical and occupational therapy students, constructed a 15-item survey representing four key domains related to telehealth utilization: 1. Access to technology, 2. Comfort using technology, 3. Perception of the utility of telehealth, and 4. Functional ability to engage in telehealth appointments. We developed one to three questions per domain and included additional questions assessing patients’ past experiences with telehealth.
Conclusions: Guided by principles of the CO-TEACH curriculum and working as a group of interprofessional student leaders, we developed a concise screening tool to better identify the barriers to telehealth faced by Hotspotting patients. Following IRB review of the screening tool, we will pilot the tool with patients in the Duke Hotspotting program, conduct data analysis, and adapt the survey accordingly. We envision this survey being used to identify and proactively address barriers to telehealth for patients at risk for inequitable access to care.
Reflections/Implications/Lessons Learned: This project idea was inspired by the interprofessional collaboration promoted in the CO-TEACH curriculum. As a result, we were able to connect with and gather perspectives from a variety of health professionals to holistically review potential barriers to telehealth access.
