Evidence map›Paper›PMID 35780165›Full record

ArticleBMC health services research2022

Managing innovation: a qualitative study on the implementation of telehealth services in rural emergency departments.

Mochamad Muska Nataliansyah, Kimberly A S Merchant, James A Croker, Xi Zhu, Nicholas M Mohr, James P Marcin, Hicham Rahmouni, Marcia M Ward

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Barriers to and Facilitators of Technology Adoption in Emergency Departments: A Comprehensive Review.International journal of environmental research and public health · 2025
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Mochamad Muska NataliansyahDepartment of Surgery, Division of Surgical Oncology, Collaborative for Healthcare Delivery Science, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53005, USA. mnataliansyah@mcw.edu.
Kimberly A S MerchantDepartment of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, USA.
James A CrokerCardiovascular Research Institute, University of California School of Medicine, San Francisco, CA, USA.
Xi ZhuDepartment of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
Nicholas M MohrDepartment of Emergency Medicine, Carver College of Medicine, University of Iowa, Iowa City, USA.
James P MarcinUniversity of California Davis School of Medicine, Sacramento, CA, USA.
Hicham RahmouniRichard G. Lugar Center for Rural Health, Union Health, Terre Haute, IN, USA.
Marcia M WardDepartment of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, USA.
University of Iowa · USGeisinger Health System · USMedical College of Wisconsin · USUniversity of California, Davis · USUniversity of California, Los Angeles · USUniversity of California, San Francisco · US

Funding

AHRQ HHS K08 HS025753
6 · The paper itself

Abstract

backgroundTelehealth studies have highlighted the positive benefits of having the service in rural areas. However, there is evidence of limited adoption and utilization. Our objective was to evaluate this gap by exploring U.S. healthcare systems' experience in implementing telehealth services in rural hospital emergency departments (TeleED) and by analyzing factors influencing its implementation and sustainability.

methodsWe conducted semi-structured interviews with 18 key informants from six U.S. healthcare systems (hub sites) that provided TeleED services to 65 rural emergency departments (spoke sites). All used synchronous high-definition video to provide the service. We applied an inductive qualitative analysis approach to identify relevant quotes and themes related to TeleED service uptake facilitators and barriers.

resultsWe identified three stages of implementation: 1) the start-up stage; 2) the utilization stage; and 3) the sustainment stage. At each stage, we identified emerging factors that can facilitate or impede the process. We categorized these factors into eight domains: 1) strategies; 2) capability; 3) relationships; 4) financials; 5) protocols; 6) environment; 7) service characteristics; and 8) accountability.

conclusionsThe implementation of healthcare innovation can be influenced by multiple factors. Our study contributes to the field by highlighting key factors and domains that play roles in specific stages of telehealth operation in rural hospitals. By appreciating and responding to these domains, healthcare systems may achieve more predictable and favorable implementation outcomes. Moreover, we recommend strategies to motivate the diffusion of promising innovations such as telehealth.

Indexed as

Emergency Service, HospitalTelemedicineDelivery of Health CareHumansQualitative ResearchRural PopulationAdoptionImplementationInnovationRural hospitalsTelehealth

Identifiers

PMID35780165
PMCPMC9250734
OpenAlexW4283785071

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.