{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T06:18:22Z","timestamp":1770272302945,"version":"3.49.0"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"crossref","award":["RO1HS022497"],"award-info":[{"award-number":["RO1HS022497"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Expectations regarding use and potential benefits of telehealth (TH) in nursing homes (NHs) are high; however, unplanned and unexpected consequences can occur as a result of major policy and technological changes.<\/jats:p><jats:p>\n          Objectives\u2003The goal of this study was to elicit stakeholder perspectives of consequences of rapid TH expansion in NHs.<\/jats:p><jats:p>\n          Methods\u2003Using a qualitative descriptive design, we drew a sample based on findings from a national study examining trends in NH information and technology (IT) maturity, including TH use. We used maximum variation sampling to purposively select participants who (1) participated in our IT maturity survey for two consecutive years, (2) completed year 1 of the IT maturity survey prior to TH expansion (before March 6, 2020) and year 2 after TH expansion (after March 6, 2020), (3) represented a broad range of facility characteristics, and (4) were identified as an end user of TH or responsible for TH implementation. Using six questions from the IT maturity survey, we created a total TH score for each facility and selected participants representing a range of scores.<\/jats:p><jats:p>\n          Results\u2003Interviews were conducted with (n\u2009=\u200921) NH administrators and clinicians from 16 facilities. We found similarities and differences in perceptions of TH expansion according to facility TH score, NH location, and participant role. Desirable consequences included four subthemes as follows: (1) benefits of avoiding travel for the NH resident, (2) TH saving organizational resources, (3) improved access to care, and (4) enhanced communication. Undesirable consequences include the following five subthemes: (1) preference for in-person encounters, (2) worsening social isolation, (3) difficulty for residents with cognitive impairment, (4) workflow and tech usability challenges, and (5) increased burden on NH staff\/infrastructure. Participants from rural NHs perceived lack of training, poor video\/sound quality, and internet\/connectivity issues to be potential pitfalls.<\/jats:p><jats:p>\n          Conclusion\u2003Clinicians and NH administrators should consider leveraging the desirable consequences of rapid TH expansion and implement mitigation strategies to address the undesirable\/unanticipated consequences.<\/jats:p>","DOI":"10.1055\/s-0041-1735974","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T01:25:35Z","timestamp":1633569935000},"page":"933-943","source":"Crossref","is-referenced-by-count":14,"title":["Consequences of Rapid Telehealth Expansion in Nursing Homes: Promise and Pitfalls"],"prefix":"10.1055","volume":"12","author":[{"given":"Kimberly R.","family":"Powell","sequence":"additional","affiliation":[{"name":"Sinclair School of Nursing, University of Missouri, Columbia, Missouri, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory L.","family":"Alexander","sequence":"additional","affiliation":[{"name":"School of Nursing, Columbia University, New York, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,10,6]]},"reference":[{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jamda.2015.01.077","article-title":"Telehealth can bridge the gap for rural, disabled, and elderly patients","volume":"16","author":"A Z Win","year":"2015","journal-title":"J Am Med Dir Assoc"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1377\/hlthaff.2013.0922","article-title":"Use of telemedicine can reduce hospitalizations of nursing home residents and generate savings for medicare","volume":"33","author":"D C Grabowski","year":"2014","journal-title":"Health Aff 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pandemic","volume":"12","author":"V Hsiao","year":"2021","journal-title":"Appl Clin Inform"}],"container-title":["Applied Clinical 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