Journal article
A Re-conceptualization of Access for 21st Century Healthcare
Journal of general internal medicine : JGIM, Vol.26(Suppl 2), pp.639-647
11/2011
DOI: 10.1007/s11606-011-1806-6
PMCID: PMC3191218
PMID: 21989616
Abstract
Many e-health technologies are available to promote virtual patient–provider communication outside the context of face-to-face clinical encounters. Current digital communication modalities include cell phones, smartphones, interactive voice response, text messages, e-mails, clinic-based interactive video, home-based web-cams, mobile smartphone two-way cameras, personal monitoring devices, kiosks, dashboards, personal health records, web-based portals, social networking sites, secure chat rooms, and on-line forums. Improvements in digital access could drastically diminish the geographical, temporal, and cultural access problems faced by many patients. Conversely, a growing digital divide could create greater access disparities for some populations. As the paradigm of healthcare delivery evolves towards greater reliance on non-encounter-based digital communications between patients and their care teams, it is critical that our theoretical conceptualization of access undergoes a concurrent paradigm shift to make it more relevant for the digital age. The traditional conceptualizations and indicators of access are not well adapted to measure access to health services that are delivered digitally outside the context of face-to-face encounters with providers. This paper provides an overview of digital “encounterless” utilization, discusses the weaknesses of traditional conceptual frameworks of access, presents a new access framework, provides recommendations for how to measure access in the new framework, and discusses future directions for research on access.
Details
- Title: Subtitle
- A Re-conceptualization of Access for 21st Century Healthcare
- Creators
- John C Fortney - Health Services Research and Development (HSR&D), Center for Mental Health and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114 USAJames F Burgess - Center for Organization, Leadership & Management Research, VA Boston Healthcare System, Boston, MA USAHayden B Bosworth - Health Services Research and Development Service (HSR&D), Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC USABrenda M Booth - Health Services Research and Development (HSR&D), Center for Mental Health and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114 USAPeter J Kaboli - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region, Iowa City VAMC, Iowa City, IA USA
- Resource Type
- Journal article
- Publication Details
- Journal of general internal medicine : JGIM, Vol.26(Suppl 2), pp.639-647
- DOI
- 10.1007/s11606-011-1806-6
- PMID
- 21989616
- PMCID
- PMC3191218
- NLM abbreviation
- J Gen Intern Med
- ISSN
- 0884-8734
- eISSN
- 1525-1497
- Publisher
- Springer-Verlag
- Language
- English
- Date published
- 11/2011
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9984094551002771
Metrics
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