JMIR Publications

ABSTRACT

Background:

The Region 1 Disaster Health Response System is developing a disaster teleconsultation system for cross-jurisdictional care.

Objective:

To field-test acceptability and feasibility of using a prototype disaster telehealth platform with minimal-to-no training.

Methods:

We recruited field clinicians from Massachusetts hospitals and out-of-state critical-care physicians as experts for a 2-week pilot (June 2020). Experts were trained to use a prototype platform, while field clinicians received a just-in-time tool. Field clinicians requested teleconsultations for hospitalized COVID-19 patients (clinical call) or simulated patients (test call). We collected demographics, call performance data, and Telehealth Usability Questionnaire (TUQ) ratings to measure acceptability [primary outcome; total usability score (TUS) ≥6 of 7] and feasibility (secondary outcome; interface, interaction quality, and reliability items); and interviewed participants. We report descriptive statistics and key themes using the Technology Acceptance Model framework.

Results:

Ten experts from six states and 17 field clinicians from four hospitals participated. Fifty test calls and no clinical calls were logged. Most (70%) made ≥1 call; 22% (95% CI 10-34%) connected successfully. Calls failed due to platform routing errors (49%), hospital computers without cameras/microphones (10%), firewalls (8%), and expert notification failures (5%). The mean TUS was 5.6 (SD 1.3). TUQ item scores were highest in usefulness (6.0, SD 1.1) and ease-of-use (6.0, SD 1.4), and lowest in reliability (2.4, SD 1.4). Participants were comfortable using the platform. Those with difficulty identified discomfort with technology as the cause.

Conclusions:

Clinicians found the prototype platform acceptable and feasible to use with minimal-to-no training. Using familiar clinical workflows for emergency consultation and mobile devices could improve call performance and reliability.