TY  - JOUR
AU  - Melman, Alla
AU  - Vella, Simon P
AU  - Dodd, Rachael H
AU  - Coombs, Danielle M
AU  - Richards, Bethan
AU  - Rogan, Eileen
AU  - Teng, Min Jiat
AU  - Maher, Chris G
AU  - Ghinea, Narcyz
AU  - Machado, Gustavo C
PY  - 2023
DA  - 2023/11/21
TI  - Clinicians’ Perspective on Implementing Virtual Hospital Care for Low Back Pain: Qualitative Study
JO  - JMIR Rehabil Assist Technol
SP  - e47227
VL  - 10
KW  - back
KW  - barrier
KW  - barriers
KW  - care model
KW  - eHealth
KW  - e-Health
KW  - enabler
KW  - enablers
KW  - facilitator
KW  - facilitators
KW  - health services research
KW  - healthcare delivery
KW  - implementation
KW  - interview
KW  - interviews
KW  - low back pain
KW  - model of care
KW  - pain
KW  - qualitative
KW  - remote care
KW  - service delivery
KW  - service
KW  - services
KW  - telehealth
KW  - telemedicine
KW  - virtual care
KW  - virtual hospital
AB  - Background: Alternate “hospital avoidance” models of care are required to manage the increasing demand for acute inpatient beds. There is currently a knowledge gap regarding the perspectives of hospital clinicians on barriers and facilitators to a transition to virtual care for low back pain. We plan to implement a virtual hospital model of care called “Back@Home” and use qualitative interviews with stakeholders to develop and refine the model. Objective: We aim to explore clinicians’ perspectives on a virtual hospital model of care for back pain (Back@Home) and identify barriers to and enablers of successful implementation of this model of care. Methods: We conducted semistructured interviews with 19 purposively sampled clinicians involved in the delivery of acute back pain care at 3 metropolitan hospitals. Interview data were analyzed using the Theoretical Domains Framework. Results: A total of 10 Theoretical Domains Framework domains were identified as important in understanding barriers and enablers to implementing virtual hospital care for musculoskeletal back pain. Key barriers to virtual hospital care included patient access to videoconferencing and reliable internet, language barriers, and difficulty building rapport. Barriers to avoiding admission included patient expectations, social isolation, comorbidities, and medicolegal concerns. Conversely, enablers of implementing a virtual hospital model of care included increased health care resource efficiency, clinician familiarity with telehealth, as well as a perceived reduction in overmedicalization and infection risk. Conclusions: The successful implementation of Back@Home relies on key stakeholder buy-in. Addressing barriers to implementation and building on enablers is crucial to clinicians’ adoption of this model of care. Based on clinicians’ input, the Back@Home model of care will incorporate the loan of internet-enabled devices, health care interpreters, and written resources translated into community languages to facilitate more equitable access to care for marginalized groups. 
SN  - 2369-2529
UR  - https://rehab.jmir.org/2023/1/e47227
UR  - https://doi.org/10.2196/47227
UR  - http://www.ncbi.nlm.nih.gov/pubmed/37988140
DO  - 10.2196/47227
ID  - info:doi/10.2196/47227
ER  -