(PO-004) (PO-004) Providers' Perspectives on the Use of Telehealth in an Outpatient Collaborative Care Clinic for Human Trafficking Survivors during the COVID-19 Pandemic

Background:
The University of Miami Trafficking Healthcare Resources and Intra-Disciplinary Victim Services and Education (THRIVE) clinic is a multi-disciplinary, trauma-informed, collaborative care clinic where human trafficking survivors can access psychiatric, gynecological, and primary care services (George, 2018). To minimize patient and physician exposure to COVID-19, the clinic transitioned to a hybrid telehealth care model. By surveying providers’ perspectives on telehealth, we aimed to assess how telehealth may have affected our delivery of care to trafficking victims.


Method:
We distributed an anonymous survey adapted from the Telehealth Usability Questionnaire (Hyung-Youl, 2020) to providers within our clinic. Participants rated their agreement on a 5-point likert scale for 13 items, which measured views on telehealth’s ease of use, interaction quality, reliability, perception, safety, satisfaction, future use, and necessity.


Results:
Fifty-five percent of clinic providers completed the survey. Sixty to eighty percent of participants agreed with telehealth’s ease of use, interaction quality, and perception. However, 60% disagreed with telehealth’s reliability. There were mixed results about safety, with staff expressing privacy and confidentiality concerns with telehealth due to patients' vulnerable conditions. While 80-100% expressed satisfaction with telehealth and endorsed its necessity during the COVID-19 pandemic, 80% did not find it more convenient than in-person visits and 73% did not agree with telehealth replacing in-person visits. Providers also identified that some patients faced challenges with internet availability, hindering access to telehealth.


Discussion:
While prior studies have noted high patient satisfaction with telehealth, physician perspectives on telehealth have not been as favorable (Yu, 2021). In a prior project on patient satisfaction with telehealth within this clinic, participating patients expressed “excellent” satisfaction with telehealth and reported appreciation for continued access to services during the pandemic, citing telehealth’s convenience and the elimination of travel barriers. However, there was only a limited patient response, which may reflect the disadvantages of telehealth use in this clinic. Clinic staff identified such disadvantages including interrupted follow-up due to lack of access and availability of technological resources and perceived limited privacy on telehealth platforms.


Conclusion:
While telehealth has been convenient and necessary during the COVID-19 pandemic, it comes with challenges when caring for this vulnerable patient population. Implementing a hybrid telehealth model for trafficking survivors during the pandemic can promote patients' safety, ensure continuity of care, and increase providers’ satisfaction in care delivery.

References:
George JS, et al. (2018). Trafficking Healthcare Resources and Intra-disciplinary Victim Services and Education (THRIVE) Clinic: A Multidisciplinary One-stop Shop Model of Healthcare for Survivors of Human Trafficking. Journal of Human Trafficking. 6. 1-11.

Hyung-Youl Park, et al.Telemedicine and e-Health.Ahead of print.https://doi.org/10.1089/tmj.2020.0369

Yu, James, et al. “Evaluation and Feedback for Telehealth From Patients and Physicians During the Early Stage of COVID-19 Pandemic Period.” Cureus vol. 13,1 e12633. 11 Jan. 2021

Learning Objectives:

• To describe telehealth use in a clinic for trafficking survivors, a particularly vulnerable population that may have been especially impacted by the COVID-19 pandemic.
• To highlight providers’ perspectives on telehealth use in a clinic for trafficking survivors.