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Creating Research Questions
1
Creating Research Questions
Faizan Malik
Liberty University
February 20
th
, 2022
Creating Research Questions
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Problem Statement
The general problem to be addressed is the increasing use of telehealth services by medical professionals, due to the ongoing Covid-19 pandemic, and its impacts on patients, medical professionals, and the healthcare system. With multiple healthcare policies being eased to accommodate such services, healthcare providers are at a crossroads to best manage the care of their patients. Although many patients and providers have shown an overall satisfaction with telehealth services, several impediments exist for widespread within certain communities, "these roadblocks have created disparities that are most acute in rural areas, and for racial minorities, the elderly, and those with low levels of educational attainment" (Cortelyou-Ward et al., 2020). Many in the medical community have also raised their concerns over aspects of treatment within telehealth services, such as the physical exam. "The true effectiveness of a telehealth physical examination and its subsequent impact on diagnosis, clinical management, and medical outcomes is yet to be determined in all settings" (Reeves et al., 2020). The healthcare system must also reexamine policies and regulations to allow for continued use of telehealth services beyond the pandemic. "It remains to be seen whether the temporary flexibilities surrounding delivery and payment of telehealth services will remain in place; some require Congressional action to make permanent while others can be made permanent through rulemaking" (Schofield, 2021). The specific problem to be addressed in evaluating the current and future use of telehealth
services within the healthcare industry and the impact on patients, medical professionals, and the healthcare system.
Creating Research Questions
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Research Questions
Qualitative Research Questions
What roadblock exists for minority patients living in rural areas when attempting to use telehealth services for primary care?
o
The main focus of the research will be focused on how there are certain impediments to expanding telehealth services in rural communities, primarily due to issues with access to healthcare and technology (also known as the digital divide). "The digital divide represents an important social problem accompanying the diffusion of the internet in the USA, and in other nations, The digital divide is the gap that exists between individuals advantaged by the internet and those individuals relatively disadvantaged by the internet" (Rogers, 2021). The research
will seek to identify commonalities of such impediments, be it based on age, race,
socioeconomic status, or other variables. It will also focus on the use of telehealth services within primary care, to keep a narrow scope of research.
Null hypothesis: There are no measurable differences for access to telehealth services between urban and rural areas, or amongst various demographics.
Can proper training for medical providers improve the efficacy of telehealth services?
o
This research question will focus on the medical provider aspect of telehealth services. Although such services existed before Covid-19, the use of telehealth has increased significantly during the pandemic. However, given the rapid nature of the pandemic, there is little to no formal training allotted for medical professionals. This research question will compare those who have received
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training on telehealth vs those who have not, to investigate if there are any noticeable differences.
Null hypothesis: Training has no effect on the overall performance of medical providers during telehealth services.
How have temporarily changed healthcare regulations impacted the expanded use of telehealth services during the Covid-19 pandemic?
o
Many healthcare policies had been eased or lifted during the Covid-19 pandemic to allow for more widespread use of telehealth services. With many of those policies either expiring or having the restrictions reinstated, this research question will explore how the change of policy affected healthcare delivery during the pandemic and if those changes allow for continued use of such services.
Null hypothesis: Eased or lifted healthcare policies have had no positive impact on expanding the use of telehealth services.
Quantitative Research Questions
What are the minimum technical requirements needed to expand telehealth services into rural communities? o
Since the digital divide is well established, this research question will aim to understand the minimum requirements of technology to expand telehealth services to rural communities and for the aforementioned demographics. The different types of telehealth services will also be examined, along with their respective efficacy. "Telehealth applications are very diverse, ranging from home care for chronic diseases to remote primary care and subspecialist services such as
pediatric cardiology. Telehealth can be delivered synchronously, also known as
Creating Research Questions
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real-time, where the participants interact with each other simultaneously, and asynchronously, also known as store-and-forward, in which information such as X-rays or photographs are collected, transmitted, and then utilized at a later time” (Wade et al., 2010).
What are the mortality rates for patients being treated via telehealth services during the Covid-19 pandemic, as compared to similar demographics using in-person services?
o
According to Dicker, “A mortality rate is a measure of the frequency of occurrence of death in a defined population during a specified interval.” This research question will aim to compare mortality rates of patients being treated primarily with telehealth services during the Covid-19 pandemic, compared to those using more traditional in-person visits. Some limitations will exist, as many medical providers offer both variations of services, thus an established minimum will need to be established for both primarily telehealth services and primarily in-
person visits.
How have reimbursement rates for Medicare and Medicaid patients using telehealth services compared to similar patients using in-person services?
o
"Because of COVID-19, some restrictions on reimbursement, security, licensing, and prescribing have been relaxed to promote rapid telehealth uptake to support physical distancing. For instance, the Centers for Medicare and Medicaid Services
(CMS) have expanded reimbursement for telehealth services for the duration of the COVID-19 pandemic, and many private payers have followed suit" (Haque, 2020). This research question will compare these reimbursements before and
Creating Research Questions
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during the pandemic, aiming to understand if such reimbursements can be sustained by both medical providers and the healthcare system
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Works Cited
Cortelyou-Ward, K., Atkins, D. N., Noblin, A., Rotarius, T., White, P., & Carey, C. (2020). Navigating the digital divide: barriers to telehealth in rural areas. Journal of Health Care for the Poor and Underserved, 31(4), 1546-1556.
Dicker, R. C., Coronado, F., Koo, D., & Parrish, R. G. (2006). Principles of epidemiology in public health practice; an introduction to applied epidemiology and biostatistics.
Haque, S. N. (2021). Telehealth beyond COVID-19. Psychiatric Services, 72(1), 100-103.
Reeves, J. J., Ayers, J. W., & Longhurst, C. A. (2021). Telehealth in the COVID-19 era: a balancing act to avoid harm. Journal of Medical Internet Research, 23(2), e24785.
Rogers, E. M. (2001). The digital divide. Convergence, 7(4), 96-111.
Schofield, M. (2021). Regulatory and legislative issues on telehealth. Nutrition in Clinical Practice, 36(4), 729-738.
Wade, V. A., Karnon, J., Elshaug, A. G., & Hiller, J. E. (2010). A systematic review of economic
analyses of telehealth services using real-time video communication. BMC health services research, 10(1), 1-13.