Investments in Primary Care Research for 2021 and 2022

This study examined the impact of the shift in healthcare to telehealth, as a response to the COVID-19 pandemic, on innovative nurse-led care models used to provide care throughout Colorado.

Study Overview

Problem: Due to the public health emergency from the COVID-19 pandemic, there was a sudden shift to using telehealth to provide healthcare. In Colorado, nurse-led models of care are used to deliver behavioral health, primary care, prenatal care, and home visitation to rural and economically vulnerable populations. The impacts of the abrupt and unexpected shift to telehealth on nurse-led models of care are unknown.

Main Objective: To evaluate the impacts of the sudden shift to telehealth at the onset of the COVID-19 pandemic on nurse-led care for vulnerable patients across Colorado.

Approach: The research team of nurse scientists used claims data, surveys, and interviews in a mixed methods approach to evaluate telehealth implementation on statewide utilization of nurse-led models of care, patient outcomes, and patient and provider experiences.

Results: To date, findings from this study show that across three different nurse-led care models in Colorado, patients who were Hispanic and those living in rural areas were more likely to use phone rather than video telehealth visits.¹ Additional results from patient surveys showed that those who had video telehealth visits had higher trust in the service provided than those who had phone visits. Provider surveys across the State showed consistent positive responses to the ease of use of telehealth with their patients.¹

Additional study findings are expected. Publications can be found here.

Primary Care Relevance

Findings from this study help inform how well telehealth approaches impact primary care access and utilization for the most vulnerable patients.

AHRQ Primary Care Priority Area

Research to improve primary care, including regarding quality, access and affordability, the workforce, care delivery models, financing, digital healthcare, person-centeredness, and health equity.

Notes

^1. Barton AJ, Amura CR, Willems EL, Medina R, Centi S, Hernandez T, Reed SM, Cook PF. Patient and Provider Perceptions of COVID-19-Driven Telehealth Use From Nurse-Led Care Models in Rural, Frontier, and Urban Colorado Communities. J Patient Exp 2023 Jan 25;10:23743735231151546. doi: 10.1177/23743735231151546. PMID: 36741820; PMCID: PMC9893383