Building cohesion in distributed telemedicine teams: findings from the Department of Veterans Affairs National Telestroke Program

Abstract Background As telemedicine adoption increases, so does the importance of building cohesion among physicians in teams. For example, acute telestroke services, stroke specialists provide rapid remote assessment and treatment to patients at hospitals without specialty care. In National Telestroke Program (NTSP) U.S. Department Veterans Affairs, a virtual (distributed) hub throughout country provides 24/7 consultations nationwide. We examined how these adapted distributed teamwork, we identified cohesion-related factors program development support. Methods studied employed by NTSP. Semi-structured, confidential interviews with were recorded transcribed. explored extent which had developed sense shared identity team cohesion, this development. Using qualitative approach constant comparison methods, two researchers coded each interview transcript independently using codebook. used matrix displays identify themes, special attention communication, trust, satisfaction. Results Of 13 least 8 months NTSP practice, 12 completed interviews; 7 previously practiced programs other healthcare systems. Interviewees reported high levels trust sometimes even more their colleagues than co-located colleagues. Factors facilitating perceived included weekly case conference call, transparency discussing challenges, engagement tasks, support from leadership. Although lack in-person contact was associated lower annual meetings helped mitigate issue. Despite technical challenges establishing new telehealth system within existing national infrastructure, providers satisfaction Conclusion A can level comparable standard practice. Engaging transparent discussion challenging cases, reviewing clinical evidence, contributing improvements may promote