title: Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people.
abstract: BACKGROUND
  Among indigenous populations in remote locations who are at increased risk for chronic diseases such as diabetes, telemedicine has the potential to improve access to health care services and thus may reduce adverse health outcomes. Yet few studies are available on how best to use telemedicine technology in reducing ethnic and racial health care disparities.
  
  
  OBJECTIVE
  We examined perspectives of patients and providers in 2 indigenous populations in Alaska and Hawai'i about the use of telemedicine in primary care chronic disease management.
  
  
  METHODS
  Six focus groups with patients and providers at 2 sites (3 in Alaska and 3 in Hawai'i).
  
  
  RESULTS
  Three broad themes were common to both sites: (a) benefits and barriers of using telemedicine; (b) building patient-provider relationships; and (c) elements of an acceptable telemedicine primary care encounter. Two key elements were endorsed by both patients and providers as important for an effective telemedicine encounter: (a) the initial patient-provider interaction should be face-to-face; and (b) patients must see the same provider on follow-up visits.
  
  
  CONCLUSIONS
  The use of telemedicine in chronic disease management has potential to improve patient care in remote indigenous populations and may supplement patient-provider relationships.
authors: Research Department, Southcentral Foundation, Anchorage, AK, USA.
authors: Vanessa
authors: V
authors: Hiratsuka
authors: Rebecca
authors: R
authors: Delafield
authors: Helene
authors: H
authors: Starks
authors: Adrian Jacques
authors: AJ
authors: Ambrose
authors: Marjorie Mala
authors: MM
authors: Mau
mesh_terms: D000328:Adult; D000368:Aged; D000413:Alaska; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006254:Hawaii; D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D010817:Physician-Patient Relations; D017216:Telemedicine
keywords: Alaska; Indians, North America; chronic disease treatment; focus groups; patient perspective; provider perspective; technology use
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