Abstract
OBJECTIVE: Hybrid in-person and telehealth work environments are now common among health care providers. When in-person and telehealth services are not well integrated, provider workload could increase, negatively affecting provider satisfaction and burnout and hindering implementation of interventions aimed at improving quality. A lack of measures of telehealth integration has hindered studies of such impacts. This article presents the Integration of Telehealth and In-Person Services (ITIPS) survey, developed to assess telehealth integration and its facilitators from the provider's perspective. The ITIPS survey represents a meaningful step toward measuring integration in hybrid healthcare environments, including indicators of the extent of telehealth integration and factors promoting telehealth integration. MATERIALS AND METHODS: Using an exploratory sequential mixed-methods design, this study included semi-structured interviews and a participant-driven, modified-Delphi survey development approach consisting of 2 rounds of Qualtrics surveys to obtain participant feedback. Some participants engaged in all phases, whereas others participated either in interviews or in the modified Delphi surveys. RESULTS: Interviews identified multiple indicators of telehealth integration related to decisions about the visit modality, provider and staff workflows, as well as influencing factors such as leadership priorities related to quality and access, physical space, scheduling systems, and staff support. Our study yielded a survey with 22 items measuring the extent of telehealth integration in a practice environment and 31 items assessing factors influencing the level of telehealth integration. CONCLUSION: This study presents the ITIPS survey, which has undergone assessments for content validity and is ready for psychometric assessment for additional types of validity.