What is known? |
SARS-CoV-2 has mandated a shift to telemedicine to deliver patient-centred care in an outpatient setting. The evidence base for telemedicine includes a diverse group of interventions with very few focusing on its use in delivering specialist–patient consultations with the patient in their own home. |
What is the question? |
What are patients' and clinicians' experiences of delivering specialist outpatient care through telephone lead clinics? What are the disadvantages and advantages of such an approach and what mediates them? |
What was found? |
The patients' main concern regarding telemedicine is poorer communication. The cumulative effect of other inconveniences resulted in overall poorer quality of consultation using telemedicine. Clinicians perceived almost all aspects of telemedicine as inferior, particularly the loss of visual inspection as a clinical tool, confidentiality concerns, time efficiency and relationship building difficulties. The following factors were identified by both parties as being important to a successful telemedicine interaction: familiarity with the patient/doctor; patients' current state of health; purpose of the appointment (initial assessment or follow-up); nature of discussion (especially sensitive/complex subjects); condition being assessed; and the involvement of particular vulnerable groups (those with cognitive impairment or sensory impairments, young children or those with language barriers). |
What is the implication for practice now? |
For clinicians to see telemedicine as a viable option in the long term, any system introduced will need to incorporate mediating factors that are likely to promote a successful interaction as described herein. Extra administrative burdens associated with telemedicine will also need to be streamlined if this modality is to aid in healthcare efficiency. If this can be achieved, patients are reasonably open to having some of their consultations at home and the advantages of telemedicine may come to the fore. |