Communication in Telehealth: A State-of-the-Art Literature Review of Conversation-Analytic Research

Abstract

We provide a state-of-the-art review of research on conversation analysis and telehealth. We conducted a systematic review of the literature, focusing on studies that investigate how technology is procedurally consequential for the interaction. We discerned three key topics: the interactional organization, the therapeutic relationship, and the clinical activities of the encounter. The literature on telehealth is highly heterogeneous, with significant differences between text-based care (e.g., via chat or e-mail) and audio(visual) care (e.g., via telephone or video). We discuss the extent to which remote care can be regarded as a demarcated field for study or whether the medium is merely part of the “context,” particularly when investigating hybrid and polymedia forms of care involving multiple technological media.

Tailoring communication practices to support effective delivery of telehealth in general practice

“…The principles that were developed from these findings and iterated through the co-design process align with existing advice in this space (e.g. [ 8 , 14 , 26 , 72 ]). As such, they are not entirely new concepts but are supported further by the findings in this study along with evidence from other studies.…”

“…Attending to conversational flow can support development of shared understanding and allows participants to manage interactional difficulties [ 8 ]. Conversational flow was, in part, supported within consultations through reference to non-mutual realities.…”

“…While there is high acceptance of telehealth by both GPs and patients [ 5 – 7 ], the nuances of effective communication in this context have yet to be incorporated into telehealth guidelines. This is due in part to limited evidence on how such consultations occur in practice [ 8 ]. The correlation between effective, person-centered communication and safe, high-quality clinical care is well-established [ 9 ].…”

“…Patients’ educational levels, type of health condition, and prior experience with telehealth also affected their experiences with this mode of healthcare delivery [ 34 ]. However, very little literature exists describing how the use of telehealth impacts the communication of participants [ 8 ].…”