GP perceptions of telehealth services in Australia: a qualitative study

Guzman, Keshia R. De; Snoswell, Centaine L.; Giles, Chantelle; Smith, Anthony C; Haydon, Helen M

doi:10.3399/bjgpo.2021.0182

Cited by 33 publications

(120 citation statements)

References 35 publications

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“…Many clinicians and health services have continuously expressed the need for funding to provide telehealth services, particularly within the primary care sector. 11,12,18 These study findings further support that additional telehealth funding was important from a GP perspective. This was demonstrated through the significant provision of GP telehealth consultations after the first policy change.…”

Section: Importance Of Funding For Telehealth Uptake and Provisionsupporting

confidence: 64%

“…The high use of telephone over videoconference by GPs has been influenced by many factors such as the perception that sufficient quality care can be provided by telephone, consumer demand, and financial considerations in general practice settings. 11,12 However, GP services are also impacted by the complex interdependencies of local practice needs, organisational levels, and government policies. 11,13 This means that GP services are heavily affected by policy changes implemented at a federal level.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 However, GP services are also impacted by the complex interdependencies of local practice needs, organisational levels, and government policies. 11,13 This means that GP services are heavily affected by policy changes implemented at a federal level. Given the continually evolving situation of COVID-19, and the need to ensure telehealth sustainability post-pandemic, learning from and building on past telehealth experiences are important.…”

Section: Introductionmentioning

confidence: 99%

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The impact of telehealth policy changes on general practitioner consultation activity in Australia: a time-series analysis

Guzman

Snoswell²,

Smith³

2022

Aust. Health Rev.

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Objective. To examine the impact of telehealth policy changes on general practitioner (GP) consultation activity in Australia, during the coronavirus disease 2019 (COVID-19) pandemic, from January 2019 to December 2021. Methods. An interrupted time-series analysis was conducted to analyse the impact of two major policy changes, introduced through the Medicare Benefits Schedule (MBS), on GP consultation (in-person, videoconference, telephone) activity. The first policy change was the introduction of additional COVID-19 telehealth funding through the MBS on 30 March 2020. The second policy change was the limitation on telephone consultation length to under 20 min on 1 July 2021. The rate of GP telehealth provision and activity was compared between pre-and post-intervention periods, separated by these MBS policy changes. Results. After the first policy change, there was a significant increase in telehealth provision, with a simultaneous decrease in in-person consultations (P < 0.0001). However, telehealth provision decreased in the months following this first policy change (P < 0.0001), while in-person activity increased. After the second policy change, the initial videoconference provision increased (P < 0.0001). However, all telehealth activity decreased afterwards. In the months following the second policy change, the decrease in monthly activity for in-person (P = 0.700), telephone (0.199) and videoconference (P = 0.178) consultations was not significant. Conclusions. The introduction of additional telehealth funding and limitations on telephone consultation length encouraged the initial provision and growth of telehealth services. However, these policy changes did not sustain the long-term upward trajectory of telehealth activity. Telehealth policies should increase opportunities for appropriate and sustainable GP telehealth services.

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Section: Importance Of Funding For Telehealth Uptake and Provisionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of telehealth policy changes on general practitioner consultation activity in Australia: a time-series analysis

Guzman

Snoswell²,

Smith³

2022

Aust. Health Rev.

Self Cite

View full text Add to dashboard Cite

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“…16 This trend has been qualitatively explored where it was reported that clinicians found the telephone easier to initiate than videoconferencing. 13,17 A study exploring the effect in outpatient pharmacist clinics during the pandemic found that even when videoconference consultations were reimbursed at a higher rate for the organisation, clinician willingness played a major role in modality choice with telephone staying predominant. 13 However, psychiatrists and psychologists used a higher proportion of videoconference than the telephone, with the exception of psychiatrist review consultations.…”

Section: Discussionmentioning

confidence: 99%

Increase in telemental health services on the Medicare Benefits Schedule after the start of the coronavirus pandemic: data from 2019 to 2021

et al. 2022

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Objective. To describe the change in telemental health service volume that resulted from the introduction of the Medicare Benefits Schedule (MBS) item numbers in 2020 for services provided by psychologists and psychiatrists in Australia for a 3-year period, from January 2019 to December 2021. Methods. Quarterly MBS activity and cost data for mental health services provided by consultant psychiatrists, clinical psychologists, and psychologists between January 2019 and December 2021 were extracted from the MBS statistics website. Data were grouped by profession and delivery mode (in-person, telephone or videoconference) and reported using activity counts. Descriptive analysis and interrupted time-series regression analysis were conducted. Specific descriptive explorations were also conducted for psychiatrists, including: new client consultations, review or general consultations, and group consultations. Results. The delivery of mental health services by telehealth (telemental health) during the pandemic has increased (P < 0.0001). When the pandemic started in March 2020, telemental health services provided by psychiatrists and psychologists increased from a combined 1-2% per quarter to 29% videoconference and 20% telephone in quarter two 2020. After the onset of the pandemic, videoconference remained the primary form of telehealth for these professions. However, the telephone accounted for approximately a third of the telehealth activity after the new item numbers were introduced. Conclusion.Telemental health services are more likely to be conducted by videoconference than by telephone. The observed increase in telehealth service activity confirms how crucial appropriate funding models are to the sustainability of telehealth services in Australia. The growth in telehealth was used to support people with mental health conditions in Australia.

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“… 4 Nevertheless, there is a paucity of evidence in this field, reflecting low levels of VC usage in primary care to date. 5 , 23 , 25 …”

Section: Introductionmentioning

confidence: 99%

Healthcare in the hand: Patients’ use of handheld technology in video consultations with their general practitioner

et al. 2022

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Objective To analyse how the patient's use of handheld technology in video consultations with their general practitioner affects communication and the possibilities for the delivery of quality healthcare. Focusing on the visually communicated aspects of the video consultation, we present three episodes from our recordings of eight video consultations between Danish general practitioners and patients. Methods Using a multimodal social semiotic framework to conduct a micro-level analysis, we present episodes from our data in which the hardware's affordance of mobility gave rise to salient events in the interactions of patients who used handheld devices to carry out their video consultations. Results Patients’ use of technology plays a significant role in the interactions between general practitioner and patient and is thus an important factor to consider in how practice is shaped when using handheld video consultation technology. Conclusions Our findings demonstrate that the mobility of handheld devices (smartphone, tablet) can be used to augment sensing and embodiment and enhance the delivery of healthcare in video consultations. However, mobility may also disrupt the interaction. As a result, possibilities for the delivery of quality healthcare lie quite literally in the patients’ hands.

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GP perceptions of telehealth services in Australia: a qualitative study

Cited by 33 publications

References 35 publications

The impact of telehealth policy changes on general practitioner consultation activity in Australia: a time-series analysis

The impact of telehealth policy changes on general practitioner consultation activity in Australia: a time-series analysis

Increase in telemental health services on the Medicare Benefits Schedule after the start of the coronavirus pandemic: data from 2019 to 2021

Healthcare in the hand: Patients’ use of handheld technology in video consultations with their general practitioner

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