Implementation of a broadband video consultation service for children with posture and movement disorders

Abstract

We evaluated the implementation of a video consultation service in a regional community of paediatric physiotherapists. Twenty-two paediatric therapists in primary care settings and a rehabilitation centre participated in this study. The implementation comprised three phases: introduction, learning and consultation. Evaluation of the implementation focused on the participants' satisfaction with regard to the implementation procedure, the education received, the technical helpdesk support and the usage of the application once put into practice. The introduction phase was very short (only two sessions) but the learning phase took much longer; it took 12 months for 21 therapists to complete the learning phase. Only 14 of the 21 therapists entered the actual consultation phase. Participants were generally satisfied with the education received and judged the helpdesk to be sufficient. The helpdesk was contacted 36 times by 14 participants. Within the 12-month study period, the therapists performed 24 video consultations. The average time to compose a question was 115 min and the average time to answer it was 43 min. Implementation of a video consultation service is possible but takes more time than initially foreseen and only about two-thirds of the professionals actually adopted it into routine practice.

A systematic scoping review of change management practices used for telemedicine service implementations

“…In most cases, it was necessary to complete a formal workflow analysis to assign the appropriate number of staff members to support a new telemedicine service. This included technical support [45,61], help-desk support [80] and administrative support [55].…”

“…Training was normally delivered during the implementation of telemedicine to ensure maximum utility [50,56,78]. Training included how to use and troubleshoot equipment [46,49] and how to perform consultations through the technology [52,80]. Ongoing training and regular site checks were required to maintain telemedicine programs, especially in facilities with high staff turnover [41,53,67].…”

Video Teleconsultation Service: Who Is Needed to Do What, to Get It Implemented in Daily Care?

“…The domains of the Freeband Business Blueprint Model 11 match quite well to the five determinants important for successful implementation as described by Broens et al 10 According to Broens, acceptance, technology, finance, organization, policy, and legislation should all be addressed to come to a successful implementation. Acceptance is the only aspect not addressed in this study but has been most often addressed 13,14 already in the early development phase and is as such also done for the current application as described by Visser et al 12 and Engbers et al 15 In all domains, major or minor challenges exist to realize largescale implementation. In more detail, the challenges facing for implementation of the service appeared to be the market size and the slow implementation speed.…”

“…However, the market for the case of this study is not that large. Given the fact that implementation occurs via a network of professionals and as such is rather time consuming, 12 it is hypothesized that the video teleconsult as a single telemedicine application will not be viable in short time. 16 This suggests that various telemedicine services probably will need to be combined.…”

Telerehabilitation in Scotland: Current Initiatives and Recommendations for Future Development

“…It was recommended that a web-based teleconsultation system would allow AHPs across Scotland to access specialist AHP consultation as required, while a national telerehabilitation service would provide assessment and treatment services where local specialist AHPs were not available. The web-based teleconsultation system leverages the experiences within the Dutch health care system in which such a system was shown to speed-up appropriate referral and support primary care ( Visser et al, 2009 ; Vollenbroek-Hutten et al, 2009 ). Other benefits that may come from the implementation of a teleconsultation system include increased access to specialist AHP expertise for those areas where such expertise is not available or is only sporadically available, as well as increased multidisciplinary case management, especially where resourcing in specific disciplines is limited.…”