Physicians’ experiences of video consultation with patients at a public virtual primary care clinic: a qualitative interview study

Abstract

Objective: To describe physicians' experiences of video consultation with new patients visiting a publicly owned virtual primary care clinic. Design: In this qualitative study, data were collected from semi-structured individual interviews and analysed by systematic text condensation. Setting: A publicly owned virtual primary care clinic in Region V€ astra G€ otaland, Sweden. Subjects: Ten primary care physicians working at the clinic. Results: Connecting with a patient over video could be either straightforward or deficient, depending on communication and the patient's condition. Clinical experience, communication skills, and involving patients throughout the consultation and examination were crucial for assessments over video where patients were guided to perform self-examination. The flexibility of work and the regulated assignment online were positive for the physicians' work situation and wellbeing. Providing video consultation within the same organisation as the patient's regular health centre was considered to facilitate patient care and safety. Video consultation was considered suitable for some diagnoses and for some patients not able to reach a primary healthcare centre, though doubts were expressed about the healthcare and social benefits of this virtual care service. Conclusion: For the physicians, video consultation induced changes in the basis for assessment of primary care patients. The limitations on informational exchange demanded an extended form of patient involvement founded upon consultation skills, clinical experience and new skills for virtual examination. Combining virtual care with traditional general practice has the potential to reduce the workload for the individual physician and ensure medical competence in virtual primary care. Video consultation experienced suitable in some situations, but easy access to it expressed problematic in terms of medical prioritisation in healthcare. KEY POINTS Video consultation is suitable for primary care visits for some patients, but physicians' experiences of this are rarely studied. Clinical experience and consultation skills are important for video assessment of primary care patients which involves physician-guided patient self-examination. Video consultation facilitates care in some situations and could benefit from the provider being connected to patient's regular health centre. Virtual care offers a flexible way of working but challenges healthcare prioritisation from the primary care physician's perspective.

Attitudes, Barriers, and Concerns Regarding Telemedicine Among Swedish Primary Care Physicians: A Qualitative Study

“…Focusing on the context of Swedish primary care, three different studies recently found that physicians considered the types of telemedicine evaluated to be suitable for some patients and questions, but not for all. 35–37 This compares well to our category “Useful under certain conditions”, underlining the need for implementation in cooperation with the profession.…”

“…Findings include increased efficiency and more precise communication, but also reports of overuse, information overload, and misinterpretations. [33][34][35][36][37] While most papers cover specific tools, PCPs' overall views and experiences of telemedicine have been little studied, and not at all in a Swedish context. Consequently, in 2019, we conducted a web-based survey regarding telemedicine among PCPs in southern Sweden.…”

Healthcare professionals' experience of performing digital care visits - a scoping review

“…The categories will be used as subheadings further on, the results related to each of them will be presented and explained in more detail. (Tables 3, 4, and 5) Flexibile working hours and/or place (13,37,39,(45)(46)(47) Saved travel time/costs (39,41,47) Feeling more relaxed and at ease (39,45)…”

“…Convenience (46,47) Reduced workload (37,39) E ciency Shorter visits (13,48,49,54) Increased productivity/e ciency (35,37,39,41,45,48,50,51) Satisfaction Overall positive experience (13,35,40,41,43,44,46,47,49,(51)(52)(53)(54) Easy to learn how to use (41,44) Easy to use (13,39,(41)(42)(43)47,49,51,(53)(54)(55)(56) Satisfaction with the system/platform and/or its features (13,47,48,52) Comfortable to treat patients via digital care visits (39,48) The interaction between healthcare professional a...…”

“…(37) Saved travel time and costs were also mentioned as bene ts in several publications. Physicians from three studies thought the use of digital care visits saves the commuting time, (39,41,47) this plays a role in enhancing healthcare professionals' quality of life: "saving travel time, being present at home, and participating in family activities […] was considered bene cial." (39) Digital care visits provide exibility which contributes to healthcare professionals feeling less stressed and more at ease.…”