Practical aspects of telehealth: doctor–patient relationship and communication

Sabesan, Sabe; Allen, David T.; Caldwell, Patrina H Y; Loh, Poh-kooi; Mozer, Roslyn; Komesaroff, Paul A.; Talman, Paul; Williams, Michael; Shaheen, Nargis; Grabinski, O.

doi:10.1111/imj.12323

Cited by 51 publications

(56 citation statements)

References 9 publications

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“…Hence, the environment and specific place in which the video visit is conducted is complex and affected by many factors that need to be accounted for (cf. [6]). We have observed and described a number of situations in which the place selected by the patient has caused disturbances and limitations.…”

Section: From One Place To Another -Transformation Of Responsibilitymentioning

confidence: 99%

“…[6] [7]). The clinician can only see parts of the place the patient participates from, i.e., a place including one, for the clinician, visible and one invisible space.…”

Section: Consequences Of the Choice Of Placementioning

confidence: 99%

“…Studies of the physical environment relate to comfort levels and researchers highlight the aspect of quality privacy which implies the importance of privacy during an examination, i.e., no one should be able to intrude. Improving the doctor-patient communication during video visits does not include any specific recommendations of the physical environment even though the doctor-patient communication is said to be "an important part of any therapeutic relationship […] It is complex and affected by many factors including […] the physical environment […]" [6]. Little is known of the patients' environment' impact on the consultation, but we know that the physical clinical environment affects patient satisfaction, attitudes and work performances [7].…”

Section: Introductionmentioning

confidence: 99%

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Effects of the Digital Transformation: Qualitative Study on the Disturbances and Limitations of Using Video Visits in Outpatient Care (Preprint)

Sturesson¹,

Groth²

2018

Preprint

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Background: Video mediated meetings with patients were introduced in outpatient care at a hospital in Sweden. New behaviours and tasks emerged due to changes of roles, work processes and responsibilities. The study investigates effects of digital transformation, in this case how video visits in outpatient care change work processes and introduces new tasks, in order to further improve the concept of video visits. Objective: Through real-time, social interactional features of preparing for and conducting video visits, the study examines clinicians' perceived limitations and disturbances, and how the conditions between patients and clinicians may change when using video visits instead of face-to-face meetings in outpatient care. Methods: Qualitative methods have been used including 14 observations of video visits at two different clinics and 14 followup interviews with clinicians. Transcriptions of interviews and field notes were thematically analysed, discussed and synthesised into themes. Results: Disturbances and limitations related to the technology were related to time; a flexibility to schedule the meeting unbound of place, frustrations when the other part was late for the scheduled meeting, and that more experienced users of video visits usually waited longer before logging in. They were also related to sound; problems getting the sound to work satisfactory during the video visits, and problems with the image. Disturbances and limitations related to the surroundings were related to both the patient's and the clinician's environment; the principle of video technology in itself may affect the experience and the content of the consultation, and the surrounding chosen changes the conditions for and reduces the participants' field of view. Conclusions:We could see 1) a transformation of roles and responsibilities when turning from face-to-face meetings to video visits, 2) that video visits add new circumstances, with a risk of introducing disturbances and limitations, that in turn affects the content of the meeting, 3) that avoiding negative disturbances during a video visit, requires a sensibility from the clinician's side as well as a trust in the patient's judgement, 4) that both expected and unexpected disturbances and limitations during a video visit affect the clinician's behaviour, feelings, the content of the meeting and how the clinician's relate to the different components of the concept, and 5) that there is a change of roles introduced when conducting video visits, e.g., the clinician taking the first line support if both (s)he and the patient encounter problems with the technology.

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Section: From One Place To Another -Transformation Of Responsibilitymentioning

confidence: 99%

“…[6] [7]). The clinician can only see parts of the place the patient participates from, i.e., a place including one, for the clinician, visible and one invisible space.…”

Section: Consequences Of the Choice Of Placementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of the Digital Transformation: Qualitative Study on the Disturbances and Limitations of Using Video Visits in Outpatient Care (Preprint)

Sturesson¹,

Groth²

2018

Preprint

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“…33 While telemedicine can be much more convenient for patients and allow a provider to reach many more patients, the interaction is not always as robust as a face-to-face interaction. 34 The use of teleconsultation (video advice and, sometimes, care from a previously unknown provider) is expanding rapidly, though state-focused licensing of providers limits the geographic spread of telemedicine programs. 30 Their primary focus is on urgent primary care (general medicine, dermatology, and behavioral health).…”

Section: Current Statusmentioning

confidence: 99%

The Promise of Information and Communication Technology in Healthcare: Extracting Value From the Chaos

Mamlin

Tierney

2016

The American Journal of the Medical Sciences

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Health care is an information business with expanding use of information and communication technologies (ICTs). Current ICT tools are immature, but a brighter future looms in many areas. We examine six areas of ICT in health care: electronic health records (EHRs), health information exchange (HIE), patient portals, telemedicine, social media, and mobile devices and wearable sensors and monitors. In each of these areas, we examine the current status and future promise, highlighting how each might reach its promise.Steps to better EHRs include a universal programming interface, universal patient identifiers, improved documentation, and improved data analysis. HIEs will require federal subsidies for sustainability and support from EHR vendors, targeting seamless sharing of EHR data. Patient portals must bring patients into the EHR with better design and training, greater provider engagement, and leveraging HIEs. Telemedicine needs sustainable payment models, clear rules of engagement, and quality measures and monitoring. Social media needs consensus on rules of engagement for providers, better data mining tools, and approaches to counter disinformation. Mobile and wearable devices will benefit from a universal programming interface, improved infrastructure, more rigorous research, and integration with EHRs and HIEs.ICT tools are are evolving quickly in health care and require a rational and well-funded national agenda for development, use, and assessment.-3-

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“…One consists in the fact that the great majority of people asking for medical advice by means of ICT resources do not have proper medical training. The communication of symptoms or specific clinical situations can therefore be difficult or misleading in case of absence of objective information such as biomedical data and/or video support [3]. This paper presents a system conceived to improve the first level teleconsultation by allowing the correct flow of the relevant information on the status of a patient, avoiding problems related to verbal communication or jammed transmission.…”

Section: Paper Presented At the Meeting "The Way Forward Of Maritime mentioning

confidence: 99%

An ontology-based consultation system to support medical care on board seagoing vessels

Carletti

Giuliodori²,

Pietri³

et al. 2016

International Maritime Health

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Practical aspects of telehealth: doctor–patient relationship and communication

Abstract: The fourth in a series of articles about the practical aspects of telehealth, this paper provides advice and information for specialists to communicate effectively with patients during a telehealth video consultation.

Cited by 51 publications

References 9 publications

Effects of the Digital Transformation: Qualitative Study on the Disturbances and Limitations of Using Video Visits in Outpatient Care (Preprint)

Effects of the Digital Transformation: Qualitative Study on the Disturbances and Limitations of Using Video Visits in Outpatient Care (Preprint)

The Promise of Information and Communication Technology in Healthcare: Extracting Value From the Chaos

An ontology-based consultation system to support medical care on board seagoing vessels

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