Sustaining allied health telehealth services beyond the rapid response to COVID-19: Learning from patient and staff experiences at a large quaternary hospital

Abstract

The patient, clinician and administration staff perspectives of telehealth (specifically videoconferencing) services provided by Allied Health Professions (AHP) at a large quaternary hospital were explored. The purpose was to understand stakeholders’ perceptions of the service during initial COVID-19 restrictions and examine factors that influenced the implementation and sustained use of telehealth. A sequential mixed-methods approach was undertaken. Stage 1 involved surveys completed by patients (n = 109) and clinicians (n = 66) who received and provided care via telehealth, respectively, across six AHP departments. Stage 2 involved focus groups with clinicians (n = 24) and administrative staff (n = 13) to further examine implementation and sustainability factors. All participant groups confirmed that telehealth was a valid service model and valued the benefits it afforded, particularly during COVID-19 restrictions. Both patients and clinicians reported that not all AHP services could be delivered via telehealth and preferred a blended model of telehealth and in-person care. Increased administrative staff assistance was needed to support growing telehealth demand. Main factors to address are the need to expand AHP telehealth models and workforce/patient training, improve workflow processes and enhance technical support. Despite rapid implementation, telehealth experiences were overall positive. Study findings are being used to generate solutions to enhance and sustain AHP telehealth services.

A mixed-method study on the provision of remote consultations for non-communicable disease patients during the first wave of the COVID-19 pandemic in Latvia: lessons for the future

“…The necessity for a well-established framework for remote consultations with easy-to-use administrative systems, clear guidelines and centralized technological support was noted by the clinicians in the interviews. These findings align with conclusions from other studies that indicate the necessity of a strategic approach and the involvement of all main stakeholders in the development of telemedicine services [ 36 , 37 ]. Remote consultations must be considered a separate health care service, not an on-site consultation performed remotely, and must be planned and organized accordingly.…”

About face: regional allied health professional early adaptation during the COVID-19 pandemic

“…Because almost half the participants indicated they would continue to use telehealth, a review of embedment 12 months after easing of restrictions could allow reflection on the place of telehealth in allied health care beyond crisis management. Our findings also add to a body of literature suggesting that further training to translate traditional practice into a hands-free environment would be positively received (Smith et al 2020;Thomas et al 2020b;Cottrell et al 2021). Including disciplinespecific challenges within this training is also recommended (Krahe et al 2021).…”

“…Participants also reported that telehealth adaptation was affected by patients' access to and ability to use the technology. A lack of appropriate equipment, poor Internet connectivity and low digital literacy were frequently raised concerns, and are findings corroborated by Cottrell et al (2021), The Australian Digital Literacy Index (Thomas et al 2020a) and a recent Royal Australasian College of Physicians Australia members survey (Royal Australasian College of Physicians 2020). Several participants also reported that some patients were unwilling to trial telehealth or did not like it, and so disengaged.…”

Telepractice and Dysphagia Management: The Era of COVID-19 and Beyond

“…In papers which examined SLP experiences with telepractice during COVID, it has been highlighted that some services simply did not have the infrastructure to support telepractice [ 6 , 7 , 13 ]. In addition, many clinicians were unaware of the current evidence for telepractice delivery of dysphagia care, there was a recognized lack of prior training or experience in delivering services via telepractice, a lack of knowledge regarding how to adequately prepare clients for telepractice sessions and manage key issues such as data safety and security, and some faced challenges created by limited reimbursement options [ 6 – 13 , 16 – 18 ]. There was equally a critical absence of general knowledge among allied health professionals about how to operate a telepractice service [ 16 , 18 ].…”

“…In addition, many clinicians were unaware of the current evidence for telepractice delivery of dysphagia care, there was a recognized lack of prior training or experience in delivering services via telepractice, a lack of knowledge regarding how to adequately prepare clients for telepractice sessions and manage key issues such as data safety and security, and some faced challenges created by limited reimbursement options [ 6 – 13 , 16 – 18 ]. There was equally a critical absence of general knowledge among allied health professionals about how to operate a telepractice service [ 16 , 18 ]. Hence, it was a time of great confusion and anxiety for services, clinical staff, and clients.…”