Telemedicine in specialist outpatient care during COVID‐19: a qualitative study

Abstract

BackgroundCOVID‐19 accelerated healthcare changes, introducing various telehealth services. Work is needed to determine the suitability of telemedicine in the post‐pandemic era.AimsTo explore perceptions and experiences of telemedicine among patients and providers (clinicians and health administrators) who were involved in telemedicine appointments in hospital outpatient clinics in 2020–2022.Design, setting and participantsQualitative study: semi‐structured interviews were conducted with 37 participants (16 patients and 21 providers) in various hospital specialist outpatient clinics in a New South Wales local health district.ResultsPatients were generally satisfied with telemedicine consultations, especially during COVID restrictions, because of the convenience of accessing care from home and minimising the risk of COVID exposure. However, patients considered that the inability to receive a physical examination was a significant disadvantage of telemedicine. Providers had ambivalent perceptions and expressed concerns about mis‐ and under‐diagnoses because of the inability to conduct physical examinations. They considered telemedicine suitable for review appointments but noted an associated increased workload and stressed the need for sustainable funding models (Medicare items). Both patients and providers recognised the need for education/training and better integration of telemedicine platforms into existing infrastructure to facilitate an optimal hybrid model of care.ConclusionDespite expressing some concerns over its limitations, patients valued telemedicine for its convenience and for meeting their needs during the pandemic. While acknowledging that patients experienced some benefits from telemedicine, clinicians expressed concerns about potential missed diagnoses, uncertain clinical outcomes and lack of administrative and technological infrastructure. The ultimate test of telemedicine will be its impact on clinical outcomes versus longstanding models of in‐person care.

Telemedicine in Improving Glycemic Control Among Children and Adolescents With Type 1 Diabetes Mellitus: Systematic Review and Meta-Analysis

“…For patients with chronic diseases, the advantages of telemedicine can be reflected in improving access to services, ensuring continuity of care, and mitigating the costs of care delivery [ 11 , 12 ]. Although telemedicine may not be able to provide physicians with comprehensive diagnostic information about a patient in the same way that a physical examination can, it can assist physicians in monitoring and recording certain specific physiological indicators (eg, blood glucose, blood oxygen concentration, blood pressure, and heart rate) to help them observe the trajectory of a patient’s health [ 13 , 14 ]. The current studies on telemedicine interventions for glycemic control in patients with diabetes focus on (1) telemonitoring (eg, a web-based telemedicine system was used to monitor patients with T1DM in the study by Ruiz de Adana et al [ 15 ]), (2) tele-education (eg, Molavynejad et al [ 16 ] delivered tele-education to patients with diabetes using remote video-based technology), and (3) teleconsultation and internet-based group appointments (eg, Bisno et al [ 17 ] provided both individual telehealth provider visits and internet-based group appointments for patients with T1DM through the CoYoT1 clinic).…”