The qualitative experience of telehealth access and clinical encounters in Australian healthcare during COVID-19: implications for policy

Abstract

Background Adaptive models of healthcare delivery, such as telehealth consultations, have rapidly been adopted to ensure ongoing delivery of essential healthcare services during the COVID-19 pandemic. However, there remain gaps in our understanding of how clinicians have adapted to telehealth. This study aims to explore the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region, and general practitioners (GP), including barriers, enablers and opportunities. Methods An interpretative qualitative study involving in-depth interviews explored the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region of Australia, and GPs, including barriers, enablers and opportunities. Data were analysed using an inductive thematic approach with constant comparison. Results Individual interviews were conducted with 10 specialists and five GPs. Key themes were identified: (1) transition to telehealth has been valuable but challenging; (2) persisting telehealth process barriers need to be addressed; (3) establishing when face-to-face consults are essential; (4) changes in workload pressures and potential for double-up; (5) essential modification of work practices; and (6) exploring what is needed going forward. Conclusions While there is a need to rationalize and optimize health access during a pandemic, we suggest that more needs to be done to improve telehealth going forward. Our results have important policy implications. Specifically, there is a need to effectively train clinicians to competently utilize and be confident using this telehealth and to educate patients on necessary skills and etiquette.

An evaluation of the introduction of telehealth for remote antenatal and postnatal contacts in Bangladesh and Lao People’s Democratic Republic during the COVID-19 pandemic

“…This is not dissimilar to other findings where health providers were concerned regarding the quality of care and the risk of increasing inequalities in healthcare access due to a lack of available technology (6, 26). Much of the evidence discusses the need for caution in sustaining telehealth services introduced during the pandemic without further evaluation on acceptability for both healthcare providers and service users, accessibility, and quality of care (6, 13, 23, 26, 27).…”

“…Community awareness about the benefits of remote care is critical to the successful implementation of telehealth (23) In our study, both the childbearing women and healthcare providers raised the issue of access to technology as a barrier to successful implementation of telehealth. This is not dissimilar to other findings where health providers were concerned regarding the quality of care and the risk of increasing inequalities in healthcare access due to a lack of available technology (6,26). Much of the evidence discusses the need for caution in sustaining telehealth services introduced during the pandemic without further evaluation on acceptability for both healthcare providers and service users, accessibility, and quality of care (6,13,23,26,27).…”

Telehealth in cancer care during the COVID-19 pandemic

“…Apart from clinical indications, it is crucial to consider patient autonomy and joint-decision making with regards to the modality of clinical encounters. The COVID-19 pandemic has accelerated the uptake of TH significantly 12 , 21 , 22 but it is only possible to keep up this momentum through ongoing funding, training and infrastructure support by policy-makers 23 , 24 , 25 . With the changes in government reimbursement for phone TH in Australia from 1 July 2022, 26 it is probable that the use of phone TH which is the predominant modality in both general practice and specialist settings may be reduced significantly with a resultant increase in face-to-face consultations where a switch to video TH may not be feasible due to challenges previously identified.…”

Prevalence and Characteristics of Australians’ Complementary Medicine Product Use, and Concurrent Use with Prescription and Over-the-Counter Medications—A Cross Sectional Study

“…Undoubtedly, the last three years of the global pandemic have changed the way many people access healthcare [ 9 ]. In Australia, there was an unprecedented increase in telehealth consultations as a primary means for general practitioner services [ 9 ].…”

“…Undoubtedly, the last three years of the global pandemic have changed the way many people access healthcare [ 9 ]. In Australia, there was an unprecedented increase in telehealth consultations as a primary means for general practitioner services [ 9 ]. However, patients who were older reported lower educational qualifications and lower health literacy scores, and lacked access to the Internet reported dissatisfaction with this mode of healthcare delivery [ 10 ].…”