Clinician perspectives on rapid transition to telehealth during COVID-19 in Australia – a qualitative study
Lillian Smyth
A * , Suzannah Roushdy A , Jerusha Jeyasingham A , Joshua Whitbread A , Peta O’Brien A , Charles Lloyd A , Christian J. Lueck A B , Carolyn A. Hawkins A C , Graham Reynolds A and Diana Perriman A D
A Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia.
B Department of Neurology, Canberra Hospital, Canberra, ACT, Australia.
C Department of Immunology, Canberra Hospital, Canberra, ACT, Australia.
D Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, ACT, Australia.
Australian Health Review 47(1) 92-99 https://doi.org/10.1071/AH22037
Submitted: 24 February 2022 Accepted: 26 September 2022 Published: 20 October 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY).
Abstract
Objective The coronavirus disease 2019 (COVID-19) pandemic precipitated a major shift in the use of telehealth in Australia. The changes highlighted gaps in our knowledge regarding the efficacy of, and clinician attitudes to, the use of telehealth. The current study expands and deepens the available evidence as a result of being collected in unique circumstances that removed one of the major barriers (lack of Medicare rebates) and also one major enablers (willingness) of telehealth uptake.
Methods Using a semi-structured interview, we invited clinicians (N = 39) to share their perspectives, attitudes and experiences of using telehealth. Topics covered included perceptions of the strengths and challenges of telehealth, and how experience of using telehealth during the COVID-19 pandemic had influenced clinicians’ views and intentions regarding their future practice. Participants included clinicians from five disciplines across public and private practice: paediatrics, neurology, immunology, rural general practice, and orthopaedics.
Results We found three key dimensions for consideration when assessing the suitability of telehealth for ongoing practice: the attributes of the patient population, the attributes of the clinical context and environment, and the risks and benefits of a telehealth approach. These findings map to the existing literature and allow us to infer that the experiences of clinicians who previously would have chosen telehealth did not differ significantly from those of our ‘pandemic-conscripted’ clinicians.
Conclusions Our findings map clearly to the existing literature and allow us to infer that the experiences of the clinicians who have chosen telehealth (and are already represented in the literature) did not differ significantly from those trying out telehealth under the unique circumstances of the removal of the Medicare Benefits Scheme barrier and external pressure that over-rides the ‘willingness’ enabling factor in uptake decisions.
Keywords: clinical care, COVID-19, immunology, neurology, orthopaedics, paediatrics, rural and remote, telehealth.
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