1
|
Woon LSC, Allison S, Bastiampillai T, Kisely S, Maguire P, Pring W, Reay R, Looi JC. Comparing the trends of MBS telepsychiatry and consultant physician telehealth services from 2017 to 2022: A retrospective study. Australas Psychiatry 2024; 32:431-439. [PMID: 39089229 PMCID: PMC11437691 DOI: 10.1177/10398562241268267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
OBJECTIVE The Medicare Benefit Schedule (MBS) telehealth items were expanded in March 2020 during the COVID-19 pandemic. We measured the use of MBS telepsychiatry items compared to consultant physician telehealth items within the context of these item changes, to understand differences in telepsychiatry and physician telehealth utilisation. METHODS Monthly counts of face-to-face and telehealth (videoconferencing and telephone) MBS items for psychiatrists and physicians from January 2017 to December 2022 were compiled from Services Australia MBS Item Reports. Usage levels were compared before and after telehealth item expansion. Usage trends for MBS telepsychiatry and physician telehealth items were compared in time-series plots. RESULTS Telehealth item expansion resulted in a greater rise of telepsychiatry services from 3.8% beforehand to 43.8% of total services subsequently, compared with physician telehealth services (from 0.6% to 20.0%). More physician telehealth services were by telephone compared with telepsychiatry services. Time-series of both telehealth services displayed similar patterns until mid-2022, when physician telehealth services declined as telephone items were restricted. Telepsychiatry services consistently comprised a greater proportion of total services than physician telehealth services. CONCLUSIONS MBS psychiatrist services showed a more substantial and persistent shift to telehealth than physician services, suggesting a greater preference and use of telepsychiatry.
Collapse
Affiliation(s)
- Luke S-C Woon
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Stephen Allison
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Tarun Bastiampillai
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Psychiatry, Monash University, Clayton, VIC, Australia
| | - Steve Kisely
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- School of Medicine, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia
- Departments of Psychiatry, Community Health and Epidemiology, Dalhouise University, Halifax, NS, Canada
| | - Paul Maguire
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - William Pring
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
- Centre for Mental Health Education and Research at Delmont Private Hospital, Melbourne, VIC, Australia
- Private Psychiatrist, Melbourne, VIC, Australia
| | - Rebecca Reay
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School of Medicine and Psychology
| | - Jeffrey Cl Looi
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University Medical School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| |
Collapse
|
2
|
Shingde R, Guha C, van Zwieten A, Kim S, Walker A, Francis A, Didsbury M, Teixeira-Pinto A, Prestidge C, Lancsar E, Mackie F, Kwon J, Howard K, Howell M, Jaure A, Hayes A, Raghunandan R, Petrou S, Lah S, McTaggart S, Craig JC, Mallitt KA, Wong G. Longitudinal associations between socioeconomic position and overall health of children with chronic kidney disease and their carers. Pediatr Nephrol 2024; 39:1533-1542. [PMID: 38049703 DOI: 10.1007/s00467-023-06236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Disadvantaged socioeconomic position (SEP) is an important predictor of poor health in children with chronic kidney disease (CKD). The time course over which SEP influences the health of children with CKD and their carers is unknown. METHODS This prospective longitudinal study included 377 children, aged 6-18 years with CKD (stages I-V, dialysis, and transplant), and their primary carers. Mixed effects ordinal regression was performed to assess the association between SEP and carer-rated child health and carer self-rated health over a 4-year follow-up. RESULTS Adjusted for CKD stage, higher family household income (adjusted odds ratio (OR) (95% CI) 3.3, 1.8-6.0), employed status of primary carers (1.7, 0.9-3.0), higher carer-perceived financial status (2.6, 1.4-4.8), and carer home ownership (2.2, 1.2-4.0) were associated with better carer-rated child health. Household income also had a differential effect on the carer's self-rated health over time (p = 0.005). The predicted probabilities for carers' overall health being 'very good' among lower income groups at 0, 2, and 4 years were 0.43 (0.28-0.60), 0.34 (0.20-0.51), and 0.25 (0.12-0.44), respectively, and 0.81 (0.69-0.88), 0.84 (0.74-0.91), and 0.88 (0.76-0.94) for carers within the higher income group. CONCLUSIONS Carers and their children with CKD in higher SEP report better overall child and carer health compared with those in lower SEP. Carers of children with CKD in low-income households had poorer self-rated health compared with carers in higher-income households at baseline, and this worsened over time. These cumulative effects may contribute to health inequities between higher and lower SEP groups over time. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Rashmi Shingde
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia.
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Siah Kim
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | - Anna Francis
- School of Medicine, University of Queensland, Brisbane, Australia
- Child and Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Madeleine Didsbury
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | - Emily Lancsar
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Fiona Mackie
- Sydney Children's Hospital, Randwick, Australia
- School of Women's and Child Health, University of New South Wales, Kensington, Australia
| | - Joseph Kwon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Kirsten Howard
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy & Economics, School of Public Health, University of Sydney, Sydney, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy & Economics, School of Public Health, University of Sydney, Sydney, Australia
| | - Allison Jaure
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Alison Hayes
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Rakhee Raghunandan
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy & Economics, School of Public Health, University of Sydney, Sydney, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Steven McTaggart
- School of Medicine, University of Queensland, Brisbane, Australia
- Child and Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Kylie-Ann Mallitt
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| |
Collapse
|
3
|
Sazon H, Catapan SDC, Rahimi A, Canfell OJ, Kelly J. How do Twitter users feel about telehealth? A mixed-methods analysis of experiences, perceptions and expectations. Health Expect 2024; 27:e13927. [PMID: 38038231 PMCID: PMC10726278 DOI: 10.1111/hex.13927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/26/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Telehealth use has increased considerably in the last years and evidence suggests an overall positive sentiment towards telehealth. Twitter has a wide userbase and can enrich our understanding of telehealth use by users expressing their personal opinions in an unprompted way. This study aimed to explore Twitter users' experiences, perceptions and expectations about telehealth over the last 5 years. METHODS Mixed-methods study with sequential complementary quantitative and qualitative phases was used for analysis stages comprising (1) a quantitative semiautomated analysis and (2) a qualitative research-led thematic analysis. A machine learning model was used to establish the data set with relevant English language tweets from 1 September 2017 to 1 September 2022 relating to telehealth using predefined search words. Results were integrated at the end. RESULTS From the initial 237,671 downloaded tweets, 6469 had a relevancy score above 0.8 and were input into Leximancer and 595 were manually analysed. Experiences, perceptions and expectations were categorised into three domains: experience with telehealth consultation, telehealth changes over time and the purpose of the appointment. The most tweeted experience was expectations for telehealth consultation in comparison to in-person consultations. Users mostly mentioned the hope that waiting times for the consultations to start to be less than in-person, more telehealth appointments to be available and telehealth to be cheaper. Perceptions around the use of telehealth in relation to healthcare delivery changes brought about by the COVID-19 pandemic were also expressed. General practitioners were mentioned six times more than other healthcare professionals. CONCLUSION/IMPLICATIONS This study found that Twitter users expect telehealth services to be better, more affordable and more available than in-person consultations. Users acknowledged the convenience of not having to travel for appointments and the challenges to adapt to telehealth. PATIENT OR PUBLIC CONTRIBUTION An open data set with 237,671 tweets expressing users' opinions in an unprompted way was used as a source for telehealth service users, caregivers and members of the public experiences, perceptions and expectations of telehealth.
Collapse
Affiliation(s)
- Hannah Sazon
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Soraia de Camargo Catapan
- Centre for Online HealthThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| | | | - Oliver J. Canfell
- Queensland Digital Health Centre, Centre for Health Services Research, Faculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
- Digital Health Cooperative Research CentreAustralian GovernmentSydneyNew South WalesAustralia
- UQ Business School, Faculty of Business, Economics and LawThe University of QueenslandBrisbaneQueenslandAustralia
| | - Jaimon Kelly
- Centre for Online HealthThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| |
Collapse
|
4
|
Bdair IA. Perceptions of pre-licensure nursing students toward telecare and telenursing. Inform Health Soc Care 2024; 49:42-55. [PMID: 38205799 DOI: 10.1080/17538157.2024.2303642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Telehealth transforms the healthcare system and provides the population with equal access to healthcare services at distance. This study aimed to investigate nursing students' perceptions toward telenursing. Students' knowledge, attitudes, advantages, disadvantages, barriers, and factors that affect the intention toward telenursing implementation were addressed. This study was conducted using a descriptive design. The study participants were 313 undergraduate nursing students. Data were gathered through a web-based survey from June to August 2022 and analyzed using SPSS version 22. Fifty-four-point-six percent (54.6%) of the students were male and 45.4% were female. Around one-fourth were internship students. Most students had access to the internet 97.4%. The results revealed that nursing students have positive perceptions toward telenursing. Their overall competencies in terms of knowledge, proficiency, awareness, and familiarity were moderate. Students raised some disadvantages and difficulties regarding telenursing; meanwhile, more advantages and suggestions to overcome the disadvantages were reported. It is of utmost importance that nursing education integrates telenursing content and practice to prepare future nurses for the successful implementation of telenursing. More research is still needed to examine the impact of telenursing on nursing practice. Nursing administrators must develop appropriate and prompt interventions to respond to the dramatically changing healthcare environment.
Collapse
Affiliation(s)
- Izzeddin A Bdair
- Nursing Department, Al-Ghad College for Applied Medical Sciences, Riyadh, Saudi Arabia
| |
Collapse
|
5
|
Sengupta A, Pettigrew S, Jenkins CR. Telemedicine in specialist outpatient care during COVID-19: a qualitative study. Intern Med J 2024; 54:54-61. [PMID: 37926924 DOI: 10.1111/imj.16288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND COVID-19 accelerated healthcare changes, introducing various telehealth services. Work is needed to determine the suitability of telemedicine in the post-pandemic era. AIMS To 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 PARTICIPANTS Qualitative 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. RESULTS Patients 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. CONCLUSION Despite 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.
Collapse
Affiliation(s)
- Agnivo Sengupta
- Respiratory Program, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Simone Pettigrew
- Health Promotion and Behaviour Change, The George Institute for Global Health, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Christine R Jenkins
- Respiratory Program, The George Institute for Global Health, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
- Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
6
|
Orsso CE, Ford KL, Kiss N, Trujillo EB, Spees CK, Hamilton-Reeves JM, Prado CM. Optimizing clinical nutrition research: the role of adaptive and pragmatic trials. Eur J Clin Nutr 2023; 77:1130-1142. [PMID: 37715007 PMCID: PMC10861156 DOI: 10.1038/s41430-023-01330-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 09/17/2023]
Abstract
Evidence-based nutritional recommendations address the health impact of suboptimal nutritional status. Efficacy randomized controlled trials (RCTs) have traditionally been the preferred method for determining the effects of nutritional interventions on health outcomes. Nevertheless, obtaining a holistic understanding of intervention efficacy and effectiveness in real-world settings is stymied by inherent constraints of efficacy RCTs. These limitations are further compounded by the complexity of nutritional interventions and the intricacies of the clinical context. Herein, we explore the advantages and limitations of alternative study designs (e.g., adaptive and pragmatic trials), which can be incorporated into RCTs to optimize the efficacy or effectiveness of interventions in clinical nutrition research. Efficacy RCTs often lack external validity due to their fixed design and restrictive eligibility criteria, leading to efficacy-effectiveness and evidence-practice gaps. Adaptive trials improve the evaluation of nutritional intervention efficacy through planned study modifications, such as recalculating sample sizes or discontinuing a study arm. Pragmatic trials are embedded within clinical practice or conducted in settings that resemble standard of care, enabling a more comprehensive assessment of intervention effectiveness. Pragmatic trials often rely on patient-oriented primary outcomes, acquire outcome data from electronic health records, and employ broader eligibility criteria. Consequently, adaptive and pragmatic trials facilitate the prompt implementation of evidence-based nutritional recommendations into clinical practice. Recognizing the limitations of efficacy RCTs and the potential advantages of alternative trial designs is essential for bridging efficacy-effectiveness and evidence-practice gaps. Ultimately, this awareness will lead to a greater number of patients benefiting from evidence-based nutritional recommendations.
Collapse
Affiliation(s)
- Camila E Orsso
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Katherine L Ford
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada
- Department of Kinesiology & Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Elaine B Trujillo
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Colleen K Spees
- Divison of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Jill M Hamilton-Reeves
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
7
|
Banbury A, Taylor ML, Gray LC, Reid N, Smith AC. Sustaining and expanding telehealth activity: Training requirements for Australian residential aged care front-line staff. PEC INNOVATION 2023; 2:100109. [PMID: 37214526 PMCID: PMC10194154 DOI: 10.1016/j.pecinn.2022.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/30/2022] [Accepted: 11/26/2022] [Indexed: 05/24/2023]
Abstract
Objective To identify the training needs of front-line aged care staff as perceived by senior clinicians and managers at selected residential aged care facilities (RACFs). Methods A qualitative explorative designed study using semi-structured interviews with a convenience sample of RACF senior managers and nurses. A hybrid analysis approach using a framework deductive analysis followed by inductive analysis for sub-themes. Results Four sub-themes emerged to sustain increased telehealth activity: technology knowledge and digital literacy skills, including understanding telehealth ecosystems and technical skills; evidence-based reviews and clinical frameworks for telehealth consultations to identify appropriate consultations and successful use cases; telehealth best practice guidelines and workflows including telehealth consultations protocols, communicating by videoconferencing, how to support families in attending telehealth consultations and optimal training models; and telehealth policy and legal guidance. Conclusion Staff require comprehensive training to sustain and expand telehealth use in RACFs. Training should focus on knowledge, skills and competencies in using telehealth as well as the broad factors of policies and understanding ICT systems to support staffs' abilities and confidence. Innovation This study provides innovative findings that identify key components and associated activities and resources for training RACF staff to ensure they have sufficient knowledge, competency, skills and confidence to integrate telehealth into care provision.
Collapse
Affiliation(s)
- Annie Banbury
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Floor, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
| | - Monica L. Taylor
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Floor, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
| | - Leonard C. Gray
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
| | - Natasha Reid
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
| | - Anthony C. Smith
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Floor, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Odense University Hospital, Kløvervænget 8C, entrance 101, 3. Floor, DK-5000 Odense C, Denmark
| |
Collapse
|
8
|
Banbury A, Taylor M, Caffery L, Der Vartanian C, Haydon H, Mendis R, Ng K, Smith A. Consumers' experiences, preferences, and perceptions of effectiveness in using telehealth for cancer care in Australia. Asia Pac J Clin Oncol 2023; 19:752-761. [PMID: 37712136 DOI: 10.1111/ajco.14002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/06/2023] [Accepted: 08/27/2023] [Indexed: 09/16/2023]
Abstract
AIM COVID-19 accelerated telehealth (video and telephone) use for cancer care to reduce disease exposure and transmission. Understanding consumers' health service delivery needs is required to sustain telehealth activity and develop new models of care. We explored consumers' experiences of telehealth in cancer care and their perspectives on improving and sustaining telehealth uptake in the future. METHODS Exploratory design mixed-methods study using the Model for Assessment of Telemedicine (MAST) framework. Consumers affected by cancer completed an online survey and semistructured interviews. Quantitative data were analyzed using descriptive statistics and chi-square. Qualitative data from the MAST consumer domain were thematically analyzed. RESULTS There were 1162 survey respondents and 18 interview participants. Video and telephone were used in cancer care with various providers. Telephone was used more frequently. Most respondents (85%) had reliable internet connections for video, however, 36% were not offered a video consultation. Video compared with telephone users were statistically significantly more likely to be satisfied with the quality of their treatment and perceived their consultation achieved as much as an in-person consultation. Telephone users (51%) compared with video users (31%) were more likely to perceive their concerns would have been better understood by their care provider if they were seen in person. Five themes emerged from the qualitative data. Consumers want modality choice, video provides superior experiences versus telephone, consultation mode preference is fluid, and consultation scheduling and administration need further consideration. CONCLUSION Consumers support telehealth in cancer care. Consumers want consultation mode choices based on their needs and purpose of consultation.
Collapse
Affiliation(s)
- Annie Banbury
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Monica Taylor
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Liam Caffery
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | | | - Helen Haydon
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Roshni Mendis
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Kawai Ng
- Cancer Australia, Sydney, Australia
| | - Anthony Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
9
|
Ross MH, Russell T, Bennell KL, Campbell PK, Kimp AJ, Foster NE, Hinman RS. Technical issues occur but are infrequent and have little impact on physiotherapist-delivered videoconferencing consultations for knee osteoarthritis: A descriptive study. Musculoskelet Sci Pract 2023; 66:102782. [PMID: 37269590 DOI: 10.1016/j.msksp.2023.102782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/03/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Clinicians often report technical issues as a barrier to adopting videoconferencing service models. This descriptive study nested within a randomised controlled trial investigated the frequency, nature and impact of technical issues during video consultations. METHODS Physiotherapists (n = 15) underwent training to deliver knee osteoarthritis care focussed on education, strengthening and physical activity. In the randomised controlled trial, participants received five physiotherapy consultations either in-person or via videoconferencing (via Zoom) over 3-months; consultations were recorded and physiotherapists documented technical difficulties. In this study, available notes were audited (n = 169 initial and n = 147 final consultations) and nature and frequency of technical issues coded. Based on whether the clinician reported technical difficulties, three subgroups were created for analysis 1) in-person, 2) videoconferencing without technical issues, 3) videoconferencing with technical issues. Forty participants were randomly selected for each subgroup (n = 120). Duration of consultation components (set-up and introduction, assessment, exercise, physical activity, education and wrap-up), total consultation duration and duration of technical issues were compared across subgroups using one-way multivariate analyses of variance with mean differences (MD) and 95% confidence intervals (CIs). RESULTS Technical issues were documented in 37% (initial) and 19% (final) of video consultations. Problems with audio/video were most frequent, occurring in 36-21% (initial) and 18-24% (final) consultations. Audio/video problems were predominantly experienced during set-up, but did not significantly increase videoconferencing consultation duration compared to in-person consultation duration (MD (95% CI) 0.72 (-3.57 to 5.01) minutes). DISCUSSION While technical issues with videoconferencing consultations frequently occur, they are typically minor, transient and resolved quickly.
Collapse
Affiliation(s)
- Megan H Ross
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
| | - Trevor Russell
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Penny K Campbell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Alexander J Kimp
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Nadine E Foster
- STARS Education and Research Alliance, Faculty of Health and Behavioural Sciences, The University of Queensland and Metro North Health, Brisbane, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
10
|
Woods L, Dendere R, Eden R, Grantham B, Krivit J, Pearce A, McNeil K, Green D, Sullivan C. Perceived Impact of Digital Health Maturity on Patient Experience, Population Health, Health Care Costs, and Provider Experience: Mixed Methods Case Study. J Med Internet Res 2023; 25:e45868. [PMID: 37463008 PMCID: PMC10394505 DOI: 10.2196/45868] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/05/2023] [Accepted: 05/26/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Health care organizations understand the importance of new technology implementations; however, the best strategy for implementing successful digital transformations is often unclear. Digital health maturity assessments allow providers to understand the progress made toward technology-enhanced health service delivery. Existing models have been criticized for their lack of depth and breadth because of their technology focus and neglect of meaningful outcomes. OBJECTIVE We aimed to examine the perceived impacts of digital health reported by health care staff employed in health care organizations across a spectrum of digital health maturity. METHODS A mixed methods case study was conducted. The digital health maturity of public health care systems (n=16) in Queensland, Australia, was examined using the quantitative Digital Health Indicator (DHI) self-assessment survey. The lower and upper quartiles of DHI scores were calculated and used to stratify sites into 3 groups. Using qualitative methods, health care staff (n=154) participated in interviews and focus groups. Transcripts were analyzed assisted by automated text-mining software. Impacts were grouped according to the digital maturity of the health care worker's facility and mapped to the quadruple aims of health care: improved patient experience, improved population health, reduced health care cost, and enhanced provider experience. RESULTS DHI scores ranged between 78 and 193 for the 16 health care systems. Health care systems in the high-maturity category (n=4, 25%) had a DHI score of ≥166.75 (the upper quartile); low-maturity sites (n=4, 25%) had a DHI score of ≤116.75 (the lower quartile); and intermediate-maturity sites (n=8, 50%) had a DHI score ranging from 116.75 to 166.75 (IQR). Overall, 18 perceived impacts were identified. Generally, a greater number of positive impacts were reported in health care systems of higher digital health maturity. For patient experiences, higher maturity was associated with maintaining a patient health record and tracking patient experience data, while telehealth enabled access and flexibility across all digital health maturity categories. For population health, patient journey tracking and clinical risk mitigation were reported as positive impacts at higher-maturity sites, and telehealth enabled health care access and efficiencies across all maturity categories. Limited interoperability and organizational factors (eg, strategy, policy, and vision) were universally negative impacts affecting health service delivery. For health care costs, the resource burden of ongoing investments in digital health and a sustainable skilled workforce was reported. For provider experiences, the negative impacts of poor usability and change fatigue were universal, while network and infrastructure issues were negative impacts at low-maturity sites. CONCLUSIONS This is one of the first studies to show differences in the perceived impacts of digital maturity of health care systems at scale. Higher digital health maturity was associated with more positive reported impacts, most notably in achieving outcomes for the population health aim.
Collapse
Affiliation(s)
- Leanna Woods
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, Australia
- Digital Health Cooperative Research Centre, Sydney, Australia
| | - Ronald Dendere
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Rebekah Eden
- UQ Business School, The University of Queensland, Brisbane, Australia
| | - Brittany Grantham
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Jenna Krivit
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Andrew Pearce
- Healthcare Information and Management Systems Society, Singapore, Singapore
| | - Keith McNeil
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, Australia
| | | | - Clair Sullivan
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Herston, Australia
- Metro North Hospital and Health Service, Brisbane, Australia
| |
Collapse
|
11
|
Nguyen J, Takesh T, Parsangi N, Song B, Liang R, Wilder-Smith P. Compliance with Specialist Referral for Increased Cancer Risk in Low-Resource Settings: In-Person vs. Telehealth Options. Cancers (Basel) 2023; 15:2775. [PMID: 37345112 DOI: 10.3390/cancers15102775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/13/2023] [Accepted: 05/13/2023] [Indexed: 06/23/2023] Open
Abstract
Efforts are underway to improve the accuracy of non-specialist screening for oral cancer (OC) risk, yet better screening will only translate into improved outcomes if at-risk individuals comply with specialist referral. Most individuals from low-resource, minority, and underserved (LRMU) populations fail to complete a specialist referral for OC risk. The goal was to evaluate the impact of a novel approach on specialist referral compliance in individuals with a positive OC risk screening outcome. A total of 60 LRMU subjects who had screened positive for increased OC risk were recruited and given the choice of referral for an in-person (20 subjects) or a telehealth (40 subjects) specialist visit. Referral compliance was tracked weekly over 6 months. Compliance was 30% in the in-person group, and 83% in the telehealth group. Approximately 83-85% of subjects from both groups who had complied with the first specialist referral complied with a second follow-up in-person specialist visit. Overall, 72.5% of subjects who had chosen a remote first specialist visit had entered into the continuum of care by the study end, vs. 25% of individuals in the in-person specialist group. A two-step approach that uses telehealth to overcome barriers may improve specialist referral compliance in LRMU individuals with increased OC risk.
Collapse
Affiliation(s)
- James Nguyen
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Thair Takesh
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Negah Parsangi
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| | - Bofan Song
- College of Optical Sciences, University of Arizona, Tucson, AZ 85721, USA
| | - Rongguang Liang
- College of Optical Sciences, University of Arizona, Tucson, AZ 85721, USA
| | - Petra Wilder-Smith
- Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA
| |
Collapse
|
12
|
Snoswell CL, Haydon HM, Kelly JT, Thomas EE, Caffery LJ, Smith AC. How do consumers prefer their care delivered: In-person, telephone or videoconference? J Telemed Telecare 2023:1357633X231160333. [PMID: 36927220 DOI: 10.1177/1357633x231160333] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
AIM To gain a better understanding of consumer experiences with and preferences for telephone and videoconference consultations (telehealth), and how these compare to traditional in-person consultations. METHODS A national cross-sectional survey was administered to a representative sample of Australian adults who have received a telehealth service within the last year. Consumers were recruited by Qualtrics® through their online sampling service. The sample was representative of the broader Australian population according to gender, age, location (state/territory), and place of residence (urban or remote). Information on demographics (e.g., age, gender, employment status), recent telehealth experience, and preferences for consultation modality was collected. To measure preferences consumers were asked to indicate which modality they would prefer (in-person, telephone, or videoconference) for different scenarios. These included consultations of various time lengths, and for the top ten conditions for which individuals sought a general practitioner. RESULTS A total of 1069 consumers completed the survey. When consumers were asked to describe their most recent telehealth appointment, most were for follow-up appointments (67%) and completed by telephone (77%) rather than by videoconference, and with a general practitioner (75%). In-person consultations at a clinic were the top preference in all clinical scenarios presented, except when needing a prescription or to receive test results. In these cases, a telephone consultation was the preferred modality. Inexperience with videoconference and duration of consultation influenced preference for consultation mode. Consumers preferred to have short consultations of around five minutes done by telehealth (telephone or videoconference), while they preferred in-person for longer consultations (up to 60 minutes). CONCLUSIONS Many Australians have used telehealth in the past year to access healthcare, with telephone being the most common form of communication. Given the option and the experience to date, consumers prefer telephone when consultations related to either prescriptions or test results. Experience with videoconference for consultations increased consumer preferences for using it for future consultations.
Collapse
Affiliation(s)
- Centaine L Snoswell
- 430948Faculty of Medicine, Centre for Online Health, The University of Queensland, Brisbane, Australia.,Faculty of Medicine, Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Helen M Haydon
- 430948Faculty of Medicine, Centre for Online Health, The University of Queensland, Brisbane, Australia.,Faculty of Medicine, Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Jaimon T Kelly
- 430948Faculty of Medicine, Centre for Online Health, The University of Queensland, Brisbane, Australia.,Faculty of Medicine, Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Emma E Thomas
- 430948Faculty of Medicine, Centre for Online Health, The University of Queensland, Brisbane, Australia.,Faculty of Medicine, Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Liam J Caffery
- 430948Faculty of Medicine, Centre for Online Health, The University of Queensland, Brisbane, Australia.,Faculty of Medicine, Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Anthony C Smith
- 430948Faculty of Medicine, Centre for Online Health, The University of Queensland, Brisbane, Australia.,Faculty of Medicine, Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia.,Centre for Innovative Medical Technology, 6174University of Southern Denmark, Odense, Denmark
| |
Collapse
|
13
|
Basch C, Orellana L, Hensher M, Gao L, Sanigorski A, Mc Namara K, Versace VL, Szakiel J, Swann J, Manias E, Peeters A. Use of General Practitioner Telehealth Services During the COVID-19 Pandemic in Regional Victoria, Australia: Retrospective Analysis. J Med Internet Res 2023; 25:e39384. [PMID: 36649230 PMCID: PMC9907565 DOI: 10.2196/39384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/25/2022] [Accepted: 11/27/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In March 2020, the Australian Government expanded general practitioner (GP) telehealth services in response to the COVID-19 pandemic. OBJECTIVE This study sought to assess use patterns of GP telehealth services in response to changing circumstances (before and during the COVID-19 pandemic and with or without a lockdown) in regional Victoria, Australia. METHODS We conducted a secondary analysis of monthly Medicare claims data from July 2019 to June 2021 from 140 regional GP practices in Western Victoria. The longitudinal patterns of proportion of GP telehealth consultations stratified by type of consultation (ie, videoconference vs telephone) and by geographical, consumer, and consultation characteristics were analyzed. RESULTS Telehealth comprised 25.8% (522,932/2,025,615) of GP consultations over the 2-year period. After the introduction of the Australian telehealth expansion policy in March 2020, there was a rapid uptake in GP telehealth services (including telephone and video services), from 0% before COVID-19 to 15% (11,854/80,922) of all consultations in March 2020, peaking at 55% (50,828/92,139) in August 2020. Thereafter, the use of telehealth declined steadily to 31% (23,941/77,344) in January 2021 and tapered off to 28% (29,263/103,798) in June 2021. Telephone services and shorter consultations were the most dominant form, and those aged 15-64 years had higher telehealth use rates than younger or older age groups. The proportion of video consultations was higher during periods with government-imposed lockdowns and higher in the most socioeconomically advantaged areas compared to less socioeconomically advantaged areas. CONCLUSIONS Our findings support the continuation of telehealth use in rural and regional Australia post pandemic. Future policy must identify mechanisms to reduce existing equity gaps in video consultations and consider patient- and system-level implications of the dominant use of short telephone consultations.
Collapse
Affiliation(s)
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | - Martin Hensher
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Lan Gao
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Andrew Sanigorski
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia
| | - Kevin Mc Namara
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Australia.,Deakin Rural Health, School of Medicine, Warrnambool, Australia
| | | | - John Szakiel
- Western Victoria Primary Health Network, Geelong, Australia
| | - Jamie Swann
- Western Victoria Primary Health Network, Geelong, Australia
| | - Elizabeth Manias
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Burwood, Australia.,School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Anna Peeters
- Institute for Health Transformation, School of Health and Social Development, Deakin University, Burwood, Australia
| |
Collapse
|
14
|
Smyth L, Roushdy S, Jeyasingham J, Whitbread J, O'Brien P, Lloyd C, Lueck CJ, Hawkins CA, Reynolds G, Perriman D. Clinician perspectives on rapid transition to telehealth during COVID-19 in Australia - a qualitative study. AUST HEALTH REV 2023; 47:92-99. [PMID: 36261136 DOI: 10.1071/ah22037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/26/2022] [Indexed: 02/04/2023]
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.
Collapse
Affiliation(s)
- Lillian Smyth
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Suzannah Roushdy
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Jerusha Jeyasingham
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Joshua Whitbread
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Peta O'Brien
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Charles Lloyd
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Christian J Lueck
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia; and Department of Neurology, Canberra Hospital, Canberra, ACT, Australia
| | - Carolyn A Hawkins
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia; and Department of Immunology, Canberra Hospital, Canberra, ACT, Australia
| | - Graham Reynolds
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Diana Perriman
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia; and Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, ACT, Australia
| |
Collapse
|
15
|
Pool J, Namvar M, Akhlaghpour S, Fatehi F. Exploring public opinion about telehealth during COVID-19 by social media analytics. J Telemed Telecare 2022; 28:718-725. [PMID: 36346934 PMCID: PMC9646901 DOI: 10.1177/1357633x221122112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/10/2022] [Indexed: 12/02/2023]
Abstract
While COVID-19 catalyzed the acceptance and use of telehealth, our understanding of how it is perceived by multi-stakeholders such as patients, clinicians, and health authorities is limited. Drawing on social media analytics, this research examines social media discourses and users' opinions about telehealth during the COVID-19 pandemic. It applies natural language processing and deep learning to explore word of mouth on telehealth with a contextualized focus on the COVID-19 pandemic. We conducted topic modeling, sentiment analysis, and emotion analysis (fearful, happy, sad, surprised, and angry emotions). The topic modeling analysis led to the identification of 18 topics, representing 6 themes of digital health service delivery, pandemic response, communication and promotion, government action, health service domains (e.g. mental health, cancer, aged care), as well as pharma and drug. The sentiment analysis revealed that while most opinions expressed in tweets were positive, the public expressed mostly negative opinions about certain aspects of COVID-19 such as lockdowns and cyberattacks. Emotion analysis of tweets showed a dominant pattern of fearful and sad emotions in particular topics. The results of this study that inductively emerged from our social media analysis can aid public health authorities and health professionals to address the concerns of telehealth users and improve their experiences.
Collapse
Affiliation(s)
- Javad Pool
- Business School, The University of
Queensland, Brisbane, Australia
| | - Morteza Namvar
- Business School, The University of
Queensland, Brisbane, Australia
| | | | - Farhad Fatehi
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Centre for Health Services Research, The University of
Queensland, Brisbane, Australia
| |
Collapse
|
16
|
Costs to the Medicare Benefits Schedule for general practitioner consultations: A time-series analysis. J Telemed Telecare 2022; 28:726-732. [DOI: 10.1177/1357633x221122135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The COVID-19 pandemic was a catalyst for the introduction of additional telehealth funding (telehealth item numbers) for general practitioner (GP) consultations through the Medicare Benefits Schedule (MBS) in Australia. This study evaluated the impact of telehealth funding on costs to the MBS for GP consultations from January 2017 to December 2021. An interrupted time series analysis assessed MBS costs (initial and monthly growth) for GP consultations (in-person, videoconference, telephone) before and after additional telehealth item numbers were introduced. From January 2017 to February 2020, total MBS costs for GP consultations were, on average, $545 million per month compared to $592 million per month from March 2020 to December 2021. There was an initial cost increase of approximately $39 million in the first month after additional telehealth funding was introduced ( p = 0.0001). Afterwards, there was no significant change in monthly costs ( p = 0.539). The introduction of additional MBS telehealth funding increased overall MBS costs for GP consultations. This increased cost for GP telehealth services could save costs to society if it translates into improved continuity of care, decreased hospitalisations, reduced productivity losses and improved patient outcomes. Future policy reform should incorporate a cost–benefit analysis to determine if increased MBS costs for GP consultations are a good investment.
Collapse
|
17
|
Gallegos-Rejas VM, Thomas EE, Kelly JT, Smith AC. A multi-stakeholder approach is needed to reduce the digital divide and encourage equitable access to telehealth. J Telemed Telecare 2022; 29:73-78. [PMID: 35733379 DOI: 10.1177/1357633x221107995] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since the COVID-19 pandemic onset, there has been exponential growth in the uptake of telehealth, globally. However, evidence suggests that people living in lower socioeconomic areas, cultural and linguistically diverse communities, people with disabilities, and with low health literacy are less likely to receive telehealth services. These population groups have disproportionately higher health needs and face additional barriers to healthcare access. Barriers that reduce access to telehealth further exacerbate existing gaps in care delivery. To improve equity of access to telehealth, we need to reduce the digital divide through a multi-stakeholder approach. This article proposes practical steps to reduce the digital divide and encourage equitable access to telehealth. Enabling more equitable access to telehealth requires improvements in digital health literacy, workforce training in clinical telehealth, co-design of new telehealth-enabled models of care, change management, advocacy for culturally appropriate services, and sustainable funding models.
Collapse
Affiliation(s)
- Victor M Gallegos-Rejas
- Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Emma E Thomas
- Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Jaimon T Kelly
- Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia
| | - Anthony C Smith
- Centre for Online Health, 1974The University of Queensland, Brisbane, Australia.,Centre for Health Services Research, 1974The University of Queensland, Brisbane, Australia.,Centre for Innovative Medical Technology, 6174University of Southern Denmark, Odense, Denmark
| |
Collapse
|