Rethinking presence: a grounded theory of nurses and teleconsultation

Aims and objectives: To develop a theory that offered an evidence-based insight into the use of teleconsultation by nurses. Background: Teleconsultation is the use of video to facilitate real-time, remote interaction between healthcare practitioners and patients. Although its popularity is growing, there is little understanding of how teleconsultation impacts on the role of nurses. Design: The study adopted a constructivist grounded theory method, supplemented by the use of Straussian analytical approaches. Methods: Using selective and theoretical approaches, registered nurses with experience of using video in health care were sampled. Data were collected using semi-structured interviews exploring experiences, knowledge and feelings surrounding teleconsultation. Interviews were recorded, transcribed and subjected to three-stage, nonlinear manual analysis (open, axial and selective coding). Results: Theoretical saturation occurred after 17 interviews. The core category identified from the data was ‘nursing presence’ Four subcategories of nursing presence were identified: operational, clinical, therapeutic and social. The degree to which presence could be achieved was dependent upon three influencing factors – enablers, constraints and compensation. Conclusions: Nurses provide different types of presence during teleconsultation, with the degree of presence dependent on specific characteristics of video-mediated communication. Where the use of video constrains the delivery of presence, nurses use a range of compensatory mechanisms to enhance patient care. Relevance to clinical practice: Teleconsultation provides an innovative approach to enhancing the delivery of health care. This study provides nurses with insight into the impact of teleconsultation on their professional role, and an understanding of how best to use video-mediated communication to support patient care

Teledentistry: An Innovative Workforce Model for Dental Hygienists

Objective/Aims: This review of literature seeks to explore teledentistry as an alternative dental hygiene workforce model that places a dental hygienist in the role of the mid-level practitioner as part of a digitally-connected oral healthcare team. It will also emphasize the innovative methods of teledentistry giving better health care delivery to diverse populations. Methods: The review of literature analyzed the conclusions and discussions of primary and secondary scholarly articles from PubMed, Google Scholar, Embase, and CINAHL. Specific key terms included teledentistry, telehealth, teleconsultation, dental hygiene, dentistry, workforce model, health care delivery. Articles included in this review were published within the five last years. Results: Multiple scholarly articles were compiled together to emphasize the importance of technology-centered dental health care for patients who were unable to travel long distances to retrieve the care they were seeking, Key limitations the research often indicated include geographic, socioeconomic barriers or distance. Conclusion: The teledentistry-assisted model presents one way to answer the call to expand overall access to oral healthcare. The comparison of articles supported the efficiency and cost-effectiveness method of teledentistry in comparison to face to face consultations. Teledentistry is especially beneficial to addressing the access to care issue particularly populations in rural areas and even penitentiary institutions.https://scholarscompass.vcu.edu/denh_student/1025/thumbnail.jp

Business Models for e-Health: Evidence from Ten Case Studies

An increasingly aging population and spiraling healthcare costs have made the search for financially viable healthcare models an imperative of this century. The careful and creative application of information technology can play a significant role in meeting that challenge. Valuable lessons can be learned from an analysis of ten innovative telemedicine and e-health initiatives. Having proven their effectiveness in addressing a variety of medical needs, they have progressed beyond small-scale implementations to become an established part of healthcare delivery systems around the world

Teleconsultation perspective for cardiovascular patients in Saudi Arabia

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.This research of teleconsultation services aims to improve the quality of diagnosis and treatment for rural cardiovascular patients through utilizing distant medical expertise. Equitable access to expert healthcare as well as improved medical management for these patients can assist in modifying cardiovascular disease (CVD) risk and reduce morbidity and mortality in Saudi Arabia. The objectives were to design and develop a new care pathway for cardiovascular disease patients by utilizing teleconsultation technology, investigate factors and issues that might act as barriers to its adoption, and then evaluate the impact of this model on the stakeholders. A small scale pilot project was used to determine the issues of technology, processes and human resources required to deliver an effective service with the context of the research setting. Four primary healthcare centres, two regional hospitals, fifteen patients and sixty other participant stakeholders were included in this study. An approach using (PCP) patient care pathways was used to introduce the teleconsultation technology and integrate it within the healthcare delivery system. Compared to the traditional PCP, the modified PCP utilising teleconsultation technology improved the quality of healthcare through: Improved access to medical care and quality of diagnosis by obtaining the expertise of a distant specialist. More efficient medical evaluation and management. Enhanced role of primary healthcare centres and participating hospitals by providing all levels of health services for patients. Evidence-based referral (reduced waiting time, reduced burden on outpatient clinics). The telconsultation adoption barriers included: Inadequacy of finance Limited infrastructure Legal and regularity difficulties. Organization issues. Literacy on technology. This study recommends the following for telemedicine implementation in the country: Promote perception and readiness for ICT services with the healthcare community. Enhance structural readiness including appropriate infrastructure and adequate funding, human resources and equipment. Proactive policies to encourage growth of the telecommunication sector and to address concerns regarding privacy and security

Rethinking presence : a grounded theory of nurses and teleconsultation

[Introduction]: Ensuring the provision of equitable, high quality care is becoming progressively more challenging in a context of an ageing population, increased prevalence of long term conditions and a prolonged period of public spending austerity. In response to these challenges, commissioners and providers have explored and piloted a range of innovative approaches to service delivery, including those that involve the utilisation of information technologies.One such modality – teleconsultation – is the utilisation of video to facilitate real-time, remote consultation between healthcare practitioners and patients. Though teleconsultation has been used as an approach to care since the 1970s, it has grown in prevalence of late, due to reduced costs, improved connectivity and greater social acceptance of video-mediated interaction. Teleconsultation is used within the acute sector (e.g. to expedite specialist stroke or burns care) and to support people living with long term conditions within the community. However, despite evidence of feasibility, clinical benefit and patient acceptance, there is little understanding of how the use of video impacts on the role of those nurses who are involved in teleconsultation

Perspectives and possibilities of telehealth medical consultations in primary care practices

Telemedicine solutions have a rising importance in health systems, on the improvement of access to care and the provision of healthcare services. The COVID-19 pandemic increased its usage, as teleconsultations could help reduce the spread of the virus, however, this should be looked at as a long-term solution, since technology is increasingly present in healthcare. This thesis aims to assess the awareness and perspectives of patients regarding video-teleconsultations, and the possibility of this solution being present in Portuguese primary health care, substituting in-person consultations. Combining evidence from literature and a sample of Portuguese patients, it was possible to analyse video-teleconsultations and non-video-teleconsultations. Patients’ awareness on the videoteleconsultations was high (81,4% of the sample), and influenced by levels of education and income, differing from the general lack of awareness described in several studies. However, the need for more focused awareness campaigns was identified, which was in accordance with literature reviewed. Non-video-teleconsultations had higher levels of awareness and use, when compared to video-teleconsultations, similar to previous studies. Finally, physical interventions, consultations’ purpose, hardware availability and quality and value’s perception of teleconsultations had a significantly influence on the patients’ opinion about the possibility of substitution of in-person consultations for this video-teleconsultations. However, demographic characteristics did not affect, which may be due to the sample size. These findings show telemedicine’s potential on the progress of the provision of care. Yet they still indicate the need for future research on patients and health professionals’ perspectives, and for strategic awareness campaigns regarding teleconsultations in primary care.A telemedicina tem um papel cada vez mais significante nos sistemas de saúde, na amplificação do acesso e melhoria da prestação de cuidados de saúde. A pandemia COVID-19 contribuiu na adoção da telemedicina, já que as teleconsultas apoiavam o objetivo da redução da propagação do vírus. No entanto, pode ser vista como uma solução a longo prazo, pois a tecnologia está cada vez mais presente na saúde. Esta tese tem como objetivo analisar o conhecimento de pacientes e suas perspetivas, sobre vídeo-teleconsultas, bem como a possibilidade de estas substituírem consultas presenciais na saúde primária em Portugal. Reunindo informação da literatura e de uma amostra de pacientes portugueses, foi possível estudar vídeo-teleconsultas e outras formas de telemedicina. O nível de conhecimento dos pacientes sobre teleconsultas nesta amostra foi elevado (81,4%), influenciado pela educação e rendimento dos pacientes, enquanto vários estudos revelaram uma geral falta de conhecimento. Contudo, ambas identificaram a necessidade de campanhas publicitárias sobre o tema. outras formas de telemedicina tiveram níveis de conhecimento e uso superiores aos das vídeoteleconsultas, como em estudos prévios. Por fim, intervenções físicas, propósito das consultas, disponibilidade de equipamento tecnológico, e perceção dos pacientes quanto ao valor e benefícios das teleconsultas, influenciaram significativamente a sua opinião na possibilidade de substituir consultas presenciais por vídeo-teleconsultas. Estas conclusões demonstram o potencial da telemedicina no progresso dos cuidados de saúde. Sugerem também a necessidade de estudos relativamente às perspetivas dos pacientes e profissionais de saúde sobre a telemedicina, bem como a necessidade de campanhas estratégicas

Telehealth in primary health care settings within Australia and internationally

Access to appropriate health care services is often limited for people living in rural or remote areas, or for those with restricted mobility. One approach to minimising the inequality in access for those located at a distance from health care services is through telehealth service delivery. This review examined the evidence on telehealth models in Australia and elsewhere, with a specific focus on synchronous, real-time video consultations, where patients and health care providers were present simultaneously

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An outline on the global insights of implementation and challenges in primary healthcare telemedicine

Background: The utilization of telephone consultation (TC) has seen a significant increase of up to 86% since the start of the COVID-19 pandemic. In order to bridge the existing knowledge gap by examining the usage and efficacy of telephone or virtual consultations in a clinical setting during the COVID-19 lockdown, the objective of the current review is to gain a comprehensive understanding of the advantages and limitations of TC in the light of physicians and familial perspectives to enlighten future healthcare planning and decision-making. Methods: The data utilized in this research spanning the period of COVID-19 and other studies related to TC that occurred before the onset of the pandemic were gathered from a variety of reputable sources, such as Pubmed, Pubmed Central, Google Scholar, Research Gate, and Science Direct with the pre-established eligibility criteria and relevant keywords. Results: Studies revealed that the incorporation of teleconsultation has demonstrated numerous benefits for patients, including effective handling of data, fair accessibility, and adherence to standardized care protocols. Nonetheless, the implementation of TC also presents obstacles such as insufficiently trained staff, technical hurdles like connectivity issues and unreliable internet connections, and the possibility of erroneous diagnoses. Conclusions: During the COVID-19 phase, TC has proven effective with fewer limitations that can be minimized by training the healthcare staff and overcoming technical issues