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.

Download Full-text

The qualitative experience of telehealth access and clinical encounters in Australian health care during COVID-19: Implications for policy

10.21203/rs.3.rs-279664/v1 ◽

2021 ◽

Author(s):

Jennifer White ◽

Julie Byles ◽

Tom Walley

Keyword(s):

Health Care ◽

General Practitioners ◽

Health Care Services ◽

Care Delivery ◽

Tertiary Hospital ◽

Policy Implications ◽

Australian Health ◽

Care Services ◽

Adaptive Models ◽

Hunter Region

Abstract BackgroundAdaptive models of health care delivery, such as telehealth consultations, have rapidly been adopted to ensure ongoing delivery of essential health care services during COVID-19. However there remain gaps in our understanding of how clinicians have adapted to telehealth. This study aims to explore the telehealth experiences or specialists, based at tertiary hospital in the Hunter Region, and General Practitioners (GP) including barriers, enables and opportunities. Methods In-depth interviews explored the telehealth experiences of specialists, based at tertiary hospital in the Hunter Region of Australia, and General Practitioners (GP) including barriers, enablers and opportunities. Data were analyzed using an inductive thematic approach with constant comparison.ResultsIndividual interviews were conducted with 10 specialist and 5 GPs. Key themes were identified: (1) Transition to telehealth has been valuable but challenging; (2) Persisting telehealth process barriers need addressing; (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 forwardDiscussionWhile there is a need to rationalise and optimise health access during a pandemic, we suggest that more needs to be done improve telehealth going forward. Our results have important policy implications. Specifically, there is a specific need to effectively train clinicians to competently utilize and be confident using this telehealth and to educate patients on necessary skills and etiquette.

Download Full-text

Active and Healthy Aging

Health Literacy ◽

10.4018/978-1-5225-1928-7.ch018 ◽

2017 ◽

pp. 369-391

Author(s):

Emine Özmete

Keyword(s):

Qualitative Research ◽

Delivery System ◽

Healthy Aging ◽

Healthcare Delivery ◽

Healthcare Services ◽

Capital City ◽

Elderly Persons ◽

Healthcare Delivery System ◽

Care And Support ◽

Depth Interviews

This study aims to investigate the difficulties experienced by elderly persons in accessing healthcare services and their satisfaction with issues as regards the healthcare system. In this study, qualitative research was carried out to assess the difficulties regarding the healthcare delivery system and satisfaction with the healthcare services. This qualitative research was performed through in-depth interviews with 6 men and 4 women aged 65+ years, in Ankara, the capital city of Turkey. It was discovered that elderly persons required the support of others to access a doctor, a health institution or hospital and the care and support of others for the regular intake of their drugs with increasing age. They were satisfied with the current family physician program. The most significant challenges experienced by elderly persons regarding the healthcare delivery system included crowded hospitals, difficulty walking, the unavailability of wheel chairs, and inadequate assistance from support staff.

Download Full-text

Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians

ESMO Open ◽

10.1136/esmoopen-2020-001090 ◽

2020 ◽

Vol 5 (6) ◽

pp. e001090

Author(s):

Grace Chazan ◽

Fanny Franchini ◽

Marliese Alexander ◽

Susana Banerjee ◽

Linda Mileshkin ◽

...

Keyword(s):

Service Delivery ◽

Patient Survival ◽

Objective Assessment ◽

Healthcare Delivery ◽

Policy Implications ◽

Clinical Practices ◽

Cancer Service ◽

Face To Face ◽

Community Transmission ◽

Negative Impacts

ObjectivesTo report clinician-perceived changes to cancer service delivery in response to COVID-19.DesignMultidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology.SettingBetween May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (n=196; 39%) with 1846 COVID-19 cases per million people, Australia (AUS)/New Zealand (NZ) (n=188; 38%) with 267/236 per million and Asia (n=75; 15%) with 121 per million at time of survey distribution.ParticipantsMedical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%).ResultsEighty-nine per cent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (n=142; 93% vs n=225; 86%, p=0.03) but regardless of community transmission levels (p=0.26). More European clinicians (n=111; 66.1%) had treated patients diagnosed with COVID-19 compared with Asia (n=20; 27.8%) and AUS/NZ (n=8; 4.8%), p<0.001. Many clinicians (n=307; 71.4%) reported concerns that reduced access to standard treatments during the pandemic would negatively impact patient survival. The reported proportion of consultations using telehealth increased by 7.7-fold, with 25.1% (n=108) of clinicians concerned that patient survival would be worse due to this increase. Clinicians reviewed a median of 10 fewer outpatients/week (including non-face to face) compared with prior to the pandemic, translating to 5010 fewer specialist oncology visits per week among the surveyed group. Mental health was negatively impacted for 52.6% (n=190) of clinicians.ConclusionClinicians reported widespread changes to oncology services, in regions of both high and low COVID-19 case numbers. Clinician concerns of potential negative impacts on patient outcomes warrant objective assessment, with system and policy implications for healthcare delivery at large.

Download Full-text

Active and Healthy Aging

Handbook of Research on Healthcare Administration and Management - Advances in Healthcare Information Systems and Administration ◽

10.4018/978-1-5225-0920-2.ch022 ◽

2017 ◽

pp. 384-406

Author(s):

Emine Özmete

Keyword(s):

Qualitative Research ◽

Delivery System ◽

Healthy Aging ◽

Healthcare Delivery ◽

Healthcare Services ◽

Capital City ◽

Elderly Persons ◽

Healthcare Delivery System ◽

Care And Support ◽

Depth Interviews

Download Full-text

Institutional Analysis on Public-Private Partnerships in Sub-Saharan Africa’s Healthcare Systems and Policy Implications

10.51240/jibe.2020.2.3 ◽

2020 ◽

Vol 21 (2) ◽

pp. 67-96

Author(s):

Aladino José Manhiça

Keyword(s):

Developing Countries ◽

Private Sector ◽

Healthcare Delivery ◽

Healthcare Services ◽

Healthcare Systems ◽

Policy Implications ◽

World Health ◽

Institutional Setting ◽

The World ◽

Sub Saharan

Many people in developing countries are exposed to a greater risk to access essential healthcare services. The World Health Organization (WHO) and the World Bank estimate that more than half of the world’s 7.3 billion people do not obtain all of the essential needed healthcare services. To minimize this burden, Sub-Saharan African (SSA) countries have embraced the private sector through public-private partnership (PPP) as a mean to achieve Universal Healthcare Coverage (UHC). A number of publications have raised the importance of institutional setting for effectiveness of the PPP in the region. However, very few have outstretched persuasive requirements to examine the effectiveness of PPP considering SSA’s socio-economic context. This paper examines the applicable environment for PPP in healthcare systems in SSA and has observed a trend of decrease in resources allocated by developing countries to healthcare services; increasing participation of private sector in healthcare delivery; the effectiveness of PPP is determined, but not limited to, by the quality of institutions and additional variables such as cultural characteristics, community attributes, and physical or material conditions.

Download Full-text

Policy Review: Dubai Health Authority’s COVID-19 Rapid Response

Medical & Clinical Research ◽

10.33140/mcr.05.001 ◽

2020 ◽

Vol 5 (Special) ◽

Keyword(s):

United Arab Emirates ◽

Well Being ◽

Healthcare Services ◽

Rapid Response ◽

Policy Implications ◽

World Health ◽

Healthcare Sector ◽

Services Delivery ◽

First Case ◽

The World

Dubai Health Authority (DHA) is the entity regulating the healthcare sector in the Emirate of Dubai, ensuring high quality and safe healthcare services delivery to the population. The World Health Organization (WHO) declared COVID-19 a pandemic on the 11th of March 2020, indicating to the world that further infection spread is very likely, and alerting countries that they should be ready for possible widespread community transmission. The first case of COVID-19 in the United Arab Emirates was confirmed on 29th of January 2020; since then, the number of cases has continued to grow exponentially. As of 8th of July 2020 (end of the day), 53,045 cases of coronavirus have been confirmed with a death toll of 327 cases. The UAE has conducted over 3,720,000 COVID-19 tests among UAE citizens and residents over the past four months, in line with the government’s plans to strengthen virus screening to contain the spread of COVID-19. There were vital UAE policies, laws, regulations, and decrees that have been announced for immediate implementation to limit the spread of COVID- 19, to prevent panic and to ensure the overall food, nutrition, and well-being are provided. The UAE is amongst the World’s Top 10 for COVID-19 Treatment Efficiency and in the World’s Top 20 for the implementation of COVID-19 Safety measures. The UAE’s mission is to work towards resuming life after COVID-19 and enter into the recovery phases. This policy research paper will discuss the Dubai Health Authority’s rapid response initiatives towards combating the control and spread of COVID-19 and future policy implications and recommendations. The underlying factors and policy options will be discussed in terms of governance, finance, and delivery.

Download Full-text

Young Adults’ Contextualization of Environmental and Sustainability Issues: A Critical Issue for Environmental Education Intervention

Journal of Education in Black Sea Region ◽

10.31578/jebs.v3i1.116 ◽

2018 ◽

Vol 3 (1) ◽

Author(s):

Anthony KOLA-OLUSANYA

Keyword(s):

Young Adults ◽

Environmental Education ◽

Lived Experiences ◽

Critical Issue ◽

Decision Makers ◽

Research Approach ◽

Face To Face ◽

Research Questions ◽

Depth Interviews ◽

Insight Into

As soon as decision makers are expected to make differences towards sustainable future, young adults’ ability to make informed and sound decisions is considered essential towards securing our planet. This study provides an insight into young adults’ knowledge of key environment and sustainability issues. To answer the key research questions, data were obtained using a qualitative phenomenographic research approach and collected through 18 face-to-face in-depth interviews with research participants. The findings of this study suggest that young adults lived experiences that play a huge role in their level of awareness of topical environmental and sustainability issues critical to humanity’s future on earth.

Download Full-text

Toward establishing telepsychology guideline: Turning the challenges of COVID-19 into opportunity (Preprint)

10.2196/preprints.24287 ◽

2020 ◽

Author(s):

Mohammed M. J. Alqahtani

Keyword(s):

Mental Health ◽

Health Care Services ◽

Task Force ◽

Healthcare Services ◽

Psychological Services ◽

Face To Face ◽

Care Services ◽

Governance Model ◽

Provision Of Services ◽

Temporary Response

BACKGROUND The COVID-19 pandemic has obstructed the classical practices of psychological assessment and intervention via face-to-face interaction. Patients and all health professionals have been forced to isolate and become innovative to continue receiving and providing exceptional healthcare services while minimizing the risk of exposure to, or transmission of, COVID-19. OBJECTIVE This document is proposed initially as a guide to the extraordinary implementation of telepsychology in the context of the COVID-19 pandemic and to extend its implementation to use fundamentally as the main guideline for telepsychology services in Saudi Arabia and other Arabic communities. METHODS A professional task force representing different areas of professional psychology reviewed, summarized, and documented methods, policies, procedures, and other resources to ensure that the recommendations and evidence reviews were valid and consistent with best practices. RESULTS The practice of telepsychology involves the consideration of legal and professional requirements. This paper provides a guideline and recommendations for procedural changes that are necessary to address psychological services as we transition to telepsychology, as well as elucidates and demonstrates practical telepsychology frameworks, procedures, and proper recommendations for the provision of services during COVID-19. It adds a focused examination and discussion related to factors that could influence the telemedicine guideline, such as culture, religion, legal matters, and how clinical psychologists could expand their telepsychology practice during COVID-19 and after, seeking to produce broadly applicable guidelines for the practice of telepsychology. Professional steps in practical telemedicine were illustrated in tables and examples. CONCLUSIONS Telepsychology is not a luxury or a temporary response. Rather, it should be considered part of a proactive governance model to secure a continuity of mental health care services. Arabic communities could benefit from this guideline to telepsychology as an essential protocol for providing mental health services during and after the COVID-19 pandemic.

Download Full-text

A City Too Busy to Remember? Aging, Structural Violence, and the Politics of Forgetting in Atlanta’s Gentrification

Innovation in Aging ◽

10.1093/geroni/igaa057.1266 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 393-393

Author(s):

John Pothen ◽

Keland Yip ◽

Ellen Idler

Keyword(s):

Older Adults ◽

Structural Violence ◽

Aging In Place ◽

Healthcare Services ◽

The Past ◽

Critical Theories ◽

Property Owners ◽

Ongoing Development ◽

The City ◽

Depth Interviews

Abstract Can forgotten stories from the past inform a city’s future? As older adults continue to live longer and comprise more of the population than ever before, the suitability of gentrifying spaces for older adults aging in place is increasingly important. Critical theories of gentrification argue that remembering the experiences of older adults in this context - experiences of suffering, resilience, and structural violence - is essential to promote changes in support aging in place. In this study, we tell a story of individual experiences, structural violence, and aging in the ongoing gentrification of one neighborhood in southwest Atlanta. We construct this narrative through a qualitative analysis of 1,500 local newspaper articles from 1950 to the present day and 10 in-depth interviews with ex-residents of the neighborhood aged 65-87. Drawing on the theory of planetary rent gaps, we frame gentrification as a class struggle between property-owners and working class residents. We highlight the city government’s role as a facilitator for property-owners through projects including the Model City initiative, preparation for the 1996 Olympics, and ongoing development surrounding the Atlanta BeltLine. We show how these projects have affected the prospects for aging in place in general and, specifically, by affecting access to healthcare services. We share this story in an effort to combat the politics of forgetting and to inform a richer, more inclusive, and more equitable future for gentrifying spaces.

Download Full-text

Mothers’ Experiences and Perceptions of Facility-based Delivery Care in Rural Ethiopia

Health Services Insights ◽

10.1177/11786329211017684 ◽

2021 ◽

Vol 14 ◽

pp. 117863292110176

Author(s):

Elin Mordal ◽

Ingrid Hanssen ◽

Andargachew Kassa ◽

Solfrid Vatne

Keyword(s):

Family Involvement ◽

Healthcare Facility ◽

Healthcare Services ◽

Skilled Birth Attendants ◽

Adequate Treatment ◽

Rural Ethiopia ◽

Birth Attendants ◽

Southern District ◽

Depth Interviews ◽

Respectful Care

In Ethiopia, delivery wards are a part of primary healthcare services. However, although the maternal mortality rate is very high, approximately 50% of mothers use skilled birth attendants. This study focused on how women in a rural southern district of Ethiopia experience maternity care offered at the local delivery wards. In this qualitative, exploratory study, 19 women who had given birth in a healthcare facility were interviewed in 2019. Individual in-depth interviews were supplemented with observations conducted at 2 different delivery wards in the same district in 2020. Two main themes emerged from the thematic content analysis: increased awareness and safety were the primary reasons for giving birth at a healthcare facility, and traditions and norms affected women’s birth experiences in public maternity wards. The main shortcomings were a shortage of medicine, ambulance not arriving in time, and lack of care at night. For some women, being assisted by a male midwife could be challenging, and the inability to afford necessary medicine made adequate treatment inaccessible. Providing continuous information gave the women a certain feeling of control. Strong family involvement indicated that collectivistic expectations were key to rural delivery wards. The healthcare system must be structured to meet women’s needs. Moreover, managers and midwives should ensure that birthing women receive high-quality, safe, timely, and respectful care.

Download Full-text