Table 3.
Clinician perspectives of the barriers, enablers and perceived usefulness of the home telehealth program
Barriers | Enablers | Perceived usefulness |
---|---|---|
Technology factors |
|
|
Limited or inconvenient access to equipment |
Families who have access to required technology. Suggestion of having equipment in more convenient locations for clinicians, e.g. from their PC or mobile devices |
Having easily accessible equipment reduces the ‘hassle’ of participating in a video-consultation |
Burden of setting up families with equipment, usernames and passwords at a stressful time |
Families who are familiar with video communication and have access to the required technology |
Simple to set up if family familiar with technology and a consultation can occur rapidly without difficulty |
Comparative ease of telephone use |
Clear benefit of using video, e.g. to observe a wound, or breathing pattern |
Provides visual information not available in a telephone call |
Discomfort with using technology |
Previous experience or a willingness to participate in video-consultations |
|
Privacy concerns- unable to control home environment, concerns with using the Internet |
Having sound proof studios where video-consultations can be undertaken without interruption within the hospital |
Ability to include multiple members of the health care team means information can be shared during one conversation |
Individual factors |
|
|
Personal preference for face-to-face interaction, video-consultations not a suitable substitute |
Receptive families who request ongoing home video-consultations. Supportive local clinicians who are willing to participate |
Presence of community-based clinicians enables ensures human presence available at family end |
Cultural, linguistic, socio-economic diversities may make communicating via Internet-video difficult |
Immigrant families often more familiar with using Internet-video to communicate with family oversees and may be more receptive to receiving health services via home video-consultation |
Ability to include multiple family members in a consultation, e.g. Indigenous Australians often leave important decision making to the tribal elder not the parents or caregiver of the child |
Service factors |
|
|
Establishing routines |
Having a coordinator to schedule video-consultations and manage administrative issues |
Efficient process of communicating with multiple stakeholders |
Strengthened community support: reduced need for video-consultations with PPCS |
Partnering with COH ensures clinicians can remain focussed on clinical care not managing telehealth |
Facilitates provision of peer-peer support and education |
Lack of time; focus on hospital inpatients |
Suggestion that having routine clinics for home video-consultation may be easier to manage than ad hoc |
Ability to provide a consultation across vast distances which would otherwise require many hours of travel time |
Staff shortages |