Telehealth goes under the spotlight

Telehealth has become a valuable tool in delivering health care.
Image: Shutterstock

by Anne Crawford

Before COVID, telehealth was gaining traction as a new way of delivering health care; in the midst of the pandemic, it became a necessity. A Monash University study set out to find what healthcare providers thought of the implementation of the model of care given its rapid acceleration in their field.

The researchers conducted a 12-month service-wide survey of the attitudes to telehealth held by clinicians, managers and administrative staff in Peninsula Health in June-July 2021. 

The study, recently published in ‘Internal Medicine’, was carried out by first author Alfred Health and Peninsula Health researcher/physiotherapist Michelle Shannon. Senior author was Associate Professor Michele Callisaya, Peninsula Clinical School, Central Clinical School.

“There has a been a number of studies into patient attitudes, particularly in Queensland because they have a remote or rural working model, but we wanted to focus on staff,” Michelle said. “It’s all well and good to think about the patient perspective but if the people who work in the service aren’t comfortable using it then it’s not very useful,” she said.

Of 134 respondents, just over a fifth used the Victorian Government’s healthdirect video call service.

Many staff may have felt that they had no choice using contactless health care because they were in a pandemic, Michelle said. “It’s a massive paradigm shift in people’s thinking about how they deliver and access health care,” she said.

“The most frequently ranked responses for the clinicians, when asked about how suitable and acceptable telehealth was to them, were that telehealth was both important (78%) and safe (79%),” Michelle said. 

“The clinicians saw the value in using it, observed others like their social peers and those in their workplace using it, and had the support of their managers to use it. They valued being able to complete the training, connecting with IT and the timeliness of that,” she said.

Managers similarly identified that telehealth was important and commented that there was encouragement to use it.

The downside was that respondents felt that in certain situations you could not replace face-to-face care, for example, examining a wound, assessing the spasticity of a leg or, in the case of speech pathologists, assessing swallowing in a young child. Social workers were concerned that that those helping older or vulnerable people to set up the technology in their home, stayed and listened-in on the conversation.  

Some staff and managers were cautious about delivering telehealth to older or vulnerable people, or to people who had limited access to technology, but said it benefited people with children because they could fit it in their daily lives. Reliable internet connectivity, using the right equipment and having a private area to conduct the appointment proved barriers. The technology worked particularly well in group classes, the study found. 

COVID aside, while a proportion of respondents would revert to the usual face-to-face form, the study found that 43 per cent of clinicians planned to continue using telehealth, and a further 43 per cent planned to expand its use. “They saw the value of a hybrid model,” Michelle said. Of the managers surveyed, 39 per cent said they would continue to use it and 22 per cent would expand its use.

“It’s been a concentrated period of time in which staff have developed the behaviours. My feeling is there’s been time to embed it in their daily lives and when something is embedded it becomes normalised,” she said.

Michelle hopes the study’s findings will help give healthcare providers and the Department of Health and Human Services information about the best ways to implement telehealth in specific health settings.

Reference

Shannon MM, Callum SM, Callisaya ML. Uncovering healthcare staff attitudes to the rapid deployment of telehealth in Victoria, 2020-2021: a 12-month telehealth experience. Intern Med J. 2022 Mar 15. doi: 10.1111/imj.15750. Epub ahead of print. PMID: 35289486. https://pubmed.ncbi.nlm.nih.gov/35289486/