ABSTRACT
Delivering care through telehealth has been a subject of concern for the healthcare industry for a long time. Its use is debatable for many in the industry because of varying reasons. However, the COVID-19 pandemic caused an enormous growth in adopting telehealth to provide care to patients. This has proved to be of a substantial benefit for patients and healthcare providers as a result of which improving its use became an area of interest for many. This paper focuses on identifying and analyzing the barriers for the healthcare industry to incorporate virtual visits/consulting on an integral level, with a goal of delivering high quality of care. These barriers have been identified from different angles and have been grouped into six categories of people (patients and physicians), organization, tasks, tools and technology, internal environment, and external environment, which are the work systems of the Systems Engineering Initiative for Patient Safety (SEIPS) framework. Moreover, we have considered the interaction between those work systems. We have been able to access a survey of more than 2,850 patients and caregivers by Rare Patient Voice for the identification of more barriers and facilitators of implementing telehealth (virtual consulting specifically) or the confirmation of previously identified factors. Some physicians have also been consulted to verify our identified barriers and research findings. We have also provided recommendations to address some of those barriers. This analysis and the provided recommendations are an attempt to overcome the hindrances of virtual consulting and establish it at a more integral level. Copyright, American Society for Engineering Management, 2022.
ABSTRACT
Virtual consultations and telemedicine have been an emerging trend in modern medicine, which has seen acceleration in uptake across a wide range of specialties as a result of the COVID-19 pandemic. Following on from previous work by the authors in 2019 examining clinician and patient appetite for virtual consultations in maxillofacial surgery, we sought to evaluate whether there had been a change in attitudes as a result of the pandemic. A clinician survey of the consultants at a large teaching hospital and prospective data collection of virtual consultation outcomes was carried out from the inception of UK government lockdown measures to tackle the pandemic. From 151 consultations, 149 (98.7%) successfully established a working diagnosis and treatment plan and/or concluded an episode of patient care, without the need to convert to a face-to-face encounter between clinician and patient. The total number of consultations (virtual or otherwise) was significantly lower than the same time period the preceding year however (1,223 compared with 465 consultations). All consultants surveyed felt the pandemic had altered their opinion of virtual clinics and their place in maxillofacial surgery but cited a number of issues. Further work is required to understand the driving forces behind staff attitudes and the long-term adoption of telemedicine within the specialty as services return to some sense of normalcy.