Emma E Thomas1,2, Monica L Taylor1,2, Elizabeth C Ward3, Rita Hwang1,4, Renee Cook1,2,3,4, Julie-Anne Ross4, Clare Webb5, Michael Harris6, Carina Hartley7, Phillip Carswell8, Clare L Burns9, Liam J Caffery1,2. 1. Centre for Online Health, 1974The University of Queensland, Brisbane, Australia. 2. Centre for Health Services Research, The 1974University of Queensland, Brisbane, Australia. 3. Centre for Functioning and Health Research, Metro South Health, and, School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane Australia. 4. Allied Health, Princess Alexandra Hospital, 157829Metro South Health, Brisbane, Australia. 5. Allied Health, Queen Elizabeth II Jubilee Hospital, 157829Metro South Health, Brisbane, Australia. 6. Allied Health, 157829Bayside Health Service, Metro South Health, Brisbane, Australia. 7. Allied Health, Logan Hospital, 157829Metro South Health, Brisbane, Australia. 8. Consumer Advisor, Princess Alexandra Hospital, 157829Metro South Health, Brisbane, Australia. 9. Speech Pathology Department, Royal Brisbane & Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia.
Abstract
INTRODUCTION: As COVID-19 restrictions reduce globally, services will determine what components of care will continue via telehealth. We aimed to determine the clinician, service, and system level factors that influence sustained use of telehealth and develop a framework to enhance sustained use where appropriate. METHODS: This study was conducted across 16 allied health departments over four health service facilities (Brisbane, Australia). It used a multi-method observational study design, involving telehealth service activity data from hospital administrative databases and qualitative interviews with allied health staff (n = 80). Data were integrated and analysed using Greenhalgh's Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework. RESULTS: Increased telehealth use during the peak COVID period reverted to in-person activity as restrictions eased. Telehealth is unlikely to be sustained without a clear strategy including determination of roles and responsibilities across the organisation. Clinician resistance due to forced adoption remains a key issue. The main motivator for clinicians to use telehealth was improved consumer-centred care. Benefits beyond this are needed to sustain telehealth and improvements are required to make the telehealth experience seamless for providers and recipients. Data were synthesised into a comprehensive framework that can be used as a blueprint for system-wide improvements and service enhancement or redesign. DISCUSSION: Sustainability of telehealth activity beyond the peak COVID period is unlikely without implementation strategies to address consumer, clinician, service, and system factors. The framework can inform how these strategies can be enacted. Whilst developed for allied health disciplines, it is likely applicable to other disciplines.
INTRODUCTION: As COVID-19 restrictions reduce globally, services will determine what components of care will continue via telehealth. We aimed to determine the clinician, service, and system level factors that influence sustained use of telehealth and develop a framework to enhance sustained use where appropriate. METHODS: This study was conducted across 16 allied health departments over four health service facilities (Brisbane, Australia). It used a multi-method observational study design, involving telehealth service activity data from hospital administrative databases and qualitative interviews with allied health staff (n = 80). Data were integrated and analysed using Greenhalgh's Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework. RESULTS: Increased telehealth use during the peak COVID period reverted to in-person activity as restrictions eased. Telehealth is unlikely to be sustained without a clear strategy including determination of roles and responsibilities across the organisation. Clinician resistance due to forced adoption remains a key issue. The main motivator for clinicians to use telehealth was improved consumer-centred care. Benefits beyond this are needed to sustain telehealth and improvements are required to make the telehealth experience seamless for providers and recipients. Data were synthesised into a comprehensive framework that can be used as a blueprint for system-wide improvements and service enhancement or redesign. DISCUSSION: Sustainability of telehealth activity beyond the peak COVID period is unlikely without implementation strategies to address consumer, clinician, service, and system factors. The framework can inform how these strategies can be enacted. Whilst developed for allied health disciplines, it is likely applicable to other disciplines.
Authors: Ashley C Mog; Megan Moldestad; Rachael Kenney; Lauren Stevenson; Marcie Lee; P Michael Ho; George G Sayre Journal: J Patient Exp Date: 2022-07-03