Informatics

The Virtual Care Consultation—A Challenge or Opportunity for the Healthcare Professional and Patient?

CITATION: Georgsson, M. (2021). The virtual care consultation – a challenge or opportunity for the health care professional and patient? Online Journal of Nursing Informatics (OJNI), 25(1).  https://www.himss.org/resources/online-journal-nursing-informatics

The virtual care consultation using video technology has exploded during the COVID-19 pandemic and is now used more than ever in the day to day operations at health care facilities the world over (Webster, 2020). More and more resources are also placed on solidifying its use. But what makes these consultations different from the ordinary face-to-face consultation and how are they experienced by the health care professional and patient?

When looking at studies that have investigated virtual care consultation usage, these have come to the conclusion that there are some characteristics that are present that differ compared to the regular face-to-face consultation with the patient (Greenhalgh et al., 2018). In a study by Greenhalgh et al. (2018) the experiences compared to the conventional consultation centered on that they were somewhat shorter, and also encouraged patients to be more verbal in the interaction. Another rather defining characteristic was that the more implicit parts in a face-to-face encounter had to be made more explicit by both parties when utilizing this technology (Greenhalgh et al., 2018). Other important findings were, according to the authors, that the virtual consultations appeared to have a more favorable outcome when the health care professional and patient already knew one another and had established a mutual trust (Greenhalgh et al., 2018).

When considering the health care professional interaction in this study, Greenhalgh et al., described that some used Skype in an adaptive manner to respond to patients asking for ad hoc consultations and this was interpreted by them as appearing to also strengthen self-management support (2018). But, it was also the case that some health care professionals felt that virtual video consultations were generally rather impractical, as well as technically challenging or not advisable from a clinical perspective (Greenhalgh et al., 2018). The conclusion that could be drawn based on this study was that some of the health care professionals and patients were somewhat satisfied with usage of the virtual healthcare consultation which was especially true when they experienced that all of their technical, practical and clinical preconditions were considered to be met (Greenhalgh et al., 2018). This also led to the video consultation to be considered in a positive manner and as safe. In the authors’ view it most likely is the case here as with any other technological innovation that there are some that are willing and wanting to adopt this way of working, finding it beneficial in their practice, while there are others that need more incentives and support to consider it (Greenhalgh et al., 2018).

Other studies comprising systematic reviews that investigated nursing professionals’ experiences when it comes to both the facilitating aspects as well as the barriers to this use of technology (Koivunen & Saranto, 2018) showed that it was their skills and attitudes, as well as their work and operations, and organizational factors that all contributed to both facilitators and barriers; and it was particularly when it came to nurse’s work and operations where the highest number of facilitators and barriers was found (Koivunen & Saranto, 2018). In addition, findings showed that nurses’ skills and attitudes could be considered as preventing factors in the implementation; which was similar to the Greenhalgh et al. study. Patients were also found to generally support the adoption (Koivunen & Saranto, 2018). The authors pointed out that a change from the traditional face-to-face nursing, calls for further discussions among professionals on how to accept this change and how it is to be implemented into practice in the best way possible. They also called for further development of the technological tools that are used (Koivunen & Saranto, 2018). Another aspect that the authors raised was the importance of the organization, and that organizations have to make sure that health care professionals have enough resources and support when it comes to the implementation of these technologies. This will be necessary if the goal is to incorporate and sustain these new digital practices in the coming years (Robbins et al., 2020).

Online Journal of Nursing Informatics

Powered by the HIMSS Foundation and the HIMSS Nursing Informatics Community, the Online Journal of Nursing Informatics is a free, international, peer reviewed publication that is published three times a year and supports all functional areas of nursing informatics.

Read the Latest Edition

Greenhalgh, T., Shaw, S., Wherton, J., Vijayaraghavan, S., Morris, J., Bhattacharya, S., Hanson, P., Campbell-Richards, D., Ramoutar, S., Collard, A., & Hodkinson, I. (2018). Real-world implementation of video outpatient consultations at macro, meso, and micro levels: Mixed-method study. Journal of Medical Internet Research, 20(4), e150. https://doi.org/10.2196/jmir.9897

Koivunen, M. & Saranto, K. (2018). Nursing professionals’ experiences of the facilitators and barriers to the use of telehealth applications: A systematic review of qualitative studies. Scandinavian Journal of Caring Science, 32(1), 24–44. https://doi.org/10.1111/scs.12445

Robbins, T., Hudson, S., Pijush, R., Sankar, S., Patel, K., Randeva, H., & Arvanitis, T. N. (2020). COVID-19: A new digital dawn? Digital Health, 6, 1-3. https://doi.org/10.1177/2055207620920083

Webster, P. (2020). Virtual health care in the era of COVID-19. The Lancet, 395(10231), 1180-1181. https://doi.org/10.1016/S0140-6736(20)30818-7

Author Bio:
Mattias Georgsson, PhD, MSc, MPH, RN has a Master of Science degree in Nursing and Master degrees in Health Informatics and Information Technology. He completed his PhD in Applied Health Technology in the Spring of 2018. He holds a position as Assistant Professor in Nursing with a specialization in Health Informatics at Jonkoping University, Sweden.