De Guzman Keshia R, Snoswell Centaine L, Giles Chantelle M, Smith Anthony C, Haydon Helen M
Centre for Online Health, The University of Queensland, Brisbane, Australia
Centre for Health Services Research, The University of Queensland, Brisbane, Australia.
BJGP Open. 2022 Mar 22;6(1). doi: 10.3399/BJGPO.2021.0182. Print 2022 Mar.
Primary care providers have been rapidly transitioning from in-person to telehealth care during the 2019 coronavirus (COVID-19) pandemic. There is an opportunity for new research in a rapidly evolving area, where evidence for telehealth services in primary care in the Australian setting remains limited.
To explore general practitioner (GP) perceptions on providing telehealth (telephone and video consultation) services in primary care in Australia.
DESIGN & SETTING: A qualitative study using semi-structured interviews to gain an understanding of GP perceptions on telehealth use in Australia.
GPs across Australia were purposively sampled. Semi-structured interviews were conducted, recorded, and transcribed verbatim for analysis. Transcripts were analysed using inductive thematic analysis to identify initial codes, which were then organised into themes.
Fourteen GPs were interviewed. Two major themes that described GP perceptions of telehealth were: (1) existence of business and financial pressures in general practice; and (2) providing quality of care in Australia. These two themes interacted with four minor themes (3) consumer-led care; (4) COVID-19 as a driver for telehealth reimbursement and adoption; (5) refining logistical processes; and (6) GP experiences shape telehealth use.
This study found that multiple considerations influenced GP choice of in-person, videoconference, or telephone consultation mode. For telehealth to be used routinely within primary care settings, evidence that supports the delivery of higher quality care to patients through telehealth and sustainable funding models will be required.
在2019冠状病毒病（COVID-19）大流行期间，基层医疗服务提供者迅速从面对面医疗转向远程医疗服务。在这个快速发展的领域有开展新研究的机会，而在澳大利亚背景下，基层医疗中远程医疗服务的证据仍然有限。
探讨澳大利亚全科医生（GP）对在基层医疗中提供远程医疗（电话和视频咨询）服务的看法。
一项定性研究，采用半结构化访谈以了解澳大利亚全科医生对远程医疗使用的看法。
对澳大利亚各地的全科医生进行目的抽样。进行半结构化访谈，录音并逐字转录以供分析。使用归纳主题分析法对转录本进行分析，以识别初始代码，然后将其组织成主题。
采访了14名全科医生。描述全科医生对远程医疗看法的两个主要主题是：（1）基层医疗中的业务和财务压力；（2）在澳大利亚提供医疗服务质量。这两个主题与四个次要主题相互作用：（3）以消费者为主导的医疗；（4）COVID-19作为远程医疗报销和采用的驱动因素；（5）完善后勤流程；（6）全科医生的经验影响远程医疗的使用。
本研究发现，多种因素影响全科医生选择面对面、视频会议或电话咨询模式。要在基层医疗环境中常规使用远程医疗，将需要有证据支持通过远程医疗为患者提供更高质量的医疗服务以及可持续的资助模式。
