Chan Simon, Khandaker Tasneem, Li Yifu, Jackson Tim M, Rahimi-Ardabili Hania, Lau Annie Ys
Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
BJGP Open. 2025 Apr 24;9(1). doi: 10.3399/BJGPO.2024.0030. Print 2025 Apr.
The usage of telehealth in general practice has risen substantially since the COVID-19 pandemic. Over this time frame, telehealth has provided care for all patient demographics, including the paediatric population (aged ≤18 years). However, the translatability of telehealth (that is, whether in-person tasks can be supported remotely via telehealth) rarely considers the paediatric population or their carers.
To examine the degree of translatability to telehealth for in-person GP consultations on paediatric patients with consideration of the carers' roles.
DESIGN & SETTING: This study screened 281 videos of in-person GP consultations set within UK general practices, and 20 of them were eligible for analysis.
A secondary analysis of in-person GP consultations was undertaken to examine tasks, physical artefacts, examinations, and the interaction between carer, patient, and GP. A novel scoring method revolving around two key metrics, taking into consideration the carer, was designed to analyse whether the tasks performed can be supported via telehealth.
Analysis of 20 eligible consultations revealed 13 distinct physical examinations, 19 physical artefacts, and 17 clinical tasks. Of these 17 clinical tasks, 41% were deemed 'easily translatable to telehealth,' 29% 'moderately translatable with patient-provided equipment', 12% 'potentially translatable', and 18% 'currently untranslatable'. The average telehealth translatability score was 6.1/10, which suggests possible challenges with telehealth support. Regarding carer involvement, 90% of consultations involved collecting patient history, 70% placation of child, and 40% had physical support during examinations.
Tasks performed during paediatric in-person GP consultations may not be easily translatable to telehealth and caution should be exercised when considering their translatability to telehealth.
自新冠疫情以来，远程医疗在全科医疗中的使用大幅增加。在此期间，远程医疗为所有患者群体提供了护理，包括儿科人群（年龄≤18岁）。然而，远程医疗的可转换性（即面对面的任务能否通过远程医疗得到远程支持）很少考虑儿科人群或其照顾者。
考虑照顾者的角色，研究针对儿科患者的面对面全科医生会诊向远程医疗转换的程度。
本研究筛选了英国全科医疗中281段面对面全科医生会诊的视频，其中20段符合分析条件。
对面对面全科医生会诊进行二次分析，以检查任务、实物、检查以及照顾者、患者和全科医生之间的互动。设计了一种围绕两个关键指标的新颖评分方法，同时考虑照顾者，以分析所执行的任务是否可以通过远程医疗得到支持。
对20次符合条件的会诊分析显示，有13种不同的体格检查、19种实物和17项临床任务。在这17项临床任务中，41%被认为“易于转换为远程医疗”，29%“在患者提供设备的情况下可适度转换”，12%“可能可转换”，18%“目前不可转换”。远程医疗可转换性的平均评分为6.1/10，这表明在远程医疗支持方面可能存在挑战。关于照顾者的参与，90%的会诊涉及收集患者病史，70%涉及安抚儿童，40%在检查期间提供身体支持。
儿科面对面全科医生会诊期间执行的任务可能不容易转换为远程医疗，在考虑其向远程医疗的可转换性时应谨慎行事。
