This work was to build on the phenomenological research undertaken previously and triangulate the results with lived experience via an autoethnographic account. The aim of this study was to understand the impact of digital innovation and technology infrastructure on the delivery of a physiotherapist-led spinal triage service.
This is an autoethnographic study. The philosophical underpinnings of the method are a critical realist ontology and a constructivist epistemology. The author spent three months observing and participating in a spinal triage clinic, keeping detailed observational records as structured diary entries and post-event reflections. The author is positioned as an experienced physiotherapist, a trainee advanced practitioner and a researcher in artificial intelligence for spinal disorders. The data was analysed using an inductive content analysis approach.
Three months of observations in diary format were transcribed and inductively analysed. Three main themes with sub-themes were identified.
Theme: IT infrastructure. Sub-themes: Fragmented applications, login processes and integration issues. Applications were fragmented with different login processes and lack of cross-talk. There were delays in clinic due to slow and cumbersome login processes experienced by clinicians when accessing applications. Delays and potential for errors in care were reflected in the difficulties due to lack of integration and cross-talk between different software applications.
Theme: Data Accessibility. Information about patient history or previous clinic appointments was not readily available leading to repetition with patients. There were challenges in accessing patient data efficiently during consultations, impacting clinician-patient interaction. This highlights the importance of seamless access to information for providing quality care.
Theme: Communication Challenges. Sub-themes: communication with other professionals and communication with patients. There were difficulties observed in coordinating with other healthcare professionals e.g. radiologists for discussing scan results. There were challenges in managing patient expectations due to medical templates used in appointment bookings and reminders sent to patients. This emphasised the need for physiotherapy-specific communication channels through internal and external IT channels.
The therapeutic alliance may be challenged in an environment where clinicians must focus their attention on slow and fragmented IT processes instead of the patient. Fitting a physiotherapy clinic into a medical template means patients’ expectations need to be managed, and clinicians need to adapt and find work-arounds.
Innovation in clinical delivery must be mirrored in customising IT infrastructure. The ethnographic approach is useful in highlighting issues which would not be uncovered by quantitative research for digital innovation.
Technology
Qualitative
