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Gilbert A1, Jaggi A1, Jones J2, May C3
1Royal National Orthopaedic Hospital, Therapies Department, Stanmore, United Kingdom, 2University of Southampton, Faculty of Health Sciences, Southampton, United Kingdom, 3London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, London, United Kingdom
Background: Physiotherapy consultations in an orthopaedic setting often require visualisation and a 'hands on' approach. There has been an increasing number of research studies exploring the effectiveness and acceptability of telephone and videoconferencing consultations within orthopaedics. Much of the drive behind this change has been to improve access to care and to link the clinic to the home environment. Many studies report positive findings, yet translation and uptake into clinical practice remains low. The introduction of communication technology consultations requires a shift in patient workload, which may impact on patient experience of accessing healthcare and managing their condition. Whilst some studies have focussed on patient acceptability of communication technology consultations, few have focussed specifically on the altered workload of being a patient with these consultations.
Purpose: The purpose of this research is to systematically review qualitative papers reporting communication technology consultations (phone and videoconference) in orthopaedics. Attention will be focussed towards the effect of communication technology on the workload of being a patient.
Methods: The protocol for the systematic review was registered and is available to view on the PROSPERO database (CRD42018100896). MEDLINE, AMED, CINAHL, PsychINFO, SCOPUS databases were independently searched, utilising the search strategy, by two researchers to identify qualitative papers reporting communication technology use in an orthopaedics setting. Data from Introduction, Results and Discussion sections were extracted and an attribution of statements formulated. All statements were thematically analysed into families of themes surrounding patient workload.
Results: The search identified 1542 papers that were included for review and 8 full texts met the inclusion criteria and were included for analysis. Two studies reported telephone consultations and 6 reported real time videoconferencing consultations. Six families of themes were identified from the meta-synthesis:
1) Skills - what were needed, how they were gained, how they were enacted in practice.
2) Clinical Interactions - the impact of technology consultations on clinical interactions.
3) Environment - the location and resources required to engage with clinical rehabilitation.
4) Processes - how technology consultations affect routine clinical practice.
5) Impact on Patient - how technology consultations influence the experience of living with illness and engagement with clinical care.
6) Preferences - the potential patients see for technology as an alternative to routine face to face care.
Conclusion(s): Literature on the use of communication technologies in healthcare, such as videoconferencing and telephone consultations, is growing in orthopaedics. Qualitative papers highlight the benefits and challenges of communication technology consultations. This review synthesises the change in workload patient's face when using these technologies. These altered demands of communication technology consultations affect patient's experience of accessing healthcare. Consideration of these factors and tailored individualised support for patients may enhance patient experience and increase suitability of communication technology consultations for orthopaedic patients.
Implications: The use of communication technology changes the work of being a patient. The appraisal of individual patient circumstances and consideration of workload is recommended to determine suitability of communication technology based consultations in an orthopaedics setting.
Keywords: Communication technology, orthopaedics, patient workload
Funding acknowledgements: This research was funded by the HEE/ NIHR ICA Programme Clinical Doctoral Research Fellowship (ICA-CDRF-2017-03-025) awarded to Anthony Gilbert.
Purpose: The purpose of this research is to systematically review qualitative papers reporting communication technology consultations (phone and videoconference) in orthopaedics. Attention will be focussed towards the effect of communication technology on the workload of being a patient.
Methods: The protocol for the systematic review was registered and is available to view on the PROSPERO database (CRD42018100896). MEDLINE, AMED, CINAHL, PsychINFO, SCOPUS databases were independently searched, utilising the search strategy, by two researchers to identify qualitative papers reporting communication technology use in an orthopaedics setting. Data from Introduction, Results and Discussion sections were extracted and an attribution of statements formulated. All statements were thematically analysed into families of themes surrounding patient workload.
Results: The search identified 1542 papers that were included for review and 8 full texts met the inclusion criteria and were included for analysis. Two studies reported telephone consultations and 6 reported real time videoconferencing consultations. Six families of themes were identified from the meta-synthesis:
1) Skills - what were needed, how they were gained, how they were enacted in practice.
2) Clinical Interactions - the impact of technology consultations on clinical interactions.
3) Environment - the location and resources required to engage with clinical rehabilitation.
4) Processes - how technology consultations affect routine clinical practice.
5) Impact on Patient - how technology consultations influence the experience of living with illness and engagement with clinical care.
6) Preferences - the potential patients see for technology as an alternative to routine face to face care.
Conclusion(s): Literature on the use of communication technologies in healthcare, such as videoconferencing and telephone consultations, is growing in orthopaedics. Qualitative papers highlight the benefits and challenges of communication technology consultations. This review synthesises the change in workload patient's face when using these technologies. These altered demands of communication technology consultations affect patient's experience of accessing healthcare. Consideration of these factors and tailored individualised support for patients may enhance patient experience and increase suitability of communication technology consultations for orthopaedic patients.
Implications: The use of communication technology changes the work of being a patient. The appraisal of individual patient circumstances and consideration of workload is recommended to determine suitability of communication technology based consultations in an orthopaedics setting.
Keywords: Communication technology, orthopaedics, patient workload
Funding acknowledgements: This research was funded by the HEE/ NIHR ICA Programme Clinical Doctoral Research Fellowship (ICA-CDRF-2017-03-025) awarded to Anthony Gilbert.
Topic: Orthopaedics; Service delivery/emerging roles
Ethics approval required: No
Institution: Royal National Orthopaedic Hospital
Ethics committee: Research and Innovation Centre Project Evaluation Panel
Reason not required: This is secondary research. The protocol of the review was registered on PROSPERO.
All authors, affiliations and abstracts have been published as submitted.
