S.K.ONG1, H.L.KOH1, P.S.S.LEE1, E.A.L.CHEW1, S.Y.TAN1, Y.Y.DING2, E.S.LEE1
NHG Polyclinics1, Tan Tock Seng Hospital2
The COVID-19 pandemic opened up prospects for video consultations (VCs) in the primary care setting in Singapore especially with the enforcement of social distancing. The objective of our study was to explore the perspectives of physicians regarding the adoption and sustainability of VCs for older adults with multimorbidity.
Individual in-depth interviews were conducted over Zoom with 15 family physicians purposively selected between July and December 2020 until theme saturation was achieved. The non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework was used to develop the interview guide. Three investigators conducted inductive thematic analysis independently until consensus was reached.
Three themes emerged. (1) The perceived value of VCs for physicians and patients. Advantages of VCs were the novel insights gathered from patients’ home environment, flexibility and accessibility extended to patients. (2) Physicians’ receptivity towards VCs. Most physicians were optimistic about the adoption and sustainability of VCs. Despite constraints of VCs where there was restricted scope for patient examination, increased responsibilities and fewer available communication cues, the future relevance of VCs was acknowledged. (3) Characteristics of an optimal VC. Optimal VC was characterized by adequate digital and health literacy, good rapport and shared goals between physicians and patients, and smooth workflow.
Video consultations do not pale in comparison to in-person consultations. VCs have additional value proposition despite certain limitations and safety concerns. Physicians expressed confidentiality, liabilities and safety concerns, but the future relevance of VCs was acknowledged. Addressing these issues may encourage physicians to adopt VCs with greater ease of mind.