Perspectives on telehealth implementation in Australia: An exploratory qualitative study with practice managers and general practitioners

Feby Savira; Andrew Sanigorski; Kevin Mc Namara; Martin Hensher; Anna Peeters; Elizabeth Manias

doi:10.1016/j.ijmedinf.2024.105473

Perspectives on telehealth implementation in Australia: An exploratory qualitative study with practice managers and general practitioners

Int J Med Inform. 2024 May 5:188:105473. doi: 10.1016/j.ijmedinf.2024.105473. Online ahead of print.

Authors

Feby Savira¹, Andrew Sanigorski², Kevin Mc Namara³, Martin Hensher⁴, Anna Peeters⁵, Elizabeth Manias⁶

Affiliations

¹ Deakin University, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia; Deakin University, Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia.
² Deakin University, Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia.
³ Deakin University, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia; Deakin University, Deakin Rural Health, School of Medicine, Warrnambool, Victoria, Australia.
⁴ University of Tasmania, Menzies Institute for Medical Research, Hobart, Tasmania, Australia.
⁵ Deakin University, Institute for Health Transformation, School of Health and Social Development, Burwood, Victoria, Australia.
⁶ Deakin University, Deakin Rural Health, School of Medicine, Warrnambool, Victoria, Australia; Deakin University, Centre for Quality and Patient Safety Research, Institute for Health Transformation, School of Nursing and Midwifery, Burwood, Victoria, Australia; Monash University, School of Nursing and Midwifery, Clayton, Victoria, Australia.

PMID: 38743998
DOI: 10.1016/j.ijmedinf.2024.105473

Abstract

Background: There is a lack of understanding regarding the impact of telehealth on clinical delivery and the feasibility of sustained implementation by health services. The COVID-19 pandemic provided an ideal opportunity to identify factors related to the implementation of telehealth. This study assessed factors that influenced telehealth implementation during COVID-19 in the Western region of Victoria, Australia, from the perspectives of practice managers and general practitioners (GPs).

Methods: Employing a qualitative approach, we conducted semi-structured interviews with 14 GPs and 11 practice managers across metropolitan and rural settings in the Western region of Victoria, Australia. Interviews were conducted between December 2021 to June 2022, which included periods during and beyond the peak of the COVID-19 pandemic. Themes were synthesised using the Consolidated Framework for Implementation Research, which comprised five domains: innovation, inner setting, outer setting, individuals and implementation process. An additional domain related to billing and finances was added.

Results: The innovation domain revealed that telehealth was identified by both stakeholder groups as a critical tool for improving healthcare access for vulnerable patients. GPs highlighted the role of telehealth in follow-up care and the need for extended telephone consultation services. For the implementation process, both stakeholder groups identified a shift in attitudes among GPs from reluctance to acceptance of telehealth. In terms of outer setting, constant changes in regulations posed challenges to administrative staff. Practice managers faced difficulties in acquiring information on changes, but those with robust professional networks were well supported. Initial loss of incentive funding and government-imposed billing methods posed hurdles for clinics. Both stakeholder groups highlighted the need for education around videoconference and a standardised telehealth platform.

Conclusion: Evolving telehealth regulations during the emergence of COVID-19 posed financial, operational and administrative challenges to primary care clinics. To ensure sustainability, policymakers should improve stakeholder communication, set interoperability standards, and ensure sustainable funding for telehealth.

Keywords: COVID-19; General practice; Implementation; Primary care; Qualitative; Telehealth.