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• W3173233039 abstract "Worldwide, telehealth was rapidly adopted as a widespread model of healthcare delivery during the early coronavirus disease 2019 (COVID-19) pandemic response. Indeed, by April 2020, telehealth services constituted 36% of all healthcare services in Australia.1 More recently (April 2021), this number has fallen to approximately 20%,1 but still remains higher than that observed before the pandemic (~1.3% of all services).1 This rapid uptake and progressive decline in the use of telehealth services has also been observed worldwide. For example, in the United States, telehealth use peaked in mid-April 2020, however as the pandemic continued, telehealth use has declined since June 2020.2 To decipher whether telehealth is a sustainable model of healthcare delivery beyond the COVID-19 pandemic, one must reflect on patients' experiences and satisfaction with telehealth services. In June 2020, we conducted a survey with 596 Australian adults to determine how people perceived telehealth services compared to traditional in-person medical appointments.3 We identified that those who rated their telehealth experience as ‘worse than’ traditional in-person medical appointments were less likely to report that telehealth would be useful following the COVID-19 pandemic. They were also more likely to be male, have a history of both depression and anxiety and a lower patient activation score (willingness to take on the role of managing their health and health care).3 Furthermore, we identified six overarching reasons for why telehealth was perceived to be worse than traditional in-person medical visits. These included: (1) communication seen as not as effective as face-to-face, (2) issues with obtaining prescriptions for medication, (3) inability to receive a physical examination from the doctor, (4) limitations and difficulties with technology, (5) reduced confidence in doctor/health professional and (6) additional burden such as face-to-face follow-up appointments still required for complex issues.3 Although we identified common reasons why telehealth was worse than traditional in-person appointment, the majority of our sample (62%) reported telehealth services to be ‘just as good as’ or ‘better than’ traditional in-person medical appointment. Therefore, these findings raise the question of what makes for a positive telehealth experience? Javanparast et al. conducted semi-structured telephone interviews with 30 patients in Australia, between May and June 2020, to determine participants' perspectives and perception with telehealth services during COVID-19.4 They found that people were more satisfied with telehealth services when they had a previously established relationship with their health professional, or the appointment was for monitoring a chronic condition or to renew a prescription.4 As such, it could be reasoned that patients prefer face-to-face over telehealth services when they are being assessed for a new medical condition. Other positives of telehealth services have included convenience (i.e., reduced travel time to appointments or waiting in waiting rooms), improved access to medical care for those who would not typically have access to medical care (including medical specialists) locally and personal safety by avoiding time in waiting rooms with other sick people.5 It is also worth highlighting that general practitioners (GPs) have similarly reported a more positive attitude towards using telehealth in their practice following the COVID-19 pandemic. In an Australian survey conducted by the Royal Australia College of General Practitioners, 67% of GPs reported a more positive attitude, 23% no change and 10% a more negative attitude towards using telehealth (n = 1782).6 The positive attitude of GPs may also have a positive impact on patients' experiences of telehealth. At the start of the COVID-19 pandemic, there was concern that telehealth services would expand the digital divide and inequity. However, in Australia, most telehealth services have been conducted via telephone rather than videoconferencing (93% vs. 7%).1 The higher number of telephone consults is a reflection of both consumers' and doctors' preference for telephone consults versus videoconferencing. The benefits of telephone consults are that it does not necessitate high levels of digital literacy for either the patient or healthcare professional, nor does it require reliable internet connections. Given that most telehealth services were conducted by telephone, it is unlikely that the shift to telehealth has expanded the digital divide and/or widened inequity. The COVID-19 pandemic has led to a once-in-a-lifetime opportunity for telehealth services to become a standard part of healthcare delivery worldwide. However, it appears that the use of telehealth is already on the decline. For telehealth to be sustainable beyond the pandemic, we must ensure that both health professionals and patients have a positive attitude towards telehealth services and that it can function effectively for both parties. By embedding telehealth training in education programmes for existing and new health professionals, it is likely that health professionals' attitudes towards telehealth will continue to be more positive. Specifically, these education programmes should include modules on strategies to improve communication during telehealth services. For example, the teach-back method, which is also known as the show-me method or closing-the-loop method, has been shown to increase people's understanding of health information during telehealth services by asking patients to repeat health information in their own words.7 In addition, teaching health literacy principles to health professionals is important to improve communication and to ensure that we do not widen the health literacy gap. To avoid expanding the digital divide, reliable internet access is necessary and dedicated support should be offered to teach digital literacy skills within the community (e.g., at libraries and community centres). However, it is important that we provide consumers with the option to engage with telehealth via either telephone or videoconferencing, such that accessibility to this healthcare service is made equitable for all. Patients and the public are a vital voice in the discussions of the future of telehealth. Collaborators: Julie Ayre, Carys Batcup, Carissa Bonner, Tessa Copp, Erin Cvejic, Rachael Dodd, Jennifer Isautier, Kirsten McCaffery, Danielle Muscat, Brooke Nickel and Kristen Pickles, of the Sydney Health Literacy Lab COVID-19 Group (in alphabetical surname order). The authors have nothing to disclose." @default.
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• W3173233039 date "2021-06-19" @default.
• W3173233039 modified "2023-09-26" @default.
• W3173233039 title "Patients are a vital voice for the future of telehealth" @default.
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