Patient experience with the use of information and communication technologies in primary care during the COVID-19 pandemic
Authors:
K. Dobiášová; J. Kopsa Těšinová; E. Tulupova
Authors‘ workplace:
Přednostka: MUDr. Mgr. Jolana Kopsa Těšinová, Ph. D.
; Univerzita Karlova 1. lékařská fakulta Ústav veřejného zdravotnictví a medicínského práva
Published in:
Prakt. Lék. 2022; 102(2): 55-68
Category:
Of different specialties
Overview
The COVID-19 pandemic has required a temporary restriction on the direct provision of health services. General practitioners in the Czech Republic, as in other countries, had to switch to a distance method of communication with patients, which had been used in their practices to a very limited extent. Despite the adoption of the Act on Electronic Health Care, the Czech Republic is still one of the countries with a low rate of digitization of health care processes. The research aimed to determine the experience of patients with the provision of healthcare by general practitioners (general practitioners for adults and general practitioners for children and adolescents) in comparison to outpatient specialists with the use of information and communication technologies (ICT) in the COVID-19 era and to identify motivational attitudes, barriers and benefits of distance medicine in primary care from the perspective of patients.
The study uses a mixed research design, a combination of qualitative and quantitative research approach sequentially QUAL-QUAN. In the first phase, 25 interviews were conducted with patients who, in the period from March 2020 to March 2021, received primary care provided by general practitioners remotely using ICT. A follow-up questionnaire survey of patients who are members of patient organizations took place in the period April-June 2021 and involved 620 respondents from 65 patient organizations, while 347 respondents had personal experience with the use of ICT in communication with their doctor.
It turned out that distance care took place mainly through telephone and e-mail communication, without using the full potential of ICT. The absence of a systemic setting of this form of health care, as well as the use of ICT and the implementation of telemedicine in primary care only in times of pandemic, without prior adaptation to a new way of communication, generates a number of new problems in the patient-physician relationship. In some cases, the unregulated use of telemedicine leads to a different quality of healthcare provided. It has also been shown that in some cases persistent paternalism negatively affects distance communication between healthcare professionals and patients. The absence of legal regulation and basic standards for the field of distance care is thus a significant barrier to the greater development of telemedicine in the practices of general practitioners, but also as a permanent part of health care in general.
Keywords:
Primary care – Telemedicine – general practitioner – distance care – information and communication technologies
Sources
1. Garattini L, Badinella Martini M, Zanetti M. More room for telemedicine after COVID-19: lessons for primary care? Eur J Health Econ 2021; 22(2): 183–186.
2. Eze ND, Mateus C, Cravo Oliveira Hashiguchi T. Telemedicine in the OECD: an umbrella review of clinical and cost-effectiveness, patient experience and implementation. PloS One 2020; 15(8): e0237585 [online]. Dostupné z: https://journals.plos. org/plosone/article?id=10.1371/journal.pone.0237585 [cit. 2022-03-18].
3. Knížek T. Digitalizace zdravotnictví: Využití dat přinese více efektivity pro pacienty, lékaře i pojišťovny [online]. Dostupné z: https://www.dreport.cz/blog/digitalizace-zdravotnictvi-vyuziti- dat-prinese-vice-efektivity-pro-pacienty-lekare-i-pojistovny/ [cit. 2022-03-18].
4. Parlament ČR. Zákon č. 372/2011 Sb. Zákon o zdravotních službách a podmínkách jejich poskytování (zákon o zdravotních službách) [online]. Dostupný z: https://www.zakonyprolidi.cz/ cs/2011-372 [cit. 2022-03-18].
5. Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices. Health Serv Res 2013; 48(6 Pt 2): 2134–2156.
6. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3(2): 77–101.
7. Parlament ČR. Zákon č. 325/2021 Sb. Zákon o elektronizaci zdravotnictví [online]. Dostupný z: https://www.zakony.cz/ zakony/2021/1/zakon-325-2021-Sb-zakon-o-elektronizaci-zdravotnictvi-SB2021325 [cit. 2022-03-18].
8. Bestsennyy O, Gilbert G, Harris A, Rost J. Telehealth: A quarter- trillion-dollar post-COVID-19 reality? 2021 [online]. Dostupné z: https://www.mckinsey.com/industries/healthcare- systems-and-services/our-insights/telehealth-a-quartertrillion- dollar-post-covid-19-reality [cit. 2022-03-18].
9. Parlament ČR. Zákon č. 89/2014 Sb. Občanský zákoník [online]. 2014. Dostupný z: https://www.zakonyprolidi.cz/cs/2012-89 [cit. 2022-03-18].
10. Parlament ČR. Zákon č. 110/2019 Sb. Zákon o zpracování osobních údajů [online]. 2019. Dostupný z: https://www.zakonyprolidi. cz/cs/2019-110 [cit. 2022-03-18].
11. Zandbelt LC, De Kanter FEC, Ubbink DT. E-consulting in a medical setting: medicine of the future? Patient Educ Couns 2016; 99(5): 689–670.
12. Gabrielsson-Järhurt F, Kjellström S, Josefsson KA. Telemedicine consultations with physicians in Swedish primary care: a mixed methods study of users’ experiences and care patterns. Scand J Prim Health Care 2021; 39(2): 204–213. Dostupné z: https://www.tandfonline.com/doi/epub/10.1080/ 02813432.2021.1913904?needAccess=true [cit. 2022-03-18].
13. Halata D, Javorská K, Býma S, Seifert B. Názory občanů České republiky na vybrané aspekty činnosti všeobecných praktických lékařů-2020. Prakt. Lék. 2021; 101(5): 261–267.
14. Farr M, Banks J, Edwards HB, et al. Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory through service co-production. BMJ Open 2018; 8(3): e019966 [online]. Dostupné z: https://bmjopen. bmj.com/content/8/3/e019966.full [cit. 2022-03-18].
15. Gomez T, Anaya YB, Shih KJ, et al. A qualitative study of primary care physicians’ experiences with telemedicine during COVID-19. J Am Board Fam Med 2021; 34(Suppl): S61–S70.
16. Mucha C, Býma S, Šonka P, a kol. Telemedicína: Doporučené diagnostické a terapeutické postupy pro všeobecné praktické lékaře. Společnost všeobecného lékařství ČLS JEP 2020 [online]. Dostupné z: https://www.svl.cz/files/files/Doporucenepostupy/ 2020/DP-Telemedicina.pdf [cit. 2022-03-18].
17. Ortega G, Rodriguez JA, Maurer LR, et al. Telemedicine, COVID-19, and disparities: policy implications. Health Policy Technol 2020; 9(3): 368–371.
18. Kloček A, Šmahelová M, Knapová L, Elavsky S. GPs’ perspectives on eHealth use in the Czech Republic: a cross-sectional mixed-design survey study [online]. BJGP Open 2019; 3(3): 1–12. Dostupné z: https://bjgpopen.org/content/bjgpoa/3/3/ bjgpopen19X101655.full.pdf [cit. 2022-03-18].
19. Parlament ČR. Zákon č. 96/2004 Sb. Zákon o podmínkách získávání a uznávání způsobilosti k výkonu nelékařských zdravotnických povolání a k výkonu činnosti souvisejících s poskytováním zdravotní péče a o změně některých souvisejících zákonů (zákon o nelékařských zdravotnických povoláních) [online]. Dostupný z: https://www.zakonyprolidi.cz/cs/2004-96 [cit. 2022-03-18].
20. European Commission and Member States. European ethical principles for digital health [online]. Dostupný z: https://solidarites- sante.gouv.fr/IMG/pdf/220201_european_ethical_principles_ for_digital_health_introduction_vdef_revue.pdf [cit. 2022-03-18].
21. Ryskina KL, Shultz K, Zhou Y, a kol. Older adults‘ access to primary care: Gender, racial, and ethnic disparities in telemedicine. Journal of the American Geriatrics Society 2021; 69(10): 2732–2740.
Labels
General practitioner for children and adolescents General practitioner for adultsArticle was published in
General Practitioner
2022 Issue 2
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