The physical examination in telecardiology and televascular consultations: a study using conversation analysis

Area of Science:

• Medical Communication
• Health Services Research
• Digital Health

Background:

• Telemedicine consultations present unique communication challenges, particularly during physical examinations.
• Effective communication strategies are crucial for successful remote patient care.
• Understanding these dynamics is key to improving telemedicine adoption and efficacy.

Purpose of the Study:

• To describe communication practices during the physical examination phases of telemedicine consultations.
• To analyze the collaborative environment created in televascular consultations.
• To identify new communication skills required for telemedicine participants.

Main Methods:

• Conversation analysis of 10 telemedicine consultations (5 telecardiology, 5 televascular) in UK primary and tertiary care.
• Examination of communication dynamics between specialists, primary care nurses, and patients.
• Focus on how physical examination is managed remotely.

Main Results:

• Physical examination is absent in telecardiology consultations.
• In televascular consultations, specialists collaborate with primary care nurses to conduct remote physical examinations, orchestrating patient and camera positioning.
• This remote collaboration creates a novel environment requiring new communication practices.

Conclusions:

• Telemedicine enables active collaboration between primary care nurses and hospital specialists, leveraging nurses' examination skills for remote assessments.
• Difficulties in remote physical examination may hinder telemedicine adoption.
• Findings can inform training interventions for both patients and healthcare professionals in telemedicine communication.