Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and...

Area of Science:

• Healthcare Management
• Digital Health Ethics
• Health Services Research

Background:

• Establishing remote consultation services involves significant political, organizational, economic, technical, relational, and clinical challenges.
• Ethical dimensions of remote consulting are often under-examined, despite their critical importance.

Purpose of the Study:

• To introduce a novel framework, Planning and Evaluating Remote Consultation Services (PERCS), for establishing and running remote consultation services.
• To address the ethical dilemmas inherent in remote healthcare delivery.

Main Methods:

• Literature review and ongoing research to develop the PERCS framework.
• Analysis of empirical data revealing contradictions and tensions in remote consultation decision-making.
• Development of guiding principles for practical application of the PERCS framework.

Main Results:

• The PERCS framework comprises 7 domains: reason for consulting, patient, clinical relationship, home/family, technologies, staff, healthcare organization, and the wider system.
• Empirical data show strategic and clinical decisions in remote consulting are fraught with contradictions, e.g., demand management vs. patient choice.
• Ethical dilemmas arise from these tensions and cannot be solved by standard procedures; they require contextual judgment.

Conclusions:

• Remote consultation services face multifaceted challenges with significant ethical implications.
• The PERCS framework provides a structured approach to planning and evaluating these services.
• Managing ethical dilemmas requires practical, context-specific judgment and guiding principles, alongside professional and patient education.