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Individuals' Perceptions as a Substitute for Guidelines and Evidence: Interview Study Among Clinicians on How They

Amia Enam¹, Heidi C Dreyer¹, Luitzen De Boer¹

¹Department of Industrial Economics and Technology Management, Faculty of Economics and Management, Norwegian University of Science and Technology, Trondheim, Norway.

JMIR Formative Research

|April 27, 2022

Summary

Clinicians have mixed views on video consultation (VC), citing a lack of evidence on its long-term impact. This uncertainty hinders sustainable, large-scale adoption of remote healthcare services.

Keywords:

clinician outpatient care professional work telemedicine video consultation work routine

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Area of Science:

Healthcare Management
Medical Informatics
Clinical Communication

Background:

Video consultation (VC) offers a cost-effective solution for outpatient care amidst global healthcare resource constraints and rising demand.
The COVID-19 pandemic accelerated the adoption of remote consultations, providing a unique opportunity to study large-scale implementation.
Sustainable implementation of VC is crucial for medical practitioners, researchers, and the public.

Purpose of the Study:

To investigate clinicians' reasoning and underlying motivations for selecting different consultation modes.
To understand clinicians' perceptions of remote consultation for assessing its large-scale adoption and sustainability.

Main Methods:

A qualitative study was conducted at a large Norwegian university hospital.
Data were collected through 29 semi-structured interviews with clinicians.
Deductive content analysis was employed using the performative model of routine as a theoretical framework.

Main Results:

Clinicians expressed varied opinions on the benefits and drawbacks of VC compared to in-person and telephone consultations.
Six distinct planning criteria influenced clinicians' choices, with varied combinations used individually.
VC introduced new ideals while potentially challenging existing clinical, interpersonal, and managerial aspects of consultation, with minimal impact on clinician tasks or perceived consultation outcomes.

Conclusions:

A significant lack of scientific evidence regarding the long-term effects of VC on clinical efficacy and interpersonal/managerial aspects was identified.
Insufficient evidence and unclear norms surrounding VC create a practice void, leading to reliance on personal judgment and diverse, sometimes contradictory, opinions.
This uncertainty poses challenges for the sustainable, large-scale implementation of VC, potentially impacting consultation service quality.