Digital chat-based care assessments in primary healthcare: nurses' work experiences and training needs

The digital transformation of society has significant implications for healthcare. Despite a growing body of research on telemedicine implementation, studies specifically examining chat-based care assessments by primary care nurses remain limited. The aim of the present study was to explore nurses' work experiences and training needs regarding chat-based care assessments in primary healthcare.

This qualitative exploratory study employed semi-structured in-depth interviews with six nurses trained in telemedicine chat technique. Data were analysed inductively using reflexive thematic analysis.

The findings indicated that chat-based care assessments could lead to prolonged assessment processes, and that nurses needed proficiency in chat techniques and effective communication skills to ensure clarity in conversations and accurate medical history acquisition. Training gaps were noted, particularly in fostering effective patient-professional relationships through brief text exchanges in the chat. The prolonged process had both advantages and disadvantages. Although it was more time-consuming, nurses got better opportunities to consider their responses and consult with colleagues, which was thought to improve the accuracy of medical assessments. Further benefits of chat-based assessments included access to chat history, the ability to share informational links, and opportunities for professional development. Nurses pointed to the need for system improvements, such as auto-anamnesis and auto-triage features, to better support their work in the future.

The study offers valuable insights for healthcare professionals, technology designers, and policymakers regarding the nuances of nurses' chat-based interactions with patients in primary care settings. The results can inform the development of targeted training programs in chat techniques and communication skills, enhancing the effectiveness of digital consultations and fostering therapeutic relationships with patients. Chat-based assessments offer clear benefits within the care process but also come with challenges.