Remote and digital services in UK general practice 2021-2023: the Remote by Default 2 longitudinal qualitative study...

Area of Science:

• Sociotechnical research
• Digital health innovation
• General practice transformation

Background:

• COVID-19 pandemic accelerated introduction of remote and digital services in UK general practice.
• Previous research highlights technology's non-'plug and play' nature and context-dependent solutions.

Purpose of the Study:

• To conduct a longitudinal qualitative study on the introduction, embedding, evolution, and abandonment of remote and digital innovations in UK general practice.
• To understand variations in digital maturity and patient/staff experiences.

Main Methods:

• Longitudinal qualitative study (Sept 2021-Dec 2023) across 12 diverse general practices.
• Ethnographic observation (>500 hours), >200 interviews, multi-stakeholder workshops, grey literature, and safety incident reports.
• Thematic coding and analysis using theoretical lenses (e.g., diffusion of innovations, digital candidacy, technostress).

Main Results:

• All practices adopted hybrid care models, but digital maturity varied significantly.
• Digitally-enabled patients often found services convenient; vulnerable groups faced exclusion.
• Remote/digital tasks were complex, labor-intensive, and stressful for staff.
• Co-design with patients required agile, bespoke approaches.

Conclusions:

• Successful digital integration requires extensive work beyond initial implementation, varying by practice priorities and population needs.
• Low digital maturity may signal a need for resources and organizational support.
• Addressing inequities and staff technostress is crucial for effective digital transformation in general practice.