Title : What factors influence patient preference for the use of communication technology consultations in orthopaedic rehabilitation ? A qualitative investigation .
Dr Anthony Gilbert
Introduction : The 2019 NHS Long Term Plan envisions that the NHS ’ redesign services so that over the next five years patients will be able to avoid up to a third of face-to-face outpatient visits ’. Despite these government targets , the use of communication technology for consultations remains low . Our previous research identified that the change in ‘ work ’ required of patients to operationalise the technologies may influence their preference ( and choice ) on whether or not to use them in clinical practice . The purpose of this research was to identify the factors that influence patient preference for the use of communication technology consultations in an orthopaedic rehabilitation setting .
Methods : A qualitative study , using semi-structured interviews , was conducted . Interviews were audio recorded and transcribed verbatim . An abductive analysis was performed to identify a range of factors that could potentially influence preference .
Results : Twenty-two patients [ 12 female , average age 46 ] and 22 clinicians [ 14 female , average age 35 ] participated in interviews . The average interview length was 48 minutes . Key factors that influence preference include : 1 ) the patient situation ( a ) condition requiring care , ( b ) general health , ( c ) infrastructure , ( d ) competing priorities ; 2 ) technology ( a ) availability , ( b ) suitability , ( c ) support requirements ; 3 ) clinical care ( a ) clinician , ( b ) capacity of service ; 4 ) the clinical encounter .
Conclusions : The factors that influence patient preference for the use of communication technology consultations in orthopaedic rehabilitation are multi-factorial . Preferences will differ between patients and may change dependent on the patient , technological and clinical situation . A thorough understanding of these factors will support the design of patient centred-care pathways utilising communication technology . Further research , utilising a deductive approach , may illuminate the weight of importance of these factors for patients .
Impact : This research presents a model explaining the factors that influence patient preference for the use of communication technology consultations in orthopaedic rehabilitation . Consideration of these factors by patients , clinicians , managers and policy makers may support successful implementation of pathways utilizing these technologies across a range of clinical settings .