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Guidance on the introduction and use of video consultations during COVID-19: important lessons from qualitative research
  1. Joseph Wherton,
  2. Sara Shaw,
  3. Chrysanthi Papoutsi,
  4. Lucas Seuren,
  5. Trisha Greenhalgh
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Dr Joseph Wherton, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; joseph.wherton{at}phc.ox.ac.uk

Abstract

Background Following several years of qualitative research, we have developed evidence-based guidance on setting up and conducting remote video consultations. Drawing on emerging evidence, we have also adapted the guidance to ensure accessibility and relevance for those using video calling during and beyond the COVID-19 pandemic.

Findings This article describes the research underpinning this guidance material, with a focus on three key areas: (1) IT infrastructure, (2) organisational routines and workflows, and (3) interactional work of a video consultation. Our research highlights that such change is not merely about installing and using new technology. It involves introducing and sustaining major changes to a complex system with multiple interacting components.

Conclusion If remote video consultations are to be adopted at scale, implementation will need to follow a socio-technical approach, continually adjusting the technology and work processes to become better aligned.

  • care redesign
  • continuous improvement
  • learning organisation

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Footnotes

  • Contributors TG was the principal investigator on three research grants that funded the work and led on the development of the guidelines presented in article. SS was principal investigator on one of the research grants that funded the work and led on the development of supporting guidance materials. JW, CP and LS all led on aspects of empirical research. JW led on the data collection and ethics approvals. CP led theoretical analysis of organisational change. LS led on conversation analysis of video consultation recordings. JW drafted the first version of this paper. All authors helped revise drafts.

  • Funding The Virtual Online Consultations: Advantages and Limitations study was funded by NIHR through the Health Services and Delivery Research stream (HSDR 13/59/26). The Studies in Co-creating Assisted Living Solutions project was funded by the Welcome Trust Senior Investigator award to TG (WT104830MA). The Qualitative Analysis of Remote Consultations project was funded by NIHR Research for Patient Benefit (PB-PG-1216-20012). The ‘scaling-up video consultations’ project (to support extension of video consultations in England) is funded by the Health Foundation. JW, SS and TG’s salaries were partly funded by the Oxford National Institute for Health Research Biomedical Research Centre Partnerships for Health, Wealth, and Innovation theme on which TG is principal investigator (BRC-1215-20008).

  • Competing interests JW and TG are undertaking an evaluation of the Scottish government’s video consultation programme.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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