Implementing video consultation between healthcare providers What to consider for successful implementation
Examensarbete för masterexamen
Quality and operations management (MPQOM), MSc
In the coming years, the Swedish healthcare system will undergo a transformation to increase accessibility, proximity, and efficiency of care, named Good quality, local healthcare. The proposed transformation involves a heavier emphasis on primary care, and digital health innovations and tools are believed to be a central component. At the orthopedic emergency department at Sahlgrenska University Hospital, implementation of synchronous video consultations (VCs) between primary care health centers have been initiated. The purpose with the implementation was to improve the referral process by making specialist competence more available for the health centers, facilitating the steering of patients to the right care level. Several initiatives aiming at implementing video consultation between healthcare providers have been taken in Sweden, but few have reached full scale implementation or been sustained. This thesis investigates video consultations between specialists and other healthcare providers to increase understanding of what to consider for successful implementation of VCs. Further, the thesis also examines in what way the consultations influence Good quality, local healthcare. The study uses semi-structured interviews with people with first-hand experience from projects where VCs between specialists and other healthcare providers were being tested or implemented. The data is analyzed though thematic analysis, and the findings are compared to the Consolidated Framework for Implementation Research. The findings imply that the VCs studied positively influence Good quality, local healthcare, although specifying the influence on a detailed level appears difficult. Understanding the effect on the dimensions of Good quality, local healthcare of a specific VC implementation could facilitate receiving funding and support, proving the relative advantage of the implementation, determining purpose and metrics, and motivating personnel by demonstrating the benefits. Additionally, 38 considerations for implementation of VCs were found. Ten categories summarize all the considerations: 1) Resistance to change 6) Measurement of improvement 2) Motivation and engagement 7) Information, education, and support personnel 3) Organizational design 8) Project scale-up 4) User-friendliness of technical set-up 9) Financials 5) Confidentiality and privacy 10) Process design The identified considerations can be used by personnel aiming to implement VCs as a checklist to help identify potentially critical aspects of the implementation of VCs between specialists and other healthcare providers. The research findings complement the CFIR by guiding language and illuminating considerations specific to VC projects, as well as generate a basis for future research and improvement of implementation efforts of video consultations between healthcare providers.
video consultation , telemedicine , ‘Good quality, local healthcare' , Consolidated Framework for Implementation Research , implementation science