Effects of Virtual Care on Patient and Provider Experience of the Clinical Encounter: Qualitative Hermeneutic Study
BackgroundVirtual health care has transformed health care delivery, with its use dramatically increasing since the COVID-19 pandemic. While it has been quickly adopted for its convenience and efficiency, there has been a relative lack of in-depth exploration of its human impa...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2024-11-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2024/1/e52552 |
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| author | Graham McCaffrey Erin Wilson Lela V Zimmer Anurag Singh Steinunn Jonatansdottir Peter Zimmer David Snadden Ian D Graham Martha MacLeod |
| author_facet | Graham McCaffrey Erin Wilson Lela V Zimmer Anurag Singh Steinunn Jonatansdottir Peter Zimmer David Snadden Ian D Graham Martha MacLeod |
| author_sort | Graham McCaffrey |
| collection | DOAJ |
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BackgroundVirtual health care has transformed health care delivery, with its use dramatically increasing since the COVID-19 pandemic. While it has been quickly adopted for its convenience and efficiency, there has been a relative lack of in-depth exploration of its human impact, specifically how both patients and providers experience clinical encounters.
ObjectiveThis analysis aims to identify and explore themes of change in how patients and providers in a geographically dispersed renal service described their experiences with virtual care, including those changes that occurred during the COVID-19 pandemic.
MethodsHermeneutics is an interpretive research methodology that treats human experience as inherently interpretive, generating meaning through interactions with others in specific, historically conditioned, social contexts. A total of 17 patients and 10 providers from various disciplines were interviewed by phone as part of a study on health care implementation in the context of a kidney care service in northern British Columbia, Canada. The interview data were analyzed using a hermeneutic approach, which emphasizes careful attention to reported experiences in relation to the relationships and contexts of care.
ResultsDuring analysis, the interdisciplinary team identified themes related to changes in the clinical encounter and how virtual care influenced perceptions of care among both providers and patients. We organized these themes into 2 categories: the structure and content of the encounter. The structure category included the convenience for patients, who no longer had to travel long distances for appointments, as well as changes in care networks. For example, communication between specialist services and local primary care providers became more crucial for ensuring continuity of care. The content category included issues related to trust-building and assessment. Providers expressed concerns about the difficulty in assessing and understanding their patients’ physical and social well-being beyond laboratory results.
ConclusionsPatients in the study appreciated the convenience of not needing to travel for appointments, while still having the option for in-person contact with local providers or specialists if their condition changed. Providers were more concerned about the loss of visual cues and sensory data for assessments, as well as the reduced opportunity to build relationships through conversation with patients. Providers also described changes in the locus of control and boundaries, as patients could join phone encounters from anywhere, bypassing traditional privacy and confidentiality boundaries. The study offers a nuanced view of the effects of virtual care on clinical encounters in one setting, seen through the experiences of both patients and providers. |
| format | Article |
| id | doaj-art-9a0c636ce7a647f09c60d83131d2aa8d |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-9a0c636ce7a647f09c60d83131d2aa8d2024-11-26T18:30:30ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-11-0126e5255210.2196/52552Effects of Virtual Care on Patient and Provider Experience of the Clinical Encounter: Qualitative Hermeneutic StudyGraham McCaffreyhttps://orcid.org/0000-0002-5702-4818Erin Wilsonhttps://orcid.org/0000-0001-5977-3452Lela V Zimmerhttps://orcid.org/0000-0002-3966-6438Anurag Singhhttps://orcid.org/0009-0006-0497-5771Steinunn Jonatansdottirhttps://orcid.org/0000-0001-5005-0944Peter Zimmerhttps://orcid.org/0000-0003-2382-3686David Snaddenhttps://orcid.org/0000-0002-4818-1184Ian D Grahamhttps://orcid.org/0000-0002-3669-1216Martha MacLeodhttps://orcid.org/0000-0002-4174-6381 BackgroundVirtual health care has transformed health care delivery, with its use dramatically increasing since the COVID-19 pandemic. While it has been quickly adopted for its convenience and efficiency, there has been a relative lack of in-depth exploration of its human impact, specifically how both patients and providers experience clinical encounters. ObjectiveThis analysis aims to identify and explore themes of change in how patients and providers in a geographically dispersed renal service described their experiences with virtual care, including those changes that occurred during the COVID-19 pandemic. MethodsHermeneutics is an interpretive research methodology that treats human experience as inherently interpretive, generating meaning through interactions with others in specific, historically conditioned, social contexts. A total of 17 patients and 10 providers from various disciplines were interviewed by phone as part of a study on health care implementation in the context of a kidney care service in northern British Columbia, Canada. The interview data were analyzed using a hermeneutic approach, which emphasizes careful attention to reported experiences in relation to the relationships and contexts of care. ResultsDuring analysis, the interdisciplinary team identified themes related to changes in the clinical encounter and how virtual care influenced perceptions of care among both providers and patients. We organized these themes into 2 categories: the structure and content of the encounter. The structure category included the convenience for patients, who no longer had to travel long distances for appointments, as well as changes in care networks. For example, communication between specialist services and local primary care providers became more crucial for ensuring continuity of care. The content category included issues related to trust-building and assessment. Providers expressed concerns about the difficulty in assessing and understanding their patients’ physical and social well-being beyond laboratory results. ConclusionsPatients in the study appreciated the convenience of not needing to travel for appointments, while still having the option for in-person contact with local providers or specialists if their condition changed. Providers were more concerned about the loss of visual cues and sensory data for assessments, as well as the reduced opportunity to build relationships through conversation with patients. Providers also described changes in the locus of control and boundaries, as patients could join phone encounters from anywhere, bypassing traditional privacy and confidentiality boundaries. The study offers a nuanced view of the effects of virtual care on clinical encounters in one setting, seen through the experiences of both patients and providers.https://www.jmir.org/2024/1/e52552 |
| spellingShingle | Graham McCaffrey Erin Wilson Lela V Zimmer Anurag Singh Steinunn Jonatansdottir Peter Zimmer David Snadden Ian D Graham Martha MacLeod Effects of Virtual Care on Patient and Provider Experience of the Clinical Encounter: Qualitative Hermeneutic Study Journal of Medical Internet Research |
| title | Effects of Virtual Care on Patient and Provider Experience of the Clinical Encounter: Qualitative Hermeneutic Study |
| title_full | Effects of Virtual Care on Patient and Provider Experience of the Clinical Encounter: Qualitative Hermeneutic Study |
| title_fullStr | Effects of Virtual Care on Patient and Provider Experience of the Clinical Encounter: Qualitative Hermeneutic Study |
| title_full_unstemmed | Effects of Virtual Care on Patient and Provider Experience of the Clinical Encounter: Qualitative Hermeneutic Study |
| title_short | Effects of Virtual Care on Patient and Provider Experience of the Clinical Encounter: Qualitative Hermeneutic Study |
| title_sort | effects of virtual care on patient and provider experience of the clinical encounter qualitative hermeneutic study |
| url | https://www.jmir.org/2024/1/e52552 |
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