Virtual consultation in kidney care: a mixed-methods study on a model for safe and effective integration into routine clinical care

Rationale and Objective Globally, the COVID-19 pandemic necessitated a rapid introduction of virtual care delivery via telephone or videoconference. The rapid advancements in e-health technology facilitated options for virtual care, including asynchronous data transfer in virtual clinic models and p...

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Main Authors: Aminu K Bello, Stephanie Thompson, Deenaz Zaidi, Scott Klarenbach, Feng Ye, Terry J Smith, Mark Courtney
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e081651.full
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author Aminu K Bello
Stephanie Thompson
Deenaz Zaidi
Scott Klarenbach
Feng Ye
Terry J Smith
Mark Courtney
author_facet Aminu K Bello
Stephanie Thompson
Deenaz Zaidi
Scott Klarenbach
Feng Ye
Terry J Smith
Mark Courtney
author_sort Aminu K Bello
collection DOAJ
description Rationale and Objective Globally, the COVID-19 pandemic necessitated a rapid introduction of virtual care delivery via telephone or videoconference. The rapid advancements in e-health technology facilitated options for virtual care, including asynchronous data transfer in virtual clinic models and patient-facing smartphone applications for communications and self-care. However, the clinical benefits of virtual consultation have not been consistently demonstrated in all facets of kidney care, and the adoption of this innovation alters workflows and health professionals’ perceptions of care delivery. This study evaluated the integration of virtual outpatient consultation safely and effectively into the kidney care programme in Alberta.Study design We leveraged a mixed-methods approach to collate data about clinicians’ experiences and opinions, forming the basis for the qualitative part of the study.Data extraction Data were collected through surveys, interviews and focus groups of nephrologists and home dialysis nurses.Analytical approach Focus group/interview transcripts for nephrologists and nurses were used to generate initial codebooks, which were iteratively refined throughout the analysis. Codes were categorised and analysed thematically, and data collected from nephrologists and nurses were analysed separately.Results The findings demonstrated that clinicians support the use of routine virtual care. Clinicians’ opinions on implementation requirements emphasised logistics for routine virtual care integration, quality of care delivered, impacts on the therapeutic relationship and regulatory policy clarification.Limitation The generalisability of the findings is limited in scope, as the study was conducted in a single nephrology programme in Canada, and may not apply to other provinces or settings.Conclusions These findings inform recommendations for safe and effective virtual care delivery and can be leveraged to inform virtual care designs in kidney care programmes. Further study is required to clarify the impacts of virtual care on specific population demographics based on geography (rural vs urban) and age (elderly population) in the post-COVID-19 era, and determine how to effectively integrate patient perspectives into this model of care.
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spelling doaj-art-e12e0082f416405487bbb9e789ad94ab2025-02-03T10:30:20ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2023-081651Virtual consultation in kidney care: a mixed-methods study on a model for safe and effective integration into routine clinical careAminu K Bello0Stephanie Thompson1Deenaz Zaidi2Scott Klarenbach3Feng Ye4Terry J Smith5Mark Courtney6Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaNephrology, University of Alberta, Edmonton, Alberta, CanadaMedicine, University of Alberta, Edmonton, Alberta, CanadaDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada2 University of Alberta, Edmonton, Alberta, CanadaDepartments of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Michigan, USADepartment of Medicine, University of Alberta, Edmonton, Alberta, CanadaRationale and Objective Globally, the COVID-19 pandemic necessitated a rapid introduction of virtual care delivery via telephone or videoconference. The rapid advancements in e-health technology facilitated options for virtual care, including asynchronous data transfer in virtual clinic models and patient-facing smartphone applications for communications and self-care. However, the clinical benefits of virtual consultation have not been consistently demonstrated in all facets of kidney care, and the adoption of this innovation alters workflows and health professionals’ perceptions of care delivery. This study evaluated the integration of virtual outpatient consultation safely and effectively into the kidney care programme in Alberta.Study design We leveraged a mixed-methods approach to collate data about clinicians’ experiences and opinions, forming the basis for the qualitative part of the study.Data extraction Data were collected through surveys, interviews and focus groups of nephrologists and home dialysis nurses.Analytical approach Focus group/interview transcripts for nephrologists and nurses were used to generate initial codebooks, which were iteratively refined throughout the analysis. Codes were categorised and analysed thematically, and data collected from nephrologists and nurses were analysed separately.Results The findings demonstrated that clinicians support the use of routine virtual care. Clinicians’ opinions on implementation requirements emphasised logistics for routine virtual care integration, quality of care delivered, impacts on the therapeutic relationship and regulatory policy clarification.Limitation The generalisability of the findings is limited in scope, as the study was conducted in a single nephrology programme in Canada, and may not apply to other provinces or settings.Conclusions These findings inform recommendations for safe and effective virtual care delivery and can be leveraged to inform virtual care designs in kidney care programmes. Further study is required to clarify the impacts of virtual care on specific population demographics based on geography (rural vs urban) and age (elderly population) in the post-COVID-19 era, and determine how to effectively integrate patient perspectives into this model of care.https://bmjopen.bmj.com/content/15/1/e081651.full
spellingShingle Aminu K Bello
Stephanie Thompson
Deenaz Zaidi
Scott Klarenbach
Feng Ye
Terry J Smith
Mark Courtney
Virtual consultation in kidney care: a mixed-methods study on a model for safe and effective integration into routine clinical care
BMJ Open
title Virtual consultation in kidney care: a mixed-methods study on a model for safe and effective integration into routine clinical care
title_full Virtual consultation in kidney care: a mixed-methods study on a model for safe and effective integration into routine clinical care
title_fullStr Virtual consultation in kidney care: a mixed-methods study on a model for safe and effective integration into routine clinical care
title_full_unstemmed Virtual consultation in kidney care: a mixed-methods study on a model for safe and effective integration into routine clinical care
title_short Virtual consultation in kidney care: a mixed-methods study on a model for safe and effective integration into routine clinical care
title_sort virtual consultation in kidney care a mixed methods study on a model for safe and effective integration into routine clinical care
url https://bmjopen.bmj.com/content/15/1/e081651.full
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