An exploratory qualitative study on patients' views of medical e-consultation in a public primary care setting

Abstract

Objective: Telemedicine is being effectively used to expand healthcare access to underserved populations and is also bringing added value to existing healthcare services. In Hong Kong, the use of telemedicine has been very limited. However, in those settings, it has been cost-effective and well-accepted by patients and healthcare professionals. In primary care, the selective use of e-consultation, as a form of telemedicine, may help enhance the healthcare accessibility of aging population with multi-morbidity and restricted mobility. This study aims to explore public primary care patients’ views on e-consultation in order to identify patientcentred issues which need to be addressed in planning such an initiative.

Design: Face-to-face semi-structured interviews were conducted in Chinese or English. The interviews were audio-recorded and transcribed and the content was analysed for recurrent themes.

Subject: 30 purposively selected primary care patients in a single General Outpatient Clinic (GOPC) in Hong Kong.

Main outcome measures: Emerging themes from the interviews with participants.

Results: Three key themes were identified: 1) advantages of e-consul tat ion; 2) concerns about e-consultation and 3) suggestions to improve the acceptability for e-consultation.

Conclusion: Primary care pat ients have minimal experience with e-consultation, but are willing to accept its use to improve accessibility to healthcare if their concerns towards safety, security and communication are addressed. Further steps to explore the feasibility of e-consultation in primary care are warranted.

目的：醫療機構可以通過遠程醫療在服務不足的地區有效 地擴展服務，同時令自身醫療服務增值。香港遠程醫療目前使用非常有限，然而它合乎成本效益並為廣大病人和醫護人員所接受。基層醫療中，選擇性地採用電子診療可幫助體弱多病和行動不便的長者使用醫療服務。本文探討公共基層病人對電子診療的看法，從而確定以後以病人為本原則制定先導計劃時需要處理的問題。

設計：以中文或英文進行半組織性的面談。會面過程錄音，再轉化成文字，根據重複主題做內容分析。

研究對象：香港一所普通科門診中30位經過挑選的基層病人。

主要測量內容：面談時參與者所提出的主題。

結果：三個主題確定為：(1)電子診療的優點；(2)對電子診療的關注；(3)改善電子診療認受性的建議。

結論：基層病人對電子診療的經驗很少，但是如果電子診療的安全性、保密性和通訊得以完善，他們還是願意接受 這種改善醫療服務的方式。電子診療用於基層醫療的可行 性可繼續探討。