A qualitative research study of primary care physicians’ views of telehealth in delivering postnatal care to women

Abstract

Background The postpartum period is a critical time for women to optimise their physical and mental health. Primary care physicians (PCP) often manage postpartum women in the community setting after uneventful births. However, women encounter difficulties accessing care before and after their conventional 6-week physical review. Telehealth-based interventional studies have demonstrated their successful applications in several areas of postpartum care but is not widely adopted. The study aimed to explore the PCPs’ views on their acceptability and perceived barriers of telehealth in delivering postpartum care to women in primary care. Methods Twenty-nine PCPs participated in eleven in-depth interviews and four focus group discussions for this qualitative study conducted in Singapore. The purposively sampled PCPs had varied demographic background and medical training. Two investigators independently coded the audited transcripts. Thematic content analysis was performed using the codes to identify issues in the pertaining to the perceived usefulness, ease of use and attitudes towards telehealth in postpartum care as described in the “Telehealth Acceptance Model” framework. Results Most PCPs perceived usefulness and ease of use of video consultation in delivering postpartum care. They recognised telehealth service to complement and support the current face-to-face postpartum care amidst the pandemic. However, training, leadership support, organizational infrastructure, healthcare financial policy and personal demographic profile influence their acceptance of a new care model for postnatal mothers. Conclusion Addressing the barriers and strengthening the facilitators will enhance PCPs’ acceptance and utilisation of the proposed hybrid (telehealth and in-person) postnatal care model for mothers.

Understanding inherent influencing factors to digital health adoption in general practices through a mixed-methods analysis

“…The literature review identified technological, social, and organizational adoption barriers. More than 90% of included studies reported organizational adoption barriers 13 , 15 , 17 , 18 , 22 , 23 , 28 – 44 (23/24), with more than half reporting high workload 17 , 22 , 29 , 30 , 34 , 36 – 44 and a lack of time 13 , 15 , 17 , 18 , 23 , 28 , 29 , 31 – 34 , 36 , 40 , 42 (each 14/24; 58%) as predominant barriers. Another 88% of studies identified social adoption barriers 13 , 15 , 17 , 18 , 22 , 23 , 28 – 32 , 35 – 44 (21/24).…”

“…Another 88% of studies identified social adoption barriers 13 , 15 , 17 , 18 , 22 , 23 , 28 – 32 , 35 – 44 (21/24). Of these, physicians’ familiarity with digital health solutions 15 , 17 , 18 , 22 , 23 , 28 , 30 – 32 , 36 , 38 – 44 (17/24; 71%) was the most cited social barrier, followed by overall awareness 15 , 18 , 22 , 23 , 29 , 30 , 32 , 35 , 43 , 44 (10/24; 42%) and patient preferences 15 , 18 , 23 , 29 – 31 , 35 , 38 , 40 , 42 (10/24; 42%).…”

“…Looking into potential strategies to support and improve digital health adoption, we identified strategies in five categories in our literature review: development-related, awareness-related, knowledge-related, implementation-related, and policy-related strategies. Around two-thirds of studies identified strategies concerning the development of digital health solutions as potentially helpful to improve adoption 15 , 17 – 19 , 28 , 29 , 31 , 33 , 34 , 36 – 39 , 42 – 44 (16/24; 67%). Among these, the most frequently cited development-related strategies were improvements in the usefulness of digital health solutions 17 – 19 , 28 , 29 , 31 , 33 , 36 – 38 , 42 – 44 (13/24; 54%), followed by improvements in their usability 28 , 29 , 31 , 34 , 36 , 39 , 42 , 43 (8/24; 33%).…”

“…Around two-thirds of studies identified strategies concerning the development of digital health solutions as potentially helpful to improve adoption 15 , 17 – 19 , 28 , 29 , 31 , 33 , 34 , 36 – 39 , 42 – 44 (16/24; 67%). Among these, the most frequently cited development-related strategies were improvements in the usefulness of digital health solutions 17 – 19 , 28 , 29 , 31 , 33 , 36 – 38 , 42 – 44 (13/24; 54%), followed by improvements in their usability 28 , 29 , 31 , 34 , 36 , 39 , 42 , 43 (8/24; 33%). All other categories were present in around half of the included studies, with the call for ongoing training 15 , 17 – 19 , 34 , 37 , 38 , 40 , 43 , 44 (10/24; 42%) and improved reimbursement 15 , 17 , 18 , 22 , 34 , 38 , 39 , 43 (8/24; 33%) as additionally vital improvement strategies.…”

Review on the Advancements of Stethoscope Types in Chest Auscultation

“…Nurses and doctors may use the medical information obtained by electronic stethoscopes in both telemedicine and face-to-face clinical settings for teaching [74]. Advanced research studies have been performed, which monitor the degree of success in certain countries such as Canada's telehealth programs [75], and Singapore's postnatal care with telehealth [76]. Another example of a telehealth study in Singapore explores the potential use of telehealth in an orthopedic clinical setting including HIPAA-compliant peer-to-peer communication, with clinical outreach in the setting of trauma [77].…”