Cross-sectoral communication by bringing together patient with cancer, general practitioner and oncologist in a video-based consultation: a qualitative study of oncologists’ and nurse specialists’ perspectives

Hansen, Dorte Gilså; Trabjerg, Theis Bitz; Sisler, Jeffrey; Søndergaard, Jens; Jensen, Lars Henrik

doi:10.1136/bmjopen-2020-043038

Cited by 2 publications

(9 citation statements)

References 41 publications

(45 reference statements)

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“…Moreover, few studies differentiated between aspects of continuity. Johnsen et al 43 looked specifically at relational and episodic continuity, while Trabjerg et al , 44 Hansen et al , 38 and Tönnies et al 41 reported improved managerial and informational continuity with integrated primary–specialist consultations without referring to it as such, for example, describing ‘more coherent patient trajectory [ies] ’ and ‘roles and tasks [becoming] more apparent to both patients and professionals and [sharing] knowledge between health sectors’. 44 …”

Section: Resultsmentioning

confidence: 99%

“…Integrated care consultations, for example, whereby the patient and GP were situated together in the GP practice and conducted a joint remote consultation with an oncologist, were shown to improve understanding of the roles of different specialists (such as cancer and mental health) in the patient’s journey, resulting in a more coherent care pathway and improved managerial continuity. 38 , 41 , 44 …”

Section: Resultsmentioning

confidence: 99%

“…Moreover, few differentiated between aspects of continuity. knowledge between health sectors' (38,41,49).…”

Section: Sparsity Of Studies Specifically Reporting and Measuring Con...mentioning

confidence: 99%

“…Integrated care consultations for example, whereby the patient and GP situated together in the GP practice conducted a joint remote consultation with an oncologist, were shown to improve understanding of the roles of different specialists (e.g. cancer, mental health) in the patient's journey, resulting in a more coherent care pathway and improved managerial continuity (38,41,44). In two studies patients, GPs, and oncologists felt that such integrated consultations contributed to better continuity of care and thus health outcomes with all gaining a better understanding of how to optimize managerial and informational continuity (38,44) -although such structures may be considered to be pushing the boundaries of traditional general practice activities, relating more to the primary-secondary care interface.…”

Section: Quigley Et Al's Independent Evaluation Of Babylon Gp At Hand...mentioning

confidence: 99%

“…Furthermore, one study reported health policy experts' opinions that the relationship of trust between a GP and their patient, often formed over 'a long time' (i.e. reflecting relational continuity) could help motivate patients to engage in remote consultations with mental health specialists (41), whilst oncologists reported how the 'long-established relationships [between GP and patient] could help overcome mistrust of specialists or the wider system (38). Finally, informational continuity was deployed strategically to proactively contact vulnerable patients by telephone, demonstrating the value of combining continuity and remote approaches (40).…”

Section: Quigley Et Al's Independent Evaluation Of Babylon Gp At Hand...mentioning

confidence: 99%

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The impact of remote care approaches on continuity in primary care: a mixed-studies systematic review

et al. 2023

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Background: The value of continuity in primary care has been demonstrated for multiple outcomes. However, little is known about how the expansion of remote and digital care models have impacted continuity. Aim: To conduct a mixed-methods systematic review to explore how expansion of remote and digital care models have impacted continuity. Design and Setting: A systematic search of electronic databases with snowball sampling to identify relevant qualitative and quantitative studies. Methods: 17 English-language studies (any country, 2000-2022) exploring remote or digital approaches in primary care and continuity were identified. Relevant data were extracted, analysed using GRADE-CERQual, and narratively synthesised. Results: The specific impact of remote approaches on continuity was rarely overtly addressed. Some patients expressed a preference for relational continuity depending on circumstance, problem, and context, whilst others prioritised access. Clinicians valued continuity with some viewing remote consultations more suitable for patients where there was high episodic or relational continuity. With lower continuity, patients and clinicians considered remote consultations harder, higher risk, and poorer quality. Some evidence suggested remote approaches, and/or their implementation risked worsening inequalities and causing harm by reducing continuity where it was valuable. However, if deployed strategically and flexibly, remote approaches could improve continuity. Conclusion: The dearth of evidence around continuity in a remote and digital context is troubling. Further research should explore the links between the shift to remote care, continuity and equity, using real-world evaluation frameworks to ascertain when and for whom continuity adds most value and how this can be enabled or maintained.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Moreover, few differentiated between aspects of continuity. knowledge between health sectors' (38,41,49).…”

Section: Sparsity Of Studies Specifically Reporting and Measuring Con...mentioning

confidence: 99%

Section: Quigley Et Al's Independent Evaluation Of Babylon Gp At Hand...mentioning

confidence: 99%

Section: Quigley Et Al's Independent Evaluation Of Babylon Gp At Hand...mentioning

confidence: 99%

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The impact of remote care approaches on continuity in primary care: a mixed-studies systematic review

et al. 2023

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Hospitalisation at Home of Patients with COVID-19: A Qualitative Study of User Experiences

Heras

Andersen

Matthies

et al. 2023

IJERPH

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Hospitalisation at Home (HaH) is a new model providing hospital-level care at home as a substitute for traditional care. Biometric monitoring and digital communication are crucial, but little is known about user perspectives. We aim to explore how in-patients with severe COVID-19 infection and clinicians engage with and experience communication and self-monitoring activities following the HaH model. A qualitative study based on semi-structured interviews of patients and clinicians participating in the early development phase of HaH were conducted. We interviewed eight clinicians and six patients. Five themes emerged from clinicians: (1) staff fear and concerns, (2) workflow, (3) virtual closeness, (4) patient relatives, and (5) future HaH models; four themes emerged from patients: (1) transition to home, (2) joint responsibility, (3) acceptability of technologies, and (4) relatives. Despite technical problems, both patients and clinicians were enthusiastic about the conceptual HaH idea. If appropriately introduced, treatment based on self-monitoring and remote communication was perceived acceptable for the patients; however, obtaining vitals at night was an overwhelming challenge. HaH is generally acceptable, perceived patient-centred, influencing routine clinical workflow, role and job satisfaction. Therefore, it calls for educational programs including more perspective than issues related to technical devices.

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Cross-sectoral communication by bringing together patient with cancer, general practitioner and oncologist in a video-based consultation: a qualitative study of oncologists’ and nurse specialists’ perspectives

Cited by 2 publications

References 41 publications

The impact of remote care approaches on continuity in primary care: a mixed-studies systematic review

The impact of remote care approaches on continuity in primary care: a mixed-studies systematic review

Hospitalisation at Home of Patients with COVID-19: A Qualitative Study of User Experiences

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