Health Care Professionals’ Perspectives on the Utilisation of a Remote Surveillance and Care Tool for Patients With COVID-19 in General Practice: a Qualitative Study

Abstract

BackgroundMost COVID-19 patients with severe symptoms are treated in hospitals. General practices are responsible for assessing most ambulatory patients. However, they face several challenges managing COVID-19 patients and those with non-COVID-19 conditions. To support general practices and early identify severe courses, in April 2020 we designed a software tool for the structured surveillance of high-risk home-quarantined COVID-19 patients in general practice (CovidCare) including several telephone monitorings. This study presents the qualitative results of a mixed-methods process evaluation study on CovidCare. MethodsIn a qualitative process evaluation study conducted between March and May 2021, we explored the perspectives of seven general practitioners (GPs) and twelve VERAHs (medical care assistants with special training) on CovidCare using semi-structured interviews based on the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance). We used deductive qualitative content analysis employing the RE-AIM framework to assess the utilization and implementation of CovidCare. ResultsOverall, most health care professionals were satisfied with CovidCare. They highlighted 1) a good orientation for the management of COVID-19 patients especially due to a high level of uncertainty at the beginning of the pandemic, 2) the possibility to gain new knowledge and 3) the structured data collection as facilitators for the implementation of CovidCare. Moreover, CovidCare reduced the workload for GPs while some VERAHs perceived a higher workload as they were responsible for large parts of the CovidCare management. However, CovidCare positively affected the VERAHs’ job satisfaction as most patients provided positive feedback and felt less anxious about coping with their disease. Previous experience with the software and an easy integration into daily practice were considered to be crucial utilisation drivers. Time and personnel resources were identified as main barriers. Participants suggested a less comprehensive version of CovidCare, the expansion of inclusion criteria as well as an app for the patients’ self-management to further improve CovidCare.ConclusionThe COVID-19 surveillance and care tool for COVID-19 patients with increased risk was perceived as useful by GPs and VERAHs. Supportive remote health care tools such as CovidCare are a viable means to maintain a comprehensive and continuous health care during a pandemic and may strengthen the primary care system.Trial registrationGerman Clinical Trials Register DRKS00022054; date of registration: 02/06/2020; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00022054