A Scoping Review of Challenges and Existing Tools How to Support Patient-Provider Communication During Telemedicine Consultations?

Main Article Content

Marie Dominique Antoine
Maria Cherba
Sylvie Grosjean
Sylvain Boet
Richard Waldolf

Abstract

In light of the COVID-19 public health restrictions, the use of telemedicine has been on the rise. This care delivery model is valued for its potential to increase care access while providing safe care. However, it changes the way patients and providers interact. Communication during video consultations requires embodied engagement to compensate for the physical distance. This study aimed to identify patient-provider communication challenges during video consultations and assess the tools developed to support patient-provider communication according to the published literature from 2019 to 2022. Searches of eight databases (Medline (Ovid), PubMed, ProQuest Nursing and Allied Health, CINAHL, Web of Science, Scopus, PsychInfo, and Social Services Abstracts), and a Google search for grey literature were conducted. Nineteen articles met inclusion criteria. Findings show that patients and providers share the same concerns, such as a lack of trust relating to physical distance, the ability to establish a meaningful relationship, and a lack of confidence in clinical assessment. The available tools, however, are based on guidelines that are difficult to adapt to the diversity of interaction contexts. There is a need for tools that consider the complexity of patient-provider communication in order to address the challenges stemming from the lack of trust in the context of video consultations. These findings can inform strategies for effective patient-provider communication during video consultations to improve the quality of care and optimize outcomes in this context. 

Article Details

Section
Review & Clinical Practice
Author Biography

Marie Dominique Antoine, University of Ottawa

I am a doctoral candidate in communications. I come from a law background. I graduated from the University of Ottawa with a Master's degree in communication in 2015. My research focuses primarily on communication and health, specifically, autism spectrum disorder. My master's thesis focused on communication in the care of children with autism. The objectives were to understand how communication occurs within the system during the care of autistic children in order to identify potential barriers to parent-provider communication. My doctoral study aims to explore available information provided to parents in conventional healthcare settings after children’s autism diagnosis and parental perceptions of the information in relation to usage in treatment decision-making. Precisely, the goal is to assess the extent to which there is a gap in available information and the information used in decision-making and how parents cope with this gap.

References

Canadian Medical Association. (2019). Virtual Care in Canada: Discussion paper. CMA Summit. Available from: https://www.cma.ca/sites/default/files/pdf/News/Virtual_Care_discussionpaper_v2EN.pdf.

Holstead, R. G., & Robinson, A. G. (). Discussing Serious News Remotely: Navigating Difficult Conversations During a Pandemic. JCO Oncology Practice. 2020:1-7.

Paige, S. R., Bunnell, B. E., & Bylund, C. L. Disparities in Patient-Centered Communication via Telemedicine. Telemedicine and e-Health. 2021 Apr. Available on 2023-02-01.

Dorion, M., & Dionne, E. La téléconsultation et la Covid-19 : pour un renouvellement des pratiques professionnelles face aux enjeux de formation. Pédagogie Médicale; 2022 : 1-6.

Alverson, D. International and Global Telemedicine: Making It Work. Telemedicine, Telehealth and Telepresence. 2021 Jan:235-255.

Timpel, P., Oswald, S., Schwarz, P. E., & Harst, L. Mapping the evidence on the effectiveness of telemedicine interventions in diabetes, dyslipidemia, and hypertension: an umbrella review of systematic reviews and meta-analyses. Journal of medical Internet research. 2020 Mar 18;22(3): e16791.

Aldahmash, A. M., Zakiuddin, A., Qadri, F. R., Thapa, S., & Abdulrahman, M. A. Implementing a connected health intervention for remote patient monitoring in Saudi Arabia and Pakistan: explaining ‘the what’ and ‘the how’. Globalization and Health. 2019 Mar: 1-7.

Fatehi, F., Jahedi, F., Tay-Kearney, M.-L., & Kanagasingam, Y. Teleophthalmology for the elderly population: A review of the literature. International Journal of Medical Informatics. 2020 Jan. 136:1-8.

Stamenova, V., Agarwal, P., Kelley, L., Fujioka, J., Nguyen, M., Phung, M., et al. Uptake and patient and provider communication modality preferences of virtual visits in primary care: a retrospective cohort study in Canada. BMJ open. 2020 Jul: 1-9.

Orlando, J. F., Beard, M., Kumar, S., & Borsci, S. Systematic review of patient and caregivers’ satisfaction with telehealth videoconferencing as a mode of service delivery in managing patients’ health. PloZ One. 2019 Aug 30;14(8): e0221848.

Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, et al. Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Family Medicine and Community Health. 2020 Aug:1-9.

Schifeling, C. H., Shanbhag, P., Johnson, A., Atwater, R. C., Koljack, C., Parnes, B. L., et al. Disparities in Video and Telephone Visits Among Older Adults During the COVID-19 Pandemic: Cross-Sectional Analysis. JMIR. 2020 Nov; 3(2): e23176.

Naeem, F., Husain, M. O., Husain, M. I., & Javed, A. Digital psychiatry in low- and middle-income countries post-COVID-19: Opportunities, challenges, and solutions. Indian Journal of Psychiatry. 020 Sep;62(Suppl 3): S380-S382.

Harris, B., Ajisola, M., Alam, R., Watkins, J. A., Arvanitis, T. N., Bakibinga, P., et al. Mobile consulting (mConsulting) as an option for accessing healthcare services for communities in remote rural areas and urban slums in low-and middle-income countries: A mixed methods study. medRxiv. 2021 Jun; (7): 1-24.

Donaghy et al. Acceptability, benefits, and challenges of video consulting: a qualitative study in primary care. British Journal of General Practice. 2019 Jun: e586-e594.

Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018,169(7):467-473.

Gopal, R. K., Solanki, P., Bokhour, B., Skorohod, N., Hernandez-Lujan, D., & Gordon, H. Provider, Staff, and Patient Perspectives on medical Visits Using Clinical Video Telehealth: A Foundation for Educational Initiatives to Improve Medical Care in Telehealth. The Journal for Nurse Practitioners. 2021: 582-587.

Christensen, L. F., Wilson, R., Hansen, J. P., Nelsen, C. T., & Gildberg, F. A. A qualitative study of patients’ and providers’ experiences with the use of videoconferences by older adults with depression. International Journal of Mental Health Nursing. 2021: 427-439.

Gordon, H. S., Solanki, P., Bokhour, B. G., & Gopal, R. K. “I’m Not Feeling Like I’m Part of the Conversation” Patients’ Perspectives on Communicating in Clinical Video Telehealth Visits. Journal of General Internal Medicine. 2020 Feb: 1751–1758.

Frankel, R. M., & Beckman, H. “Won’t You Be My Doctor?”: Four Keys to a Satisfying Relationship in an Increasingly Virtual World. Journal of Patient Experience. 2020: 851–855.

Dahiya, M., Olayinka, L., Kaplan, G. G., Reeb, L., Ma, C., Panaccione, R., & Kroeker, K. I. (2022). The Impact of the COVID-19 Pandemic on IBD Care in Alberta: Patient and Provider Perspectives. Journal of the Canadian Association of Gastroenterology, 2022:1-8.

Hall, M. A., Camacho, F., Dugan, E., & Balkrishnan, R. (2002). Trust in the medical profession: Conceptual and measurement issues. Health Services Research. 2002; 37(5): 1419-1439.

Sutcliffe, A. G., Wang, D., & Dunbar, R. M. Modelling the role of trust in social relationships. ACM Transactions on Internet Technology. 2015; 15(4): 16-24.

Verma, P., & Robert, K. Patients’ and physicians’ experiences with remote consultations in primary care, during the covid-19 pandemic: a multi-method rapid review of the literature. BJGP Open. 2022:1-18.

Canadian Medical Association. Virtual Care Guide for Patients. 2020. Available from: Canadian Medical Association: https://www.cma.ca/sites/default/files/pdf/Patient-Virtual-Care-Guide-E.pdf.

Howells, B. Virtual consultations – the challenges for good communication with our patients. 2020 Jul 6. Retrieved 07 12, 2021. Available from: AQUA - Advancing Quality Alliance: https://aqua.nhs.uk/virtual-consultations-the-challenges-for-good-communication-with-our-patients/

Gomez, T., Anaya, Y. B., Shih, K. J., & Tarn, D. M. A Qualitative Study of Primary Care Physicians’ Experiences With Telemedicine During COVID-19. Journal of the American Board of Family Medicine. 2021 Feb: S61-S70.

Matthews, J. C., Matthew, D. E., Mathur, S., John, N. S., Nayak, S., & Bothra, V. 411 Patient perspectives regarding online consultations during the COVID-19 pandemic. RCPCH Conference Singapore 6th–7th March 2021. BMJ Journals. 2021;5(Suppl 1): A1–A132.

Cleveland clinic center for excellence in healthcare communication. (2020). Empathy in virtual visits. Cleveland. Available from: https://consultqd.clevelandclinic.org/communicating-with-patients-in-a-new-world-of-virtual-visits/.

Moeller, A. M., Christensen, L. F., Hansen, J. P., & Andersen, P. T. Patients’ acceptance of video consultations in the mental health services: A systematic review and synthesis of qualitative research. Digital Health, Jan 2022:(8)1-16.

Dermer, M. Virtual Care Playbook. Canadian Medical Association. 2021 Sep: 1-16.

Kieran, R., Murphy, C., Maher, E., Buchalter, J., Sukor, S., & Alken, S. (2022). A permanent legacy of the pandemic? Outcomes of and staff views on the introduction of virtual clinics to an Irish oncology service. Irish Journal of Medical Science, 1-8.

Modic, M. B., Neuendorf, K., & Windover, A. K. Enhancing Your Webside Manner: Optimizing Opportunities for Relationship-Centered Care in Virtual Visits. Journal of Patience Experience. 2020; 7(6):869-877.

Greenhalgh, T. Video consultations: a guide for practice. 2020 Mar 18. Available from: BJGP Life: https://bjgplife.com/video-consultations-guide-for-practice/.

Gleeson, H. B., & Kalsi, A. S. Remote clinical consultations in restorative dentistry—A survey. Journal of Dentistry. 2022: 1-9.

Byrne, E., & Watkinson, S. Patient and clinician satisfaction with video consultations during the COVID-19 pandemic: an opportunity for a new way of working. Journal of Orthodontics. 2020; 48(1), 64-73.

Banerjee, S. C., Staley, J. M., Howell, F., Malling, C., Moreno, A., Kotsen, C., . . . Parker, P. A. Communicating Effectively via Tele-oncology (Comskil TeleOnc): a Guide for Best Practices for Communication Skills in Virtual Cancer Care. Journal of Cancer Education; 2021 Feb 05: 1-6.

International Chronic and Complex Conditions Research Group IC3RG. Developing a Strong ‘Web-Side Manner’ for Healthcare Providers using Video-Based Virtual Care. REFRESH. 2020. Available from: https://cdn.dal.ca/content/dam/dalhousie/pdf/sites/ic3rg/Webside%20Manner%20Tips.pdf.

Shannon, Claude E., and Warren Weaver. The Mathematical Theory of Communication. Illinois: University of Illinois Press. 2015.

Watzlawick, P., Bavelas, J. B., & Jackson, D. D. Pragmatics of Human Communication: A Study of Interactional Patterns, Pathologies, and Paradoxes. New York: W. W. Norton & Company, Inc. 2011.

Street, Richard L. "Communicating in medical encounters: An ecological perspective." In Handbook of health communication, by Theresa L. Thompson, Alicia M. Dorsey, Roxanne Parrott, & Katherine I. Miller. London: Lawrence Erlbaum Associates, 2003. 63-89 p.

Bateson, G. Steps to an Ecology of Mind: Collected Essays in Anthropology, Psychiatry, Evolution, and Epistemology. Chicago: University Of Chicago Press. 2000.

Vas V, North S, Rua T, et al. Delivering outpatient virtual clinics during the COVID-19 pandemic: early evaluation of clinicians’ experiences. BMJ Open Quality. 2022; 11: e001313.

Cegala, D. J., & Broz, S. L. Provider and patient communication skills training. In T. L. Thompson, Handbook of Health Communication. Mahwah, NJ: Lawrence Erlbaum Associates; 2003. 95-120p.

Dang, Bich N., Robert A. Westbrook, Sarah M. Njue, and Thomas P. Giordano. Building trust and rapport early in the new doctor-patient relationship: a longitudinal qualitative study. BMC Medical Education. (2017); 17(32): 1-10.

Maynard, & Heritage, J. Conversation analysis, doctor-patient interaction and medical communication. Medical Education. (2005); 39(4): 428-435.