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Research

Translating primary care to telehealth: analysis of in-person consultations on diabetes and cardiovascular disease

Jared Lane, Katrina David, Jayashanthi Ramarao, Kanesha Ward, Sunayana Raghuraman, Moomna Waheed and Annie YS Lau
BJGP Open 2023; 7 (1): BJGPO.2022.0123. DOI: https://doi.org/10.3399/BJGPO.2022.0123
Jared Lane
1 Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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  • ORCID record for Jared Lane
  • For correspondence: jared.lane@students.mq.edu.au
Katrina David
1 Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Jayashanthi Ramarao
1 Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Kanesha Ward
1 Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Sunayana Raghuraman
1 Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Moomna Waheed
1 Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Annie YS Lau
1 Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Article Figures & Data

Figures

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    Figure 1. Frequency of physical examinations performed during in-person consultations, as a percentage of total consultations (n = 17)
  • Figure 2.
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    Figure 2. Frequency of physical artefacts used during in-person consultations (n = 17). *Physical artefact dispensed either by GP or at GP reception desk
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    Figure 3. Tasks performed during in-person T2DM or CVD GP consultations as a percentage of total consultations, ordered by frequency (n = 17). *Physical dispensation either by GP or at GP reception desk

Tables

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    Table 1. Metrics used to score translatability of in-person tasks
    Metric 1: Clinical endorsement score
    Score Description
    1/5Requires in-person clinical expertise; for example, swabs, smears, excising lesions, giving injections
    2/5In-person clinical expertise is preferred but remote digital solutions are possible; for example, skin inspections, auscultation, palpation, foot examinations
    3/5Clinical endorsement is required for interpretation of results that the patient can collect in their homes, as well as for tasks that have current digital solutions; for example, temperature checks, weight, blood pressure, glucose readings, oxygen saturation, heart rate
    4/5Medical endorsement is required for tasks, such as targeted history-taking, but no specific equipment is required, making it easier to perform over telehealth
    5/5Medical expertise may not necessarily be required to complete this task; for example, printing
    Metric 2: Physical artefacts or physical interactions score
    Score Description
    1/5Requires equipment or physical examination in a manner not translatable to telehealth; for example, swabs, smears and so on
    2/5Requires equipment or physical examination potentially translatable to telehealth but preferable in-person; for example, auscultation, physical inspection involving palpation
    3/5Requires equipment that is easily purchasable in most pharmacies, or requires pick-up or delivery; for example, thermometers, blood pressure monitors
    4/5Requires equipment that is easily accessible in a patient’s home, and thus can be translated over telehealth; for example, computer, printer, weight scale
    5/5Does not require any equipment, thus readily translatable over telehealth; for example, discussing diet or medication use
    • View popup
    Table 2. Translatability to telehealth score interpretation. A non-colour dependent version of this table is available in the supplementary materials.
    Metric 1: Clinical endorsement scoreMetric 2: Physical artefacts or physical interactions score
    54321
    5 109876*
    4 98765*
    3 87654*
    2 76543*
    1 6*5*4*3*2*
    • *Not currently translatable to telehealth. Careful attention required when evaluating whether a task (with this score combination) is indeed translatable using current forms of technology.

    • Embedded Image: Easily translatable over telehealth with no additional physical artefacts required = type 5.

    • Embedded Image: Relatively easy to translate over telehealth, with minimal but easily accessible equipment required = type 4.

    • Embedded Image: Moderately translatable over telehealth but may require patient to acquire their own equipment to do so = type 3.

    • Embedded Image: Has the potential to be translated over telehealth but may require clinician to administer virtual examination, and may require patient to obtain special equipment and training = type 2.

    • Embedded Image: Not amenable to being replicated over telehealth at this stage = type 1.

    • View popup
    Table 3. Translatability to telehealth score and corresponding virtual care solution type
    Translatability to telehealth scoreDescriptionVirtual care solutionDescription
    Embedded Image= Type 5Easily translatable over telehealth with no additional physical artefacts requiredType 5Clinicians and/or patients can easily exchange information over the telephone and/or video (for example, discussing diet or medication)
    Embedded Image= Type 4Relatively easy to translate over telehealth, with minimal but easily accessible equipment requiredType 4Patients conduct self-assessment at home and communicate self-reported findings; for example, measuring weight, print electronic requests or results
    Embedded Image= Type 3Moderately translatable over telehealth but may require patient to acquire their own equipment to do soType 3Patients acquire necessary artefacts through purchase or pick-up, and perform and communicate findings. Virtual guidance or training may be required; for example, measuring oxygen saturation or blood pressure
    Embedded Image= Type 2Has the potential to be translated over telehealth but may require clinician to administer virtual examination, and may require patient to obtain special equipment and trainingType 2Clinician administers virtual examination. May require patient to obtain special equipment and training; for example, virtual foot examination
    Embedded Image= Type 1Not amenable to being replicated over telehealth at this stageN/AN/A

Supplementary Data

  • Lane_BJGPO.2022.0123_supp.pdf -

    Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.

  • Table_2_BJGPO.2022.0123.pdf -

    Table 2, non-colour dependent version

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Translating primary care to telehealth: analysis of in-person consultations on diabetes and cardiovascular disease
Jared Lane, Katrina David, Jayashanthi Ramarao, Kanesha Ward, Sunayana Raghuraman, Moomna Waheed, Annie YS Lau
BJGP Open 2023; 7 (1): BJGPO.2022.0123. DOI: 10.3399/BJGPO.2022.0123

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Translating primary care to telehealth: analysis of in-person consultations on diabetes and cardiovascular disease
Jared Lane, Katrina David, Jayashanthi Ramarao, Kanesha Ward, Sunayana Raghuraman, Moomna Waheed, Annie YS Lau
BJGP Open 2023; 7 (1): BJGPO.2022.0123. DOI: 10.3399/BJGPO.2022.0123
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Keywords

  • General Practice
  • telehealth
  • Primary healthcare
  • COVID-19
  • Diabetes mellitus, type 2
  • cardiovascular diseases

More in this TOC Section

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  • “We’re all in the same boat… some of us just have more holes in their boat”: a qualitative interview study primary care staff views of Deep End Cymru
  • General practitioner characteristics and video use in out-of-hours primary care: a register-based study
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