J Telemed Telecare - A qualitative study of ethical, medico-legal and clinical governance matters in Australian telehealth services.

Tópicos

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{ cost(1906) reduc(1198) effect(832) }
{ decis(3086) make(1611) patient(1517) }
{ clinic(1479) use(1117) guidelin(835) }
{ care(1570) inform(1187) nurs(1089) }
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{ surgeri(1148) surgic(1085) robot(1054) }
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{ estim(2440) model(1874) function(577) }
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{ imag(2675) segment(2577) method(1081) }
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{ take(945) account(800) differ(722) }
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{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
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{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ model(3480) simul(1196) paramet(876) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ time(1939) patient(1703) rate(768) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

We examined how Australian telehealth service providers perceived and addressed ethical, medico-legal and clinical governance matters arising from service delivery. Thirty-seven telehealth clinicians and managers were interviewed and a qualitative content analysis was conducted. The services covered six Australian jurisdictions and a range of clinical disciplines. There were 11 medical specialities, surgery, mental health, paediatrics, nursing and allied health. Thirty services (83%) used video consulting and 25 (68%) delivered services to rural areas. Telehealth was reported to be beneficial by reducing adverse events, improving health outcomes, offering increased patient choice of service delivery, and improving access to services for rural areas and home care. There were observations of gains or no change in patient-provider rapport compared to face-to-face communication, with some patients reportedly preferring video. Those interviewed reported some problems with privacy and security, and variable informed consent practices. No examples of malpractice were raised, although there was a common misperception that distant providers were not responsible for clinical care. With respect to clinical governance, telehealth was seen as enabling improved quality, integration and implementation of evidence-based care, and to be a major support for the rural health workforce. Although there were potential ethical, medico-legal and governance problems in Australian telehealth services, these had been easily managed in practice.

Resumo Limpo

examin australian telehealth servic provid perceiv address ethic medicoleg clinic govern matter aris servic deliveri thirtyseven telehealth clinician manag interview qualit content analysi conduct servic cover six australian jurisdict rang clinic disciplin medic special surgeri mental health paediatr nurs alli health thirti servic use video consult deliv servic rural area telehealth report benefici reduc advers event improv health outcom offer increas patient choic servic deliveri improv access servic rural area home care observ gain chang patientprovid rapport compar facetofac communic patient report prefer video interview report problem privaci secur variabl inform consent practic exampl malpractic rais although common mispercept distant provid respons clinic care respect clinic govern telehealth seen enabl improv qualiti integr implement evidencebas care major support rural health workforc although potenti ethic medicoleg govern problem australian telehealth servic easili manag practic

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