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Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom

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Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom. / Bagot, K.L.; Cadilhac, D.A.; Bladin, C.F. et al.
In: BMC Health Services Research, Vol. 17, No. 1, 751, 21.11.2017.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Bagot, KL, Cadilhac, DA, Bladin, CF, Watkins, C, Vu, M, Donnan, GA, Dewey, HM, Emsley, H, Davies, DP, Day, E, Ford, GA, Price, CI, May, CR, McLoughlin, ASR, Gibson, JME, Lightbody, CE, VST & ASTUTE investigators 2017, 'Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom', BMC Health Services Research, vol. 17, no. 1, 751. https://doi.org/10.1186/s12913-017-2694-1

APA

Bagot, K. L., Cadilhac, D. A., Bladin, C. F., Watkins, C., Vu, M., Donnan, G. A., Dewey, H. M., Emsley, H., Davies, D. P., Day, E., Ford, G. A., Price, C. I., May, C. R., McLoughlin, A. S. R., Gibson, J. M. E., Lightbody, C. E., VST, & ASTUTE investigators (2017). Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom. BMC Health Services Research, 17(1), Article 751. https://doi.org/10.1186/s12913-017-2694-1

Vancouver

Bagot KL, Cadilhac DA, Bladin CF, Watkins C, Vu M, Donnan GA et al. Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom. BMC Health Services Research. 2017 Nov 21;17(1):751. doi: 10.1186/s12913-017-2694-1

Author

Bagot, K.L. ; Cadilhac, D.A. ; Bladin, C.F. et al. / Integrating acute stroke telemedicine consultations into specialists' usual practice : a qualitative analysis comparing the experience of Australia and the United Kingdom. In: BMC Health Services Research. 2017 ; Vol. 17, No. 1.

Bibtex

@article{9e414f9916424386909425ae5d2a2423,
title = "Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom",
abstract = "BackgroundStroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations.MethodsSpecialist participants were identified using purposive sampling from two new services: Australia{\textquoteright}s Victorian Stroke Telemedicine Program (n = 6; 2010–13) and the United Kingdom{\textquoteright}s Cumbria and Lancashire telestroke network (n = 5; 2010–2012). Semi-structured interviews were conducted pre- and post-implementation, recorded and transcribed verbatim. Deductive thematic and content analysis (NVivo) was undertaken by two independent coders using Normalisation Process Theory to explore integration of telemedicine into practice. Agreement between coders was M = 91%, SD = 9 and weighted average κ = 0.70.ResultsCross-cultural similarities and differences were found. In both countries, specialists described old and new consulting practices, the purpose and value of telemedicine systems, and concerns regarding confidence in the assessment and diagnostic skills of unknown colleagues requesting telemedicine support. Australian specialists discussed how remote consultations impacted on usual roles and suggested future improvements, while United Kingdom specialists discussed system governance, policy and procedures.ConclusionAustralian and United Kingdom specialists reported telemedicine required changes in work practice and development of new skills. Both groups described potential for improvements in stroke telemedicine systems with Australian specialists more focused on role change and the United Kingdom on system governance issues. Future research should examine if cross-cultural variation reflects different models of care and extends to other networks.",
keywords = "Telemedicine, Normalisation process theory, Implementation, Barriers, Facilitators, Acute, Consultation",
author = "K.L. Bagot and D.A. Cadilhac and C.F. Bladin and Caroline Watkins and M. Vu and G.A. Donnan and H.M. Dewey and Hedley Emsley and D.P. Davies and E. Day and G.A. Ford and C.I. Price and C.R. May and A.S.R. McLoughlin and J.M.E. Gibson and C.E. Lightbody and VST and {ASTUTE investigators}",
year = "2017",
month = nov,
day = "21",
doi = "10.1186/s12913-017-2694-1",
language = "English",
volume = "17",
journal = "BMC Health Services Research",
issn = "1472-6963",
publisher = "BMC",
number = "1",

}

RIS

TY - JOUR

T1 - Integrating acute stroke telemedicine consultations into specialists' usual practice

T2 - a qualitative analysis comparing the experience of Australia and the United Kingdom

AU - Bagot, K.L.

AU - Cadilhac, D.A.

AU - Bladin, C.F.

AU - Watkins, Caroline

AU - Vu, M.

AU - Donnan, G.A.

AU - Dewey, H.M.

AU - Emsley, Hedley

AU - Davies, D.P.

AU - Day, E.

AU - Ford, G.A.

AU - Price, C.I.

AU - May, C.R.

AU - McLoughlin, A.S.R.

AU - Gibson, J.M.E.

AU - Lightbody, C.E.

AU - VST

AU - ASTUTE investigators

PY - 2017/11/21

Y1 - 2017/11/21

N2 - BackgroundStroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations.MethodsSpecialist participants were identified using purposive sampling from two new services: Australia’s Victorian Stroke Telemedicine Program (n = 6; 2010–13) and the United Kingdom’s Cumbria and Lancashire telestroke network (n = 5; 2010–2012). Semi-structured interviews were conducted pre- and post-implementation, recorded and transcribed verbatim. Deductive thematic and content analysis (NVivo) was undertaken by two independent coders using Normalisation Process Theory to explore integration of telemedicine into practice. Agreement between coders was M = 91%, SD = 9 and weighted average κ = 0.70.ResultsCross-cultural similarities and differences were found. In both countries, specialists described old and new consulting practices, the purpose and value of telemedicine systems, and concerns regarding confidence in the assessment and diagnostic skills of unknown colleagues requesting telemedicine support. Australian specialists discussed how remote consultations impacted on usual roles and suggested future improvements, while United Kingdom specialists discussed system governance, policy and procedures.ConclusionAustralian and United Kingdom specialists reported telemedicine required changes in work practice and development of new skills. Both groups described potential for improvements in stroke telemedicine systems with Australian specialists more focused on role change and the United Kingdom on system governance issues. Future research should examine if cross-cultural variation reflects different models of care and extends to other networks.

AB - BackgroundStroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations.MethodsSpecialist participants were identified using purposive sampling from two new services: Australia’s Victorian Stroke Telemedicine Program (n = 6; 2010–13) and the United Kingdom’s Cumbria and Lancashire telestroke network (n = 5; 2010–2012). Semi-structured interviews were conducted pre- and post-implementation, recorded and transcribed verbatim. Deductive thematic and content analysis (NVivo) was undertaken by two independent coders using Normalisation Process Theory to explore integration of telemedicine into practice. Agreement between coders was M = 91%, SD = 9 and weighted average κ = 0.70.ResultsCross-cultural similarities and differences were found. In both countries, specialists described old and new consulting practices, the purpose and value of telemedicine systems, and concerns regarding confidence in the assessment and diagnostic skills of unknown colleagues requesting telemedicine support. Australian specialists discussed how remote consultations impacted on usual roles and suggested future improvements, while United Kingdom specialists discussed system governance, policy and procedures.ConclusionAustralian and United Kingdom specialists reported telemedicine required changes in work practice and development of new skills. Both groups described potential for improvements in stroke telemedicine systems with Australian specialists more focused on role change and the United Kingdom on system governance issues. Future research should examine if cross-cultural variation reflects different models of care and extends to other networks.

KW - Telemedicine

KW - Normalisation process theory

KW - Implementation

KW - Barriers

KW - Facilitators

KW - Acute

KW - Consultation

U2 - 10.1186/s12913-017-2694-1

DO - 10.1186/s12913-017-2694-1

M3 - Journal article

VL - 17

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

IS - 1

M1 - 751

ER -