How does the use of digital consulting change the meaning of being a patient and/or a health professional? Lessons from the Long-term Conditions Young People Networked Communication study.
Digital health
Long-term Conditions Young People Networked Communication
access
digital consulting
empowerment
healthcare professional
identity
patient
power
workload
Journal
Digital health
ISSN: 2055-2076
Titre abrégé: Digit Health
Pays: United States
ID NLM: 101690863
Informations de publication
Date de publication:
Historique:
received:
21
10
2019
accepted:
22
06
2020
entrez:
4
8
2020
pubmed:
4
8
2020
medline:
4
8
2020
Statut:
epublish
Résumé
While studies have examined the impact of digital communication technology on healthcare, there is little exploration of how new models of digital care change the roles and identities of the health professional and patient. The purpose of the current study is to generate multidisciplinary reflections and questions around the use of digital consulting and the way it changes the meaning of being a patient and/or a health professional. We used a large pre-existing qualitative dataset from the Long-term Conditions Young People Networked Communication (LYNC) study which involved interviews with healthcare professionals and a group of 16-24 years patients with long-term physical and mental health conditions. We conducted a three-stage mixed methods analysis. First, using a small sample of interview data from the LYNC study, we identified three key themes to explore in the data and relevant academic literature. Second, in small groups we conducted secondary analysis of samples of patient and health professional LYNC interview data. Third, we ran a series of rapid evidence reviews. We identified three key themes: workload/flow, impact of increased access to healthcare and vulnerabilities. Both health professionals and patients were 'on duty' in their role more often. Increased access to healthcare introduced more responsibilities to both patients and health professionals. Traditional concepts in medical ethics, confidentiality, empathy, empowerment/power, efficiency and mutual responsibilities are reframed in the context of digital consulting. Our collaboration identified conflicts and constraints in the construction of digital patients and digital clinicians. There is evidence that digital technologies change the nature of a medical consultation and with it the identities and the roles of clinicians and patients which, in turn, calls for a redefinition of traditional concepts of medical ethics. Overall, digital consulting has the potential to significantly reduce costs while maintaining or improving patient care and clinical outcomes. Timely study of digital engagement in the National Health Service is a matter of critical importance.
Sections du résumé
BACKGROUND
BACKGROUND
While studies have examined the impact of digital communication technology on healthcare, there is little exploration of how new models of digital care change the roles and identities of the health professional and patient. The purpose of the current study is to generate multidisciplinary reflections and questions around the use of digital consulting and the way it changes the meaning of being a patient and/or a health professional.
METHOD
METHODS
We used a large pre-existing qualitative dataset from the Long-term Conditions Young People Networked Communication (LYNC) study which involved interviews with healthcare professionals and a group of 16-24 years patients with long-term physical and mental health conditions. We conducted a three-stage mixed methods analysis. First, using a small sample of interview data from the LYNC study, we identified three key themes to explore in the data and relevant academic literature. Second, in small groups we conducted secondary analysis of samples of patient and health professional LYNC interview data. Third, we ran a series of rapid evidence reviews.
FINDINGS
RESULTS
We identified three key themes: workload/flow, impact of increased access to healthcare and vulnerabilities. Both health professionals and patients were 'on duty' in their role more often. Increased access to healthcare introduced more responsibilities to both patients and health professionals. Traditional concepts in medical ethics, confidentiality, empathy, empowerment/power, efficiency and mutual responsibilities are reframed in the context of digital consulting.
CONCLUSIONS
CONCLUSIONS
Our collaboration identified conflicts and constraints in the construction of digital patients and digital clinicians. There is evidence that digital technologies change the nature of a medical consultation and with it the identities and the roles of clinicians and patients which, in turn, calls for a redefinition of traditional concepts of medical ethics. Overall, digital consulting has the potential to significantly reduce costs while maintaining or improving patient care and clinical outcomes. Timely study of digital engagement in the National Health Service is a matter of critical importance.
Identifiants
pubmed: 32742716
doi: 10.1177/2055207620942359
pii: 10.1177_2055207620942359
pmc: PMC7375714
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
2055207620942359Informations de copyright
© The Author(s) 2020.
Références
J Med Internet Res. 2009 Sep 30;11(3):e36
pubmed: 19793720
Methods Inf Med. 1998 Sep;37(3):294-301
pubmed: 9787631
Front Public Health. 2015 May 05;3:134
pubmed: 26000272
Implement Sci. 2016 Oct 26;11(1):146
pubmed: 27782832
Digit Health. 2015 Jun 29;1:2055207615593698
pubmed: 29942543
Inform Prim Care. 2008;16(3):203-11
pubmed: 19094407
J Telemed Telecare. 2009;15(3):150-2
pubmed: 19364901
J Med Internet Res. 2014 Nov 19;16(11):e257
pubmed: 25413368
Community Ment Health J. 2017 Oct;53(7):842-851
pubmed: 28097493
Inform Prim Care. 2004;12(4):201-6
pubmed: 15808021
N Engl J Med. 1996 May 30;334(22):1441-7
pubmed: 8618584
Soc Sci Med. 2008 Nov;67(10):1481-91
pubmed: 18701201
J Med Internet Res. 2017 Apr 10;19(4):e102
pubmed: 28396301
BMC Med Ethics. 2018 Feb 23;19(1):11
pubmed: 29475437
Inform Prim Care. 2004;12(3):129-38
pubmed: 15606985
Fam Med. 2013 May;45(5):335-40
pubmed: 23681685
J Gen Intern Med. 1995 Feb;10(2):59-66
pubmed: 7730940
Rev Am Hist. 1997 Sep;25(3):451-5
pubmed: 11619503
J Health Serv Res Policy. 2005 Jan;10(1):45-53
pubmed: 15667704
J Med Internet Res. 2017 Apr 25;19(4):e122
pubmed: 28442454
J Med Internet Res. 2009 Mar 30;11(1):e10
pubmed: 21821504
BMJ. 2005 Nov 19;331(7526):1199-201
pubmed: 16293845
Soc Sci Med. 2015 Nov;145:145-53
pubmed: 25464871
J Telemed Telecare. 2017 Aug;23(7):665-672
pubmed: 27450571
Soc Sci Med. 2015 Oct;142:90-9
pubmed: 26298645
Digit Health. 2016 Nov 21;2:2055207616675559
pubmed: 29942570
J Med Internet Res. 2017 Sep 29;19(9):e329
pubmed: 28963090
Soc Sci Med. 2001 Jun;52(12):1889-901
pubmed: 11352414
Diabetes Technol Ther. 2011 May;13(5):563-9
pubmed: 21406018
Fam Pract. 2016 Oct;33(5):523-8
pubmed: 27418587
Sci Eng Ethics. 2018 Feb;24(1):93-107
pubmed: 28281148
Adm Policy Ment Health. 2011 Nov;38(6):459-75
pubmed: 21259068
Prim Health Care Res Dev. 2017 Jan;18(1):14-23
pubmed: 27132634
Soc Sci Med. 1998 Nov;47(10):1573-88
pubmed: 9823053
J Med Internet Res. 2003 Apr-Jun;5(2):e9
pubmed: 12857665
Mhealth. 2017 Sep 14;3:38
pubmed: 29184890
Implement Sci. 2016 Mar 22;11:40
pubmed: 27001107