JMIR Publications

ABSTRACT

Background:

This study reports the experiences faced by a multi-disciplinary healthcare team (PACT), on shifting rapidly from face-to-face care to using video meetings(s) (VM) for clinical and collaborative services during the initial phase of the Covid-19 pandemic. PACT focuses on the transitional phase between hospital and primary care, for elderly patients in Northern Norway with complex and long-term needs (CLN). PACT emphasises the patient-centred care (PCC) approach whereby the sharing of power, and the patients ‘answer to “what matters to you?” drives care decisions. However, during the Covid-19 (novel coronavirus) pandemic VM was the only option for assessing, planning, coordinating, and performing treatment and care. This study explores how PACT managed to maintain PCC under these conditions.

Objective:

In this paper, we address the following research questions: How do we preserve a PCC focus for persons with CLN in care services, when VM becomes the main mode of clinical communication, due to social distancing measures during the Covid-19 pandemic? What are the challenges and possibilities for healthcare personnel in PACT when a rapid transfer from face-to-face care to video meetings is needed?

Methods:

This case study has a qualitative approach based on four semi-structured focus group interviews, from May and June 2020, with 18 PACT members and leaders.

Results:

From the case study, we learn that VMs are not a good solution for all persons with CLN. Healthcare personnel in PACT had divided opinions on the potential of using VM to preserve PCC for this heterogeneous patient group. Some found it difficult to digitally assess and communicate with patients with hearing disabilities and reduced cognitive capacity. Whereas others reported the opposite, namely that VM made it possible to include even the most fragile patients. The study outlines that using VM presented the opportunity for more efficient use of healthcare personnel, reduced travelling time for patients, and improved the information exchange between healthcare levels. This implied that integration of VM contributed to preservation of the PCC focus during the Covid-19 pandemic. There was an overall agreement in PACT that face-to-face care had to be the core foundation for a PCC approach, and VM was mainly useful to reinforce follow-up and coordination.

Conclusions:

The rapid transfer from face-to-face care generated a need for time to practice and define guidelines for using the technology amongst the different healthcare actors. In addition, technical support to healthcare personnel and patients was important to highlight. Scaling up the use of VM made it important in defining overall agreements between the different healthcare organisations for rearranging healthcare services.