Translating primary care to telehealth: analysis of in-person paediatric consultations and role of carers.

Abstract

Background: The usage of telehealth in general practice has risen substantially since the COVID-19 pandemic. Over this time frame, telehealth has provided care for all patient demographics, including the paediatric population (aged ≤18 years). However, the translatability of telehealth (that is, whether in-person tasks can be supported remotely via telehealth) rarely considers the paediatric population or their carers.

Aim: To examine the degree of translatability to telehealth for in-person GP consultations on paediatric patients with consideration of the carers' roles.

Design & setting: This study screened 281 videos of in-person GP consultations set within UK general practices, and 20 of them were eligible for analysis.

Method: A secondary analysis of in-person GP consultations was undertaken to examine tasks, physical artefacts, examinations, and the interaction between carer, patient, and GP. A novel scoring method revolving around two key metrics, taking into consideration the carer, was designed to analyse whether the tasks performed can be supported via telehealth.

Results: Analysis of 20 eligible consultations revealed 13 distinct physical examinations, 19 physical artefacts, and 17 clinical tasks. Of these 17 clinical tasks, 41% were deemed 'easily translatable to telehealth,' 29% 'moderately translatable with patient-provided equipment', 12% 'potentially translatable', and 18% 'currently untranslatable'. The average telehealth translatability score was 6.1/10, which suggests possible challenges with telehealth support. Regarding carer involvement, 90% of consultations involved collecting patient history, 70% placation of child, and 40% had physical support during examinations.

Conclusion: Tasks performed during paediatric in-person GP consultations may not be easily translatable to telehealth and caution should be exercised when considering their translatability to telehealth.