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Hospital-based ambulatory clinic adoption of video and telephone visits before and during the COVID-19 pandemic: a convergent mixed-methods study

Vess Stamenova (Women's College Hospital, Toronto, Canada)
Suman Budhwani (Women's College Hospital, Toronto, Canada)
Charlene Soobiah (Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada)
Jamie Fujioka (Women's College Hospital, Toronto, Canada)
Rumaisa Khan (Women's College Hospital, Toronto, Canada)
Rebecca Liu (Women's College Hospital, Toronto, Canada)
Ilana Halperin (Division of Endocrinology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada) (Department of Medicine, University of Toronto, Toronto, Canada)
R. Sacha Bhatia (Women's College Hospital, Toronto, Canada) (Department of Medicine, University of Toronto, Toronto, Canada)
Laura Desveaux (Women's College Hospital, Toronto, Canada) (Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada) (Institute for Better Health, Trillium Health Partners, Mississauga, Canada)

Journal of Integrated Care

ISSN: 1476-9018

Article publication date: 5 July 2022

12

Abstract

Purpose

The purpose of this study is to understand virtual care use (e.g. telephone and video visits) during the COVID-19 pandemic across three hospital-based ambulatory clinics (i.e. mental health, renal and respiratory care) and to describe associated patient and provider experiences.

Design/methodology/approach

A mixed-methods convergent study was conducted including quantitative electronic medical records data on virtual care use, electronic surveys assessing domains of experience (e.g. satisfaction, acceptance and technology use) among patient and providers and semi-structured interviews exploring the associated barriers and facilitators of virtual care adoption.

Findings

Virtual care adoption rates and relative modality use (telephone vs video) varied across specialty clinics. Mental health clinics) showed the greatest use of virtual care and greater use of video over telephone, as compared to renal and respiratory care, where telephone was used almost exclusively. Patients and providers reported an overall good satisfaction and acceptance of virtual care (60–72%) across clinics, but commonly observed barriers (technical problems, behavioral adaptations needed and inequity) persisted. Good value propositions, tech support and the presence of early adopters who can support others in workflow re-design and highlight value propositions of virtual care were listed as adoption facilitators.

Originality/value

The study provides a unique opportunity to compare the rate of virtual care adoption before and during the COVID-19 pandemic across distinct specialties that operate within the same organizational and political setting. This study showed that the nature of the condition (e.g. mental health conditions) and the characteristics of the users (e.g. younger patients) may drive models of care with higher rate of video use. Focusing on removing common barriers, like providing tech support and ensuring equitable access to patients, continues to be important even in the context of high virtual care adoption rates during the pandemic.

Keywords

Acknowledgements

The authors would like to thank the Patient Advisors Network for providing partnership in this project and all the patients and providers for participating in the study.

Funding: Funding for this project was provided by the Ontario Ministry of Health through the Centre for Digital Health Evaluation.

Citation

Stamenova, V., Budhwani, S., Soobiah, C., Fujioka, J., Khan, R., Liu, R., Halperin, I., Bhatia, R.S. and Desveaux, L. (2022), "Hospital-based ambulatory clinic adoption of video and telephone visits before and during the COVID-19 pandemic: a convergent mixed-methods study", Journal of Integrated Care, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/JICA-01-2022-0011

Publisher

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Emerald Publishing Limited

Copyright © 2022, Emerald Publishing Limited

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