Patient experience with telemedicine in primary care during the COVID pandemic: a qualitative study

Abstract

BackgroundThe Czech Republic is one of the countries with the low rate of digitization of health care processes, and the current legislation provides only isolated elements of electronic health care. Due to the COVID-19 pandemic, general practitioners (GPs) in the Czech Republic, as in other countries, had to rapidly switch to telemedicine visits. Information on patient perspectives about these visits is lacking. Our study aims to understand patients' perceptions about telemedicine visits at GPs during COVID-19, and to identify barriers and benefits of telemedicine in primary care.MethodsA qualitative approach was applied. 40 semi-structured interviews were conducted (25 with patients who had telemedicine visits with a GP, and 15 with representatives of patients' organisations). Data was analysed using a thematic analysis.ResultsIt has been shown that telemedicine visits took place mainly through telephone and email communication, without using the full potential of telemedicine. The absence of legal regulation and guidelines for telemedicine and the implementation of telemedicine in primary care without prior adaptation generates a number of problems in the patient-physician relationship. In some cases, the unregulated use of telemedicine leads to inequalities in access to healthcare. Persistent medical paternalism has also been shown to significantly affect telemedicine visits in primary care.ConclusionsThe results of the research will be used for the proposal of legislative changes in the field of distance care. Telemedicine guidelines will be created, considering the specifics of primary care. An educational program for patients on the improvement of their digital health literacy and on communication in healthcare using digital technologies will be created.Project funding: TL04000105 Digital literacy in primary health care: COVID-19 as a challenge for the development of information communication technologies, Technology Agency of the Czech Republic.Key messages Implementation of telemedicine in primary care, without prior adaptation to a new way of communication, generates problems in the patient-physician relationship.The absence of legal regulations and guidelines for telemedicine can lead to inequalities in access to healthcare.