Patient-initiated video consultations: A qualitative study on reasons for patient-booking in Danish general practice.

Abstract

This qualitative study explores when and why patients book video consultations through an online booking platform within the context of Danish general practice and how the technology affects patients' use of this consultation type. We conducted thirteen semi-structured interviews with patients from the same general practice who were experienced users of video consultations scheduled through the clinic's online booking platform. Interviews were analysed using thematic analysis and drawing on actor-network theory and Bruno Latour's concept of technical mediation as an analytical framework. We introduce the concept of "hybrid patients," highlighting how values tied to video consultation that motivates patients to book them emerge through technical mediation in the network between patients, general practitioners (GPs) or practice staff, and the video technology. We identified three emerging values: efficiency, control and diminished presence. Video consultation affords efficient consultations that save patients' time. It mediates patients' sense of control when they experience certainty concerning their health issues. Video consultation mediates diminished presence that increases relational distance. However, it simultaneously allows for efficiency and emotional distance between patients and their GP, and between patients and their health issues. When initiating the use of video consultation, the patient plays an active and conscious role in adjusting to the mediated values (efficiency, control and diminished presence) linked to this form of consultation. These emerging values are context-specific, and patients employ them based on their individual requirements. Patients trust their GPs to prevent severe or vulnerable topics from being discussed in a video consultation.