Abstract
BackgroundIntroducing new technology in health care is inevitably a challenge. More knowledge is needed to better plan future telemedicine interventions. Our aim was therefore to explore health care professionals’ experience in the initial phase of introducing telemedicine technology in caring for people with diabetic foot ulcers.MethodsOur methodological strategy was Interpretive Description. Data were collected between 2014 and 2015 using focus groups (n = 10). Participants from home-based care, primary care and outpatient hospital clinics were recruited from the intervention arm of an ongoing cluster randomized controlled trial (RCT) (Clinicaltrials.gov: NCT01710774). Most were nurses (n = 29), but the sample also included one nurse assistant, podiatrists (n = 2) and physicians (n = 2).ResultsThe participants reported experiencing meaningful changes to their practice arising from telemedicine, especially associated with increased wound assessment knowledge and skills and improved documentation quality. They also experienced more streamlined communication between primary health care and specialist health care. Despite obstacles associated with finding the documentation process time consuming, the participants’ attitudes to telemedicine were overwhelmingly positive and their general enthusiasm for the innovation was high.ConclusionsOur findings indicate that using a telemedicine intervention enabled the participating health care professionals to approach their patients with diabetic foot ulcer with more knowledge, better wound assessment skills and heightened confidence. Furthermore, it streamlined the communication between health care levels and helped seeing the patients in a more holistic way.
Highlights
Introducing new technology in health care is inevitably a challenge
We came to understand that there was a generally held view in all of the focus groups that the participants experienced meaningful changes, and the changes had benefitted their practice in three ways: (1) Increased wound assessment knowledge and skills (2) Improved documentation quality (3) Streamlined communication between primary health care and specialist health care
Increased wound assessment knowledge and skills The health care professionals found that they increased their wound assessments skills when using telemedicine in their follow-up care for people with diabetic foot ulcers
Summary
Introducing new technology in health care is inevitably a challenge. More knowledge is needed to better plan future telemedicine interventions. Our aim was to explore health care professionals’ experience in the initial phase of introducing telemedicine technology in caring for people with diabetic foot ulcers. Telemedicine ( referred to as telehealth, telemedicine and telecare) has been introduced as a potential method for delivering follow-up care to people with diabetic foot ulcers [1,2,3]. A handful of small quantitative studies [4, 5] have suggested that telemedicine is a feasible method, randomised controlled trials are needed to determine ways to deliver diabetes foot care that are contextually appropriate, feasible and sustainable among people with diabetic foot ulcers [6]. The study we describe in this paper is a part of a larger cluster randomized controlled trial designed to investigate telemedicine follow-up care for people with diabetic foot ulcers in primary health care in collaboration with specialist health care. One study of telemedicine within a health care district in Finland illuminated the importance of communication between health care professionals for the quality of patient care [11], the available information on broader issues, including inter-professional collaboration at the community level, is as yet quite limited [12]
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