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

Abstract

The usage of telehealth in general practice (GP) has risen substantially ever since the COVID-19 pandemic. Over this timeframe, telehealth has provided care for all patient demographics, including the paediatric population (aged<18). However, the translatability of telehealth (ie, whether in-person tasks can be supported remotely via telehealth) rarely considers the paediatric population or their carers. To examine the degree of translatability to telehealth for in-person GP consultations on paediatric patients with consideration of the carers' roles. This study screened 281 videos of in-person GP consultations set within UK general practices, and 20 of them were eligible for analysis. Secondary analysis of in-person GP consultations 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. 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 'definitely or easily translatable to telehealth,' ' 29% 'somewhat 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. Tasks performed during paediatric in-person GP consultations may not be easily translatable to telehealth and caution should be exercised when considering its translatability to telehealth.