JMIR Publications

ABSTRACT

Background:

Video consultations have become an established component of general practice and are increasingly promoted to improve access, efficiency, and healthcare sustainability. While previous research has primarily explored the perspectives of individual patients and healthcare professionals, less is known about how organisations involved in strategic video consultation implementation consider their benefits, challenges, and future role within healthcare systems.

Objective:

This study aims to explore the experiences of organisational interest-holders involved in implementing video consultations in Danish general practice, focusing on the perceived strengths, weaknesses, opportunities, and threats related to their use.

Methods:

A qualitative interview study was conducted with 17 representatives from 13 organisations involved in the development, support, regulation, governance, or strategic implementation of video consultations in Denmark. Purposive and snowball sampling identified participants from four different organisational groups: patient organisations, professional interest organisations, technology and digital health organisations, and public health authorities. Semi-structured interviews were conducted between October and December 2023. Data were analysed using deductive-inductive framework analysis informed by the Strengths, Weaknesses, Opportunities, and Threats (SWOT) framework.

Results:

Four overarching tensions, competing values, and dilemmas emerged across the organisational interest-holder groups: (1) improved access versus widening inequity, (2) efficiency versus relational and clinical quality and safety, (3) digital transformation versus implementation uncertainty, and (4) strategic governance versus target-driven digitalisation. Participants recognised that video consultations may improve accessibility, convenience, and coordination of care while supporting broader digital transformation. However, concerns were raised regarding digital exclusion, limitations in relational and clinical assessment, uncertainty about appropriate use, cross-sector implementation challenges, and governance approaches that prioritise utilisation targets over clinical value, quality, and patient safety.

Conclusions:

Exploring the perspectives of organisational interest-holders suggested that implementing video consultations in general practice is not simply a matter of increasing technology uptake. Rather, it requires balancing competing priorities related to access and equity, efficiency and quality/safety, digital transformation and implementation uncertainty, and governance and professional autonomy. Sustainable implementation should promote equitable access, context-sensitive clinical use, interoperable digital infrastructure, and governance frameworks that prioritise quality of care and patient safety alongside digital innovation.