JMIR Publications

ABSTRACT

Background:

Multimorbidity, the co-existence of multiple chronic conditions in an individual, remains as a growing public health challenge. Amidst the COVID-19 pandemic, physical distancing remains as an indispensable measure to limit the spread of the virus. This pertains especially to those belonging to high-risk groups, namely older adults with multimorbidity. In-person consultation is discouraged for this group of patients, hence there is a need for alternative form of consultation such as video consultation to continue the care provision.

Objective:

The potential of video consultations has been explored in several studies. However, the emergence of COVID-19 presents us with an unprecedented opportunity to explore the use of this technological innovation in a time when physical distancing is imperative. This study will evaluate the sustainability of video consultations on a micro, meso and macro level by assessing the views of patients, physicians, organizational and national policymakers respectively.

Methods:

The NASSS (Non-adoption, Abandonment, Scale-up, Spread and Sustainability) framework was designed as a guide for the development of healthcare technologies. In this study, the implementation and experiences of video consultations will be studied using the NASSS framework. Individual in-depth interviews will be conducted with all participants using the Zoom platform. Data will be analyzed by at least two investigators trained in qualitative methodology, organized thematically and coded in two phases – an initial phase and a focused, selective phase. All disagreements will be resolved by consulting the larger research team until consensus is reached.

Results:

This study was approved for funding on 12th June 2020 and the research ethics board has approved the conduct of the study as of 18th June 2020. Formal study recruitment will commence in July 2020. The results of the data analysis are expected to be available by December 2020.

Conclusions:

This study aims to evaluate the adoption and sustainability of video consultations for older adults with multimorbidity during the pandemic as well as post-COVID-19. The study will yield knowledge that will challenge the current paradigm on how care is being delivered for community-dwelling older adults with multimorbidity. Findings will be shared with administrators in the healthcare sector in order to enhance the safety and quality of these video consultations to improve patient care for this group of population.