JMIR Publications

ABSTRACT

Background:

Remote consultations using videoconferencing was recommended by the General Medical Council as the method for clinicians to provide patient consultations during the COVID-19 pandemic. Facilitating this while providing high quality care depends on the usability and acceptability of the technology.

Objective:

This project aimed to investigate parents’ experiences of using videoconference technology for real time remote consultations with children who had congenital heart defects during the COVID-19 pandemic lockdown.

Methods:

The study design was quasi-experimental and was underpinned by the Unified Theory of Acceptance and Use of Technology (UTAUT) model that seeks to explain and predict an individual's intention to use a technology. Parents were informed of the study by the medical team, posters were made available on the wards and clinics, and leaflets were left for browsing. Clinician screening of potential participants led to the identification of 33 children and parent(s) who were enrolled for the study. The intervention was an online remote consultation by medical staff using the PEXIP videoconferencing application. Each child and their mother/father received eight remote consultations with the same specialist doctor or nurse. Measurements were taken using online questionnaires pre and post consultation at the first, middle and last events; questions were focused on the acceptability, usability, and clinical applicability of remote consultations. Parents experiences were explored using recorded interviews and analysed thematically.

Results:

Twenty-nine children aged 4-1052 days (mean 95 days) completed the project receiving total of 189 remote consultations as part of their routine care. Parents prior experience of consultation via video conference was low, however, as time progressed their use of and acceptance of the technology increased. The intervention was warmly received by all parents who found the virtual face-to-face component particularly useful for discussion with their child’s medical team. Furthermore, parents noted the savings on time, money, and childcare.

Conclusions:

While face-to-face consultations are considered the gold standard of patient care, increasing pressures on health services and staff reduce availability. Given the ease of access and additional benefits experienced by parents and their children it is proposed that hybrid models of consultation and care provision is equal to if not superior to face-to-face in the management of children with severe congenital heart defects while reducing costs and pressure on the health service and parents.