JMIR Publications

ABSTRACT

Background:

Video consultations (VCs) are effective and beneficial, yet their use is being discontinued, and there is a preference for face-to-face consultations.

Objective:

This study investigates how patients and healthcare professionals perceive patients’ introduction to VCs, who uses them, and what drives their use in Swedish primary care.

Methods:

Six focus group interviews with with 27 HCPs and 13 individual interviews with patients in primary care were conducted. The interviews examined VC implementation and were analyzed using rapid assessment procedures.

Results:

A total of five themes were identified under the three predefined domains. Patients and HCPs described the introduction of VCs as rushed and confusing, with limited guidance and support. HCPs struggled to assist patients due to a lack of training and no access to the patient-facing interface. VC users were typically perceived as younger, digitally literate, and motivated by convenience or urgency, while older adults and those with language or cognitive barriers were often assumed to be non-users. VC use was shaped by patient preferences, accessibility, and clinical urgency, as well as by HCPs’ professional judgment and convenience. Assumptions held by HCPs about patients’ digital skills and preferences influenced whether VCs were offered, while patients’ own assumptions about complexity or suitability affected whether they accepted them. Broader factors, such as digital infrastructure, platform usability, reimbursement policies, and the COVID-19 pandemic,also significantly influenced use.

Conclusions:

To support more sustainable and equitable use of video consultations in primary care, future efforts should focus on improving the usability of VC platforms, strengthening digital infrastructure, and ensuring that both healthcare professionals and patients are better prepared to use these services. Addressing assumptions and biases, particularly around age, digital skills, and communication abilities, is crucial to prevent exclusion and to ensure that VCs are offered equitably. Policymakers and healthcare organizations should also consider the impact of organizational routines, reimbursement structures, and service design on uptake and long-term use. Strengthening support and training for both patients and HCPs may help close the digital divide and improve the appropriate integration of VCs into routine care.