JMIR Publications

ABSTRACT

Background:

Telecare has been partly integrated into the healthcare service in western countries over the last decade, aiming to assist the healthcare service battle with well-known challenges pertaining to demographic changes. Telecare is used to enhance the accessibility and efficiency of healthcare services. Focus on quality has had high priority within the healthcare service, and, recently, the emphasis on quality and telecare has become increasingly relevant, as more assistive technology is being implemented.

Objective:

The study aims to evaluate quality in the telecare service provided by municipal call centres in Norway, according to the ARCHIE framework.

Methods:

This study had a qualitative multiple case study design, investigating the quality of telecare provided through municipal call centres in Norway. Interviews and observations were performed, as well as document studies to understand the background of the call centres. Five municipal call centres were included in the study, covering approximately 60 municipalities across Norway. Eleven interviews with 15 informants, holding a variety of positions, were performed. The ARCHIE framework was used to analyse the data collected. The analysis was a combined deductive-inductive analysis identifying text segments according to the ARCHIE-framework, followed by qualitative content analysis of the text compiled according to each category in the framework.

Results:

Findings from this study show that many stakeholders were involved in the shaping of quality in the telecare service. The stakeholders and the process of allocating telecare services were mapped along with quality in the delivered services, with the results showing that none of the ARCHIE framework categories were fully met.

Conclusions:

The findings are not in line with the quality criteria for service defined by the ARCHIE framework. Several challenges were found at the system level, the professional level and the patient level within the telecare service, which reflected weaknesses with how the telecare service is organized. The voice of the patient is one key to resolve the challenges with quality in the telecare service. Patient-centred care should be at the core of decision-making. Clinical Trial: Registered and approved by the Norwegian Agency for Shared Services in Education and Research (SIKT). Ethics approval number: 426173.