Health Policy

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Andrea Fernández Coves ; Andrea Fernández Coves ; Karene Hoi Ting Yeung ; Ingeborg M van der Putten ; E. Anthony S Nelson

亮点

  • COVID-19 boosted teleconsultation adoption in Hong Kong and the Netherlands.
  • External context played a crucial role in teleconsultation uptake in both settings.
  • Hong Kong practitioners employed teleconsultation for chronic care management.
  • The dominant paradigm within Dutch practitioners was using teleconsultation for triaging purposes.
  • Comprehensive legislation and incentives are necessary for teleconsultation adoption in primary care.

摘要

The COVID-19 pandemic has boosted the adoption of digital health technologies such as teleconsultation. This research aimed to assess and compare barriers and facilitators for teleconsultation uptake for primary care practitioners in Hong Kong and the Netherlands and evaluate the role of their different healthcare funding models in this adoption process within the context of the COVID-19 pandemic.
A qualitative research following a social constructivist paradigm was performed. The study employed a conceptual framework from Lau and colleagues that identifies four levels of factors influencing change in primary care: (1) external contextual factors; (2) organization-related factors; (3) professional factors; and (4) characteristics of the intervention. The four levels were studied through semi-structured, open-ended interviews with primary care physicians. External factors were additionally assessed by means of a literature review.
Hong Kong and the Netherlands showed different penetration rates of teleconsultation. Most stakeholders in both settings shared similar barriers and facilitators in the organizational, professional, and intervention levels. However, external contextual factors (i.e., current teleconsultation legislation, available incentives, and level of public awareness) played an important and differing role in teleconsultation uptake and had a direct effect on the organization, the professionals involved, and the type of technology used. Political and organizational actions are required to develop a comprehensive legal framework for the sustainable development of teleconsultation in both settings.

Teleconsultation; Primary care; Hong Kong; Netherlands; Legislation; Health system; GP; ICT; Teleconsultation; WHO

10.5

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