Nurses' and community support workers' experience of telehealth: a longitudinal case study.
BACKGROUND
Introduction of telehealth into the healthcare setting has been recognised as a service that might be experienced as disruptive. This paper explores how this disruption is experienced.


METHODS
In a longitudinal qualitative study, we conducted focus group discussions prior to and semi structured interviews post introduction of a telehealth service in Nottingham, U.K. with the community matrons, congestive heart failure nurses, chronic obstructive pulmonary disease nurses and community support workers that would be involved in order to elicit their preconceptions and reactions to the implementation.


RESULTS
Users experienced disruption due to the implementation of telehealth as threatening. Three main factors add to the experience of threat and affect the decision to use the technology: change in clinical routines and increased workload; change in interactions with patients and fundamentals of face-to-face nursing work; and change in skills required with marginalisation of clinical expertise.


CONCLUSIONS
Since the introduction of telehealth can be experienced as threatening, managers and service providers should aim at minimising the disruption caused by taking the above factors on board. This can be achieved by employing simple yet effective measures such as: providing timely, appropriate and context specific training; provision of adequate technical support; and procedures that allow a balance between the use of telehealth and personal visit by nurses delivering care to their patients.
Department of Computer Science, Brunel University, Kingston Lane, Uxbridge, Middlesex, UK. Urvashi.Sharma@brunel.ac.uk.
Urvashi
U
Sharma
Malcolm
M
Clarke
D001291:Attitude of Health Personnel; D003153:Community Health Services; D003150:Community Health Workers; D004739:England; D017144:Focus Groups; D006302:Health Services Research; D006333:Heart Failure / Q000451:nursing; D006801:Humans; D008137:Longitudinal Studies; D024802:Nurse's Role; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing; D036301:Qualitative Research; D017216:Telemedicine; D016526:Workload