title: Experiences of front-line health professionals in the delivery of telehealth: a qualitative study.
abstract: BACKGROUND
  Telehealth is an emerging field of clinical practice but current UK health policy has not taken account of the perceptions of front-line healthcare professionals expected to implement it.
  
  
  OBJECTIVE
  To investigate telehealth care for people with long-term conditions from the perspective of the front-line health professional.
  
  
  METHODS
  A qualitative study in three sites within the UK (Kent, Cornwall, and the London Borough of Newham) and embedded in the Whole Systems Demonstrator evaluation, a large cluster randomised controlled trial of telehealth and telecare for patients with long-term and complex conditions.
  
  
  METHODS
  Semi-structured qualitative interviews with 32 front-line health professionals (13 community matrons, 10 telehealth monitoring nurses and 9 GPs) involved in the delivery of telehealth. Data were analysed using a modified grounded theory approach.
  
  
  RESULTS
  Mixed views were expressed by front-line professionals, which seem to reflect their levels of engagement. It was broadly welcomed by nursing staff as long as it supplemented rather than substituted their role in traditional patient care. GPs held mixed views; some gave a cautious welcome but most saw telehealth as increasing their work burden and potentially undermining their professional autonomy.
  
  
  CONCLUSIONS
  Health care professionals will need to develop a shared understanding of patient self-management through telehealth. This may require a renegotiation of their roles and responsibilities.
authors: Department of Social and Environmental Health Research, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London.
authors: Virginia
authors: V
authors: MacNeill
authors: Centre for Primary Care, Institute of Population Health, The University of Manchester, Manchester.
authors: Caroline
authors: C
authors: Sanders
authors: Department of Population Health, University of Oxford, Oxford.
authors: Ray
authors: R
authors: Fitzpatrick
authors: Faculty of Business, Economics and Law, Department of Health Care Management and Policy, University of Surrey, Guildford.
authors: Jane
authors: J
authors: Hendy
authors: Imperial College Business School, London.
authors: James
authors: J
authors: Barlow
authors: London School of Economics and Political Science, London.
authors: Martin
authors: M
authors: Knapp
authors: Faculty of Health Sciences, University of Southampton, Southampton.
authors: Anne
authors: A
authors: Rogers
authors: Nuffield Trust, London.
authors: Martin
authors: M
authors: Bardsley
authors: City University, London.
authors: Stanton P
authors: SP
authors: Newman
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D016000:Cluster Analysis; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000379:methods*; D005194:Family Practice / Q000379:methods / Q000592:standards; D006801:Humans; D008134:Long-Term Care; D009732:Nursing Care / Q000379:methods / Q000592:standards; D010358:Patient Participation; D011369:Professional-Patient Relations; D017216:Telemedicine
keywords: Whole System Demonstrator; primary care; qualitative; telehealth