Implementation of a pilot telehealth programme in community palliative care: A qualitative study of clinicians' perspectives.
BACKGROUND
Telehealth technologies are an emerging resource opening up the possibility of greater support if they have utility for patients, carers and clinicians. They may also help to meet health systems' imperatives for improved service delivery within current budgets. Clinicians' experiences and attitudes play a key role in the implementation of any innovation in service delivery.


OBJECTIVE
To explore clinicians' perspectives on and experiences of the utilisation of a pilot telehealth model and its integration into a specialist community palliative care programme.


METHODS
Focus groups and interviews generated data that were analysed through the lens of a realistic evaluation theoretical framework.


METHODS
The study was conducted in a metropolitan specialist palliative care service in South Australia. Participants (n = 10) were clinicians involved in the delivery of community specialist palliative care and the piloting of a telehealth programme.


RESULTS
Service providers consider telehealth resources as a means to augment current service provision in a complementary way rather than as a replacement for face-to-face assessments. Introducing this technology, however, challenged the team to critically explore aspects of current service provision. The introduction of technologies also has the potential to alter the dynamic of relationships between patients and families and community palliative care clinicians.


CONCLUSIONS
Implementation of a pilot telehealth programme in a specialist palliative community team needs to involve clinical staff in service redesign from the outset. Reliable IT infrastructure and technical support is critical for telehealth models to be effective and will aid uptake.
Discipline of Palliative and Supportive Services, School of Health Sciences, Flinders University, Adelaide, SA, Australia aileen.collier@flinders.edu.au.
Aileen
A
Collier
Discipline of Occupational Therapy, School of Health Sciences, Flinders University, Adelaide, SA, Australia.
Deidre D
DD
Morgan
Discipline of Palliative and Supportive Services, School of Health Sciences, Flinders University, Adelaide, SA, Australia Southern Adelaide Palliative Services, Adelaide, SA, Australia.
Kate
K
Swetenham
Discipline of Palliative and Supportive Services, School of Health Sciences, Flinders University, Adelaide, SA, Australia Southern Adelaide Palliative Services, Adelaide, SA, Australia.
Timothy H M
TH
To
Discipline of Palliative and Supportive Services, School of Health Sciences, Flinders University, Adelaide, SA, Australia.
David C
DC
Currow
Discipline of Palliative and Supportive Services, School of Health Sciences, Flinders University, Adelaide, SA, Australia.
Jennifer J
JJ
Tieman
D001291:Attitude of Health Personnel; D005260:Female; D006699:Home Care Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D017146:Models, Organizational; D010166:Palliative Care / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D010865:Pilot Projects; D015397:Program Evaluation; D036301:Qualitative Research; D013021:South Australia; D059039:Standard of Care; D017216:Telemedicine / Q000379:methods / Q000592:standards*; D049269:Videoconferencing
Telehealth; focus groups; homecare; palliative care; service evaluation