Improving the digital delivery of primary health care post COVID-19

COVID-19大流行导致基层医疗快速引入远程会诊，许多做法因默认而变得远程。服务提供的这一变化使护理服务得以继续，同时限制了COVID传播的风险。虽然“远程”在目前的情况下有时指的是通过电话提供的服务，但互联网视频平台的使用已显着增加，这些平台将继续存在。这项研究是一个独特的机会，以确定在初级保健中使用视频咨询所带来的具体沟通挑战，并确定如何尽量减少这些挑战。该项目将重点关注以下问题：1）在视频咨询期间，全科医生和患者面临的主要沟通挑战是什么？2)这些挑战是否在特定环境中反复出现（例如，患者群体或咨询中的活动类型）？3)如何应对和最大限度地减少这些挑战，以优化远程护理服务？该项目包括一个会话分析（CA）研究。这种归纳定性的方法分析社会互动，侧重于口头和身体行为及其社会后果。对多个事件进行深入的比较分析，可以识别和解释反复出现的模式及其后果，从而使分析超越个人的心理倾向。通过这项研究，研究结果将突出全科医生和患者目前发现的挑战领域，以及这些挑战是否存在反复出现的背景，以及参与者为谈判和克服这些挑战而制定的成功策略。调查结果将在监督小组的协助下分发给临床医生。该项目也有可能为更广泛的社会学辩论提供信息，讨论更多地依赖数字技术对社会互动的影响。

The COVID-19 pandemic has resulted in the rapid introduction of remote consultations in primary care, with many practices becoming remote by default. This change to service delivery allows care provision to continue, whilst limiting the risk of COVID transmission. While 'remote' in the current context has sometimes referred to services delivered by telephone, use of video-over-the-internet platforms has increased significantly and these are here to stay. This research is a unique opportunity to identify the specific communicative challenges posed by the use of video consultations in primary care and identify ways to minimise them. The project will focus on the following questions: 1) What are the key communicative challenges arising for GPs and patients during video consultations?2) Are there particular contexts in which these challenges recur (e.g. patient group, or activity type within consultation)?3) How can these challenges be negotiated and minimised in order to optimise remote care delivery?The project consists of a conversation analytic (CA) study. This inductive qualitative approach analyses social interaction, focusing on verbal and bodily conduct and its social consequences. Intensive comparative analysis of multiple episodes allows identification and explication of recurrent patterns and their consequences, thereby moving the analysis beyond individual psychological dispositions. Through this research the findings will highlight areas GPs and patients currently find challenging, and whether there are recurring contexts for these challenges, as well as successful strategies developed by participants to negotiate and overcome them. Findings will be disseminated to clinicians with the assistance of the supervisory team. This project also has potential to inform wider sociological debate on the impact that greater reliance on digital technology has on social interaction.