Virtually the same, but remotely different: health professionals, parents and children's experiences of remote out-patient consultations.

Abstract

To explore experiences, benefits and concerns associated with remote (telephone/video) consultations from the perspectives of children and young people with juvenile idiopathic arthritis (JIA), their parents and health professionals who were members of a multidisciplinary team in a paediatric rheumatology setting. Qualitative design (Interpretive Description) utilizing observation of remote (telephone/video) consultations and remote follow-up interviews with children and young people (7-18 years) with JIA, their parents and health professionals. The setting was a tertiary paediatric rheumatology clinic in a hospital in Northwest England. Two groups of experts-by-experience (children, young people, parents) provided high quality input into study design and dissemination materials. Data analysis used reflexive thematic analysis. Thirty-seven participants were observed (11 video, five telephone consultations): health professionals (n = 8); mothers (n = 11); fathers (n = 3); children and young people (n = 15). Parents (n = 7), children and young people (n = 8) and health professionals (n = 7) were interviewed. The overarching theme was that remote consultations were 'virtually the same but remotely different' to face-to-face hospital-based consultations. Four sub-themes were identified: 'It's a catch-up rather than a check-up'; 'A sense of familiarity but a shift in dynamics'; 'Minimizing disruption and burden'; and 'Being 'seen' but seen differently'. Overall, remote consultations were viewed positively, bringing benefits to children, young people and parents. There was a notable transition in responsibility towards children and young people and/or their parents for reporting and recognizing disease flare, compared with face-to-face consultations. Optimizing the experience of remote consultations though better preparation, information and education for children, young people, parents and health professionals is needed.