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How does the use of digital consulting change the meaning of being a patient and/or a health professional? Lessons from the Long-term Conditions Young People Networked Communication study

Authors
  • Sturt, Jackie1
  • Huxley, Caroline1
  • Ajana, Btihaj2
  • Gainty, Caitjan3
  • Gibbons, Chris4
  • Graham, Tanya1
  • Khadjesari, Zarnie5
  • Lucivero, Federica6
  • Rogers, Rebecca1
  • Smol, Annie7
  • Watkins, Jocelyn A8
  • Griffiths, Frances8, 9
  • 1 The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK
  • 2 Department of Digital Humanities, King's College London, UK
  • 3 Department of History, King's College London, UK
  • 4 Accenture Consulting, UK
  • 5 School of Health Sciences, University of East Anglia, UK
  • 6 Nuffield Department of Population Health, University of Oxford, UK
  • 7 Face Front Inclusive Theatre, UK
  • 8 Warwick Medical School, University of Warwick, UK
  • 9 Centre for Health Policy, University of the Witwatersrand, South Africa
Type
Published Article
Journal
Digital Health
Publisher
SAGE Publications
Publication Date
Jul 20, 2020
Volume
6
Identifiers
DOI: 10.1177/2055207620942359
PMID: 32742716
PMCID: PMC7375714
Source
PubMed Central
Keywords
License
Unknown

Abstract

Background While studies have examined the impact of digital communication technology on healthcare, there is little exploration of how new models of digital care change the roles and identities of the health professional and patient. The purpose of the current study is to generate multidisciplinary reflections and questions around the use of digital consulting and the way it changes the meaning of being a patient and/or a health professional. Method We used a large pre-existing qualitative dataset from the Long-term Conditions Young People Networked Communication (LYNC) study which involved interviews with healthcare professionals and a group of 16–24 years patients with long-term physical and mental health conditions. We conducted a three-stage mixed methods analysis. First, using a small sample of interview data from the LYNC study, we identified three key themes to explore in the data and relevant academic literature. Second, in small groups we conducted secondary analysis of samples of patient and health professional LYNC interview data. Third, we ran a series of rapid evidence reviews. Findings We identified three key themes: workload/flow, impact of increased access to healthcare and vulnerabilities. Both health professionals and patients were 'on duty' in their role more often. Increased access to healthcare introduced more responsibilities to both patients and health professionals. Traditional concepts in medical ethics, confidentiality, empathy, empowerment/power, efficiency and mutual responsibilities are reframed in the context of digital consulting. Conclusions Our collaboration identified conflicts and constraints in the construction of digital patients and digital clinicians. There is evidence that digital technologies change the nature of a medical consultation and with it the identities and the roles of clinicians and patients which, in turn, calls for a redefinition of traditional concepts of medical ethics. Overall, digital consulting has the potential to significantly reduce costs while maintaining or improving patient care and clinical outcomes. Timely study of digital engagement in the National Health Service is a matter of critical importance.

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