Quotes Illustrating Select Key Concepts in Each Thematic Category
| Potentially Appropriate for Telemedicine | Chronic condition management “I just did three telehealth visits this morning for things that are psychiatric/psychologic, those worked very well.” (C7) “…diabetes care is one of those where I think it works very well. Depression and mental health is one where I think it actually works very well.” (C4) “… a visit with the home health nurse and the patient together and me…. With me on the phone or with the nurse turning a video on would be fabulous use [of telemedicine post-discharge.]” (C3) Information gathering “So, for example, like a post hospitalization visit, you think would be something you would really want an exam … but actually the work is, the large majority of the time, just making sure the home health services are in place.”(C5) “…following up on measurements they made at home, like blood sugar or blood pressure.” (C3) “So if you don't need to do anything invasive …where you don't need a specimen from the patient, where you don't need to be in the same room for the patient, I think it works very, very well.” (C7) Symptoms can be described “And I mean, even vomiting, I don't want to leave the house. And I think it's easy enough to explain your symptoms to a doctor…”(P4) “Yeah. I was able to verbally explain …what the symptom was, and that was fine” (P5) |
| Potentially Inappropriate for Telemedicine | Physical examination or a procedure needed “…my yearly checkup. So I don't think that that could have been done online either.” (P2) “I'm overdue for my shingles and pneumonia shots.” (P1) “And sometimes there are things that I need to see in person, like a wound, … people are generally willing to come….” (C1) Diagnostic uncertainty “But if it's something that maybe has been re-occurring and is much more nerve-racking, I think that you would want to be in person.” (P7) “If there is a reason we are visiting doctor to figure something out, I feel it's better we go and meet.” (P3) “…antibiotics could have been withheld if the diagnosis was made in person, with all of the information gathered during a face-to-face visit.” (C1) Possibly severe situation “ …if it was something to do with breathing and lungs, I don't know that I would feel comfortable with [telemedicine.]” (P5) “… because of my recent history, I would have felt much more comfortable in person.” (P2) |
| Motivating Towards Telemedicine | Overcoming barriers “What is [the reason for] the tremendous increase in the show rate? … part of that is probably transportation; part of it is probably child care.” (C4) “So convenience, eliminate transportation.” (O1) “I'm in a wheelchair, I need someone to go with me.” (P4) Time efficiency “It really pushed doctors to keep to a time schedule … they would really disrupt their full schedule if they allowed themselves to fall behind.” (P2) “…the patients have a different sense of time on the video visit or the telephone visit, like they often want it to be short because it's…their time, not your time.” (C5) |
| Motivating Away from Telemedicine | Privacy concerns “If I can't assess … if I truly don't trust that they're in a safe space.” (C5) “…for myself, personally, I would be completely turned off by [meeting a new clinician] … I think that I would be worried that it could be anybody, literally anybody.” (P2) Technology challenges “And then we lose the sound and then we lose the video; and then it gets disconnected and then it gets reconnected or we can't start. Or halfway through I finally abandon video because it's pixilated and … just call them on the phone.” (C3) “…so I'm sure that it's of almost no value to the patient because they're not going to remember anything [without an after visit summary on paper]” (C3) Potential harms to health system “…a provider who really needs volume can certainly crank out quite a few phone calls in an hour and expect payment for them..” (O2) |
| Other Contextual Factors Expressed as Influencing Decision-Making | Decision-making about type of visit “…my presumption is that… if telemedicine was offered that my doctors felt comfortable that [this] would be the way for us to carry out my next appointment.” (P7) “Maybe we can make telemedicine as the default if the patient doesn't ask. And then I think the onus should be on the physician to make sure [it is appropriate.]” (P3) “[Some patients] don't want to do a video visit…sometimes it is because they don't have the capability to do it, they don't feel confident they can do that, or they just really feel strongly that they need a face-to-face visit.” (O3) “I worry a little bit that patients who may or may not have financial means, choose delivery options that save them money and may not be really at the level that they need.” (O2) |
Note. Alphabetized within theme and column.