A rural doctor’s telehealth training program during the COVID-19 pandemic

Introduction: In Australia, remote consultations have been used as an adjunct to traditional health care delivery during the COVID-19 pandemic using phone and video techniques with an increase in the use of phone, and to a lesser extent, video consultations for management of patient conditions, assessment, treatment, monitoring, and diagnosis.
Methods: To establish the needs of rural doctors for training in the provision of remote consultations, an online survey of members of the Australian College of Rural and Remote Medicine was undertaken. Subsequently an online scenario-based training program was designed to improve the competencies of members in providing these consultations. The outcomes of this program were analysed using pre and post-intervention surveys, and qualitative analysis of session recordings.
Results: The program improved trainee’s confidence and competence in providing safe, quality remote consultations, particularly when using video technologies. Competencies in communication, history taking, physical online examination, clinical management and professionalism improved. Trainees adapted their practice because they were now able to manage potential issues; were more aware of the capabilities of telehealth technologies; and could assist the health professional, such as a nurse or aboriginal health worker (with the patient) to do the examination. Concerns remained about setup time; technical quality; privacy; interaction with and examination of patients; and how to assess the severity of conditions.
Conclusion: The outcomes of the program showed significant improvement in the levels of confidence and competencies required for providing remote consultations using telehealth services. A need remains to improve virtual interactions with patients and acquire better technology and financial support for remote consultations. In an environment where government is asking whether remote consultations are appropriate and clinically effective, these findings provide guidance from a professional group of experienced rural practitioners.
Keywords: competencies, confidence, consultation, COVID-19, general practice, rural, remote, telehealth, training