Video versus telephone for telehealth delivery: a cross-sectional study of Australian general practice trainees.

Dec 25, 2023

Remunerated telehealth consultations were introduced in Australia in 2020 in response to the COVID-19 pandemic. Videoconferencing has advantages over telephone-consulting, including improved diagnostic and decision-making accuracy. However, videoconferencing uptake in Australia has been low. This study aimed to establish prevalence and associations of video versus telephone consultations in Australian general practice (GP) registrars’ practice.
A cross-sectional analysis of data from 2020 to 2021 (three 6-monthly data-collection rounds) from the Registrars Clinical Encounters in Training (ReCEnT) study. GP registrars record details of 60 consecutive consultations every 6-month term, for a total of 3 terms. Univariable and multivariable logistic regression were performed within the Generalized Estimating Equations framework with the outcome video versus telephone.
102,286 consultations were recorded by 1,168 registrars, with 21.4% of consultations performed via telehealth. Of these, telephone accounted for 96.6% (95% CI: 96.3-96.8%) and videoconferencing for 3.4% (95% CI: 3.2-3.7%). Statistically significant associations of using videoconferencing, compared to telephone, included longer consultation duration (OR 1.02, 95% CI: 1.01-1.03 per minute; and mean 14.9 versus 12.8 min), patients aged 0-14 years old (OR 1.29, 95% CI: 1.03-1.62, compared to age 15-34), patients new to the registrar (OR 1.19, 95% CI: 1.04-1.35), part-time registrars (OR 1.84, 95% CI: 1.08-3.15), and areas of less socioeconomic disadvantage (OR 1.27, 95% CI: 1.00-1.62 per decile).
Registrars’ telehealth consultations were mostly performed via telephone. Telephone use being associated with socioeconomic disadvantage has health equity implications. Future research should explore barriers to videoconferencing use and strategies to increase its uptake.

© The Author(s) 2023. Published by Oxford University Press.

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ABOUT THE EXPERTS

Katie Fisher,Amanda Tapley,Anna Ralston,Andrew Davey,Alison Fielding,Mieke van Driel,Elizabeth Holliday,Jean Ball,Jason Dizon,Neil Spike,Lisa Clarke,Parker Magin
Katie Fisher

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia.

Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.

Amanda Tapley

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia.

Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.

Anna Ralston

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia.

Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.

Andrew Davey

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia.

Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.

Alison Fielding

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia.

Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.

Mieke van Driel

Faculty of Medicine, General Practice Clinical Unit, University of Queensland, Level 8 Health Sciences Building, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia.

Elizabeth Holliday

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia.

Jean Ball

Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton Heights, Australia.

Jason Dizon

Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton Heights, Australia.

Neil Spike

Eastern Victoria General Practice Training, Regional Training Organisation, Hawthorn, Victoria, Australia.

Department of General Practice and Primary Health Care, University of Melbourne, Berkeley Street, Carlton, Victoria, Australia.

School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.

Lisa Clarke

Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.

Parker Magin

School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia.

Royal Australian College of General Practitioners GP Training Research Department, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia.