| | Teleclinics do not provide a complete clinical picture of medically complex patients | “(the patient) said that she was fine, but actually, she was having an asthma exacerbation…and her sugars were really crazy. Because of the COVID lockdown, the only food that she had access to was rice to feed her whole family, and actually, I think if you do not see a patient face-to-face sometimes, you cannot unpick all of that.” (Obstetrician)
“We take the opportunity to do the CBG (capillary blood glucose) in clinic, and if it confirms out suspicious of (patients) writing these levels to please us or to avoid testing, then we can reveal that issue and try to address it in a respectful and constructive way.” (Physician)
“But some (high-risk patients) do not show what’s happening. They do not have the (capillary blood glucose) numbers with them, they do not send anything in…So you have to catch them face-to-face cause a single finger prick will tell you, this is a woman with a blood sugar of 15 and that I will be admitting them now.” (Physician) | | Face-to-face visits are preferable when there are communication barriers | “A woman has been given a telephone appointment and I was thinking, I know English is her second language. You know, like she did understand some English, but I thought she was Tongan and a type 2 who does not engage very well. I cannot even get a hold of her by phone so I do not know how she got graded to be a telephone appointments…” (Midwife)
“... it’s really hard with an interpreter. Like I tried to do 3-way interpreter calls. It’s doable, but it’s really a struggle and for very superficial conversations…and it’s another person where you are trying to their schedule align with, which is challenging as well.” (Obstetrician) | | Teleclinics might improve access to care for patients who are not medically complex and who have other commitments | “Most of the women have got families and children…and they are sitting in clinic for two to four hours and they just cannot do that.” (Midwife)
“…the lower risk women, the women that are diet-controlled or just on metformin and who have not got lots of other medical risk factors… so the suitability is just got to be for the lower risk.” (Obstetrician)
“I found that telephone reviews have actually reduced the DNA (did not attend) rates, significantly. I think it’s the whole, you know, getting to clinics, finding parking spots, waiting, whereas they know that they can just get on with life and expect a phone call from us.” (Dietitian) |
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