Healthcare in the hand: Patients' use of handheld technology in video consultations with their general practitioner.

Objective: To analyse how the patient's use of handheld technology in video consultations with their general practitioner affects communication and the possibilities for the delivery of quality healthcare. Focusing on the visually communicated aspects of the video consultation, we present three episodes from our recordings of eight video consultations between Danish general practitioners and patients. Methods: Using a multimodal social semiotic framework to conduct a micro-level analysis, we present episodes from our data in which the hardware's affordance of mobility gave rise to salient events in the interactions of patients who used handheld devices to carry out their video consultations. Results: Patients' use of technology plays a significant role in the interactions between general practitioner and patient and is thus an important factor to consider in how practice is shaped when using handheld video consultation technology. Conclusions: Our findings demonstrate that the mobility of handheld devices (smartphone, tablet) can be used to augment sensing and embodiment and enhance the delivery of healthcare in video consultations. However, mobility may also disrupt the interaction. As a result, possibilities for the delivery of quality healthcare lie quite literally in the patients' hands.

What are patients' first-time experiences with video consulting? A qualitative interview study in Danish general practice in times of COVID-19.

OBJECTIVE: To explore the experiences of Danish patients using video consultation (VC) to consult their general practitioner (GP) during COVID-19 lockdown and their attitudes towards continued use beyond COVID-19. DESIGN: A qualitative design was employed, consisting of individual semi-structured interviews where participants were asked to retrospectively describe their experiences and reflections. Data were analysed using thematic analysis. SETTING: Capital and Southern Regions of Denmark. PARTICIPANTS: 27 patients (17 women and 10 men) aged between 23 and 76 years who had used VC once or more during the COVID-19 pandemic participated. The data were collected from February to October 2020. We used a convenience sampling technique and sample size was based on the principle of information power. RESULTS: Three overarching themes, each containing subthemes, were developed. Participants described pre-use reactions and concerns relating to VC as being 'better than nothing' given the COVID-19 circumstances, and preferred VC over a telephone consultation. Salient pre-use concerns related to whether the technology 'would work' and whether VC would influence consultation length and GP behaviour. Overall, participants reported positive experiences of VC use and communication attributing these mainly to 'knowing the GP' and 'feeling seen and heard'. Participants were interested in future VC use for many needs as a natural consequence of an increasingly digitalised society, not least due to COVID-19. CONCLUSIONS: Our findings contribute with knowledge about first-user experiences of VC against the background of COVID-19. Participants showed positive attitudes towards future use of VC as either a supplementary or alternative consultation form in general practice.

Reciprocal dynamics between patients' choice of place and how they experience video consultations: A qualitative study.

OBJECTIVE: To analyse the reciprocal dynamics between patients' choice of place and how they experience video consultations (VCs) with the general practitioner. METHODS: Qualitative, semi-structured interviews with 27 Danish patients were conducted over a period of 9 months, from February to October 2020. Interviews were analysed using thematic analysis. The analysis was guided by Nelly Oudshoorn's concept of technogeography of care. RESULTS: The following three themes were identified in the data: VC-home dynamics: balancing boundaries; VC-workplace dynamics: logistical considerations; and VC-body image dynamics: on-screen exposure. CONCLUSIONS: Taking human geography and science and technology studies as our analytical point of departure, we used the concept of technogeography of care and demonstrated how the reciprocal dynamics between patients' choice of place and how they experience VC made boundaries fluid and complex between different contexts and places, such as the home, the workplace and the clinic. These boundaries were negotiated differently by the patients depending on their need for privacy, convenience and support. Additionally, VC reconfigured patients' and general practitioners' roles, increasing patients' responsibility in securing an appropriate health care setting.