Exploring the experiences of staff conducting psychology consultations via telehealth in an oncology hospital.

PURPOSE: During the COVID-19 pandemic, telehealth delivery of psychological care services expanded to meet the needs of people with cancer. This study examined psychologists' attitudes toward using telehealth during the pandemic peak in a tertiary oncology hospital. METHODS: Semi-structured interviews were conducted with ten psychologists who used telehealth to deliver psychological services. Thematic analysis was conducted to identify themes in the interview data. RESULTS: Themes identified: (1) increased uptake and attendance of psychology sessions was due to greater accessibility of services; (2) clinicians reported ease of communication and building of rapport when using telehealth; and (3) clinicians perceived differences in the psychotherapeutic process when sessions were delivered via telehealth compared to in-person. CONCLUSIONS: Clinicians expressed high satisfaction with delivering telehealth psychological support for oncology patients. Implications for Psychosocial Providers: Oncology services that are considering developing or expanding a telehealth psychology service can facilitate this by ensuring a reliable technological platform and providing training and/or support to staff and patients. Clinicians should also use their clinical judgment to decide if a patient is appropriate for telehealth-delivered psychological care or if a mix of modalities is more ideal.

Integrating telehealth in to 'business as usual': Is it really possible?

The Royal Children's Hospital, Melbourne, began offering web-based telehealth video consultation in 2011, with the principle being that telehealth should be integrated into 'business as usual'. In telehealth literature, key differences between telehealth and in-person consultations can make this hard to achieve, so an audit was performed that revealed many small gaps in the process.A total of 125 telehealth appointments were booked during the study period. Of these, 13% (n = 16) were rescheduled, cancelled or changed to face-to-face appointments, and up to two main issues were identified for the remaining appointments. Some 69% of the remaining 108 appointments (n = 75) were completed successfully, with 23% (n = 25) completely seamless end to end. Overall, 39 issues were administrative (40%), 34 technical (35%) and 24 scheduling (25%); nine (8%) required some minor troubleshooting.For long-term sustainability, integrating telehealth into business as usual needs to remain the target. Scheduling and technical glitches were the main barriers to seamless telehealth. Several issues have now been addressed with the introduction of an electronic medical record, and the development of standardised processes and staff training.

Data review of an ongoing telehealth programme in a tertiary paediatric hospital.

The Royal Children's Hospital (RCH) in Melbourne has been providing teleconsultations since 2011 using web-based videoconferencing. We reviewed telehealth activity over the first 30 months of the programme. The average consultation rate was 14 per month in 2012, 39 in 2013 and 49 per month in the first half of 2014. One-third of all activity (265 out of 852 consultations) was provided by only two departments: neurology and respiratory medicine. By June 2014, 92% of departments (n = 34) had provided one or more video-consultations. Most telehealth activity was provided by just a few clinicians. A review of actual and billed activity between July 2013 and April 2014 showed that 36% of booked telehealth appointments (n = 144 of 395) were not billed to Medicare; financial and other processes have since been streamlined. A snapshot of telehealth activity over a two-month period was used to estimate the revenue from telehealth. Approximately 65 billed telehealth appointments per month would be required to fund a 0.6 FTE coordinator's post. Overall, the findings have been valuable in planning the future expansion of telehealth at the RCH.

The introduction of web-based video-consultation in a paediatric acute care setting.

The Royal Children's Hospital (RCH) in Melbourne has been providing web-based video-consultations for a range of paediatric sub-specialties since 2011. There were 346 video-consultations in the first 16 months, from a total of 65 clinicians. Most teleconsultations were with the family at home. Generally, video-consultation was used for follow-up, after at least one face-to-face visit. A total of 132 users (specialist and regional clinicians, patients and families) responded to an online survey. The major reason for both clinicians and families participating in telehealth was the savings in families' travel time. Key factors for the successful implementation of telehealth at the RCH include: a clear organisational vision; simple web-based technology; clinician ownership; sustained support. The RCH experience suggests that telehealth is suitable for both simple and highly complex paediatric patients.

Health information seeking by parents in the Internet age.

AIM: Studies have shown increasing Internet use for health information. We aimed to broadly examine parents' utilisation of information sources for their children's health, their trust in them and to define the role of the Internet for children's health information METHODS: Interview of a convenience sample of parents of patients presenting to a tertiary paediatric emergency department (ED) (Royal Children's Hospital, Melbourne, Australia) in 2006/2007. RESULTS: A total of 360 parents completed the interview. Parents had used on average five sources of health information for their children in the previous 6 months. In the previous 6 months and immediately prior to the ED visit, general practitioners were consulted for health information by 87% and 39%, chemists by 44% and 2%, the Internet by 43% and 6% and telephone advice health lines by 30% and 10%, respectively. Of these sources, parents 'greatly trusted' Royal Children's Hospital ED doctors and nurses 82% (n = 112) their regular general practitioners in 73% (n = 303), chemists in 45% (n = 160), telephone advice health lines (Nurse-On-Call) in 42% (n = 90) and the Internet in general in 10% (n = 112). Overall, 52% had sought health information for their children on the Internet. Only 20% knew and 11% had ever used the regional children's hospital web site (http://www.rch.org.au/kidsinfo), but 97% of the Internet users reported they would trust this information. CONCLUSION: While using numerous different sources, parents in this study mostly use and trust traditional sources of health information. Scores of respondents use the Internet to seek health information for their children and would value easier access to Internet sources that they trust.