Experiences of Clinicians Transitioning to Telemedicine

The COVID-19 pandemic has forced many practitioners to shift their practice online, using telemedicine to treat Opioid Use Disorder. This has allowed for the continuity of essential care whilst adhering to the social distancing guidelines, which protect people from the spread of infection.

This qualitative study, published in the Journal of Substance Abuse Treatment, analysed the experiences of providers offering telemedicine treatment to patients with OUD during COVID-19.

The researchers conducted interviews with 18 clinicians addressing the following issues

1) details on practice setting and patient population;

2) nature of telemedicine use ;

3) changes in workflow and policies;

4) barriers encountered in transitioning to telemedicine;

5) perceived impact of telemedicine on the quality of patient interactions; 

6) patient response to telemedicine. 

The data that was collected was sorted into themes.

Key findings:

• Before the COVID-19 pandemic, few had used telemedicine to treat patients with OUD whereas at the time the interviews were conducted in April 2020, nearly all clinicians were practising some form of telemedicine
• Most participants reported changing their typical clinical care patterns to reduce potential exposure to COVID-19. Often, this meant practitioners waived drug screening.
• Some of the positive comments offered about the benefits of telemedicine included improving access to care, reducing no show rate and wait times, and helping to build intimacy and connection.
• Clinicians noted several downsides to telemedicine. They complained there was a reduction in the quality of interaction and structure to the session. They found it harder to pick up on observable symptoms and non-verbal cues. Several practitioners reported it being harder to build rapport, especially if the flow and connection were interrupted.
• Despite the negative aspects of telehealthcare, most clinicians accepted they would be using it more regularly. 

It is clear that many practitioners are using telemedicine for the first time, and, consequently, there are inevitably issues that arise. Although the health care professionals could see the benefits of telemedicine, many confessed they felt it reduced the quality of practice. 

Whilst it is necessary for socially distanced care, it will be important to support healthcare professionals to develop their skills and confidence in working with patients in this way.