Open Dialogue Through Telehealth: Exploring Family and Professionals Experiences

Background

The world entered a new era of healthcare delivery when the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic. In response to the global emergency, social-distancing guidelines and travel restrictions were implemented worldwide, significantly limiting people's access to essential health services and other daily life needs (Whaibeh et al., 2020). As a result, hospitals and healthcare services urgently and quickly transitioned their services while preventing the spread of the virus (Gajarawala & Pelkowski, 2021). Consequently, telehealth has emerged as the primary solution to the limitations the global pandemic has placed on healthcare delivery, enabling the continuity and adaptability of essential healthcare services (Bouabida et al., 2022).

Telehealth is defined as the delivery of healthcare services, including diagnosis, consultation, treatment, education, care management, and patient self-management, using real-time, electronic audiovisual communication technology, typically videoconferencing (Manocchia, 2020). It is a convenient option that is more adjustable to patients' needs, providing access to care when needed, and saving time and money (Manocchia, 2020). Telehealth encompasses various modalities that can be used for multiple health conditions and populations (Shigekawa et al., 2018). Evidence shows that telehealth is well-accepted by patients of different backgrounds, and ages (Ruskin et al., 2004), with different mental health conditions, and in multiple clinical settings (King et al., 2014; Seritan et al., 2019). It provides patients access to resources and care, especially in rural areas or areas with health provider shortages. It improves efficiency without higher net costs, reduces patient traveling and waiting times, and allows a similar or improved quality of care (Rutledge et al., 2017). Telehealth use can increase patient satisfaction by providing better access to care, convenience, and stress reduction (Gajarawala & Pelkowski, 2021). However, the widespread of adoption of telehealth has unfortunately been hampered by various barriers, namely for people with less digital literacy, lack of appropriate information and training of professionals, non-existence of devices to access, or poor internet coverage, in rural or underserved areas, also lack of private spaces for sessions, among others (Appleton et al., 2023; Benudis et al., 2022; Blandford et al., 2020; Triana et al., 2020). Despite these obstacles, telehealth acceptance will likely continue to increase as patients and providers become more comfortable with technology (Gajarawala & Pelkowski, 2021). Before the COVID-19 pandemic, the use of telehealth had been increasing in mental healthcare, but it was not prevalent (Mehrotra et al., 2017) as it is today.

Telemental health requires a shift of workflows or adjustment to provide the proper care comparable to conventional in-person care (O'Reilly et al., 2007). The most common barriers identified by patients are the lack of a private space for sessions, internet lack of privacy, and security. As for providers, many feel that it is challenging to establish rapport with patients, with privacy and boundary issues that can affect the quality of care delivered (Benudis et al., 2022). Although patients appreciated the convenience and accessibility and providers valued flexibility and efficiency (Benudis et al., 2022), these benefits have placed telemental health on the map as a useful alternative (Whaibeh et al., 2020).