Virtually the same, but remotely different: health professionals, parents and children’s experiences of remote out-patient consultations

Objective
Explore experiences, benefits and concerns associated with remote (telephone/video) consultations from the perspectives of children and young people with juvenile idiopathic arthritis (JIA), their parents, and health professionals (HPs) who were members of a multidisciplinary team in a paediatric rheumatology setting.
Methods
Qualitative design (Interpretive Description) utilising observation of remote (telephone/video) consultations and remote follow-up interviews with children and young people (7-18 years) with JIA, their parents, and HPs. The setting was a tertiary paediatric rheumatology clinic in a hospital in Northwest England. Two groups of experts-by-experience (children, young people, parents) provided high quality input into study design and dissemination materials. Data analysis used reflexive thematic analysis.
Results
Thirty-seven participants were observed (11 video, 5 telephone consultations): HPs (n=8); mothers (n=11); fathers (n=3); children and young people (n=15). Parents (n=7), children and young people (n=8) and HPs (n=7) were interviewed. The overarching theme was that remote consultations were ‘virtually the same but remotely different’ to face-to-face hospital-based consultations. Four sub-themes were identified: It’s a catch-up rather than a check-up; A sense of familiarity but a shift in dynamics; Minimising disruption and burden; and, Being ‘seen’ but seen differently.
Conclusions
Overall, remote consultations were viewed positively, bringing benefits to children, young people, and parents. There was a notable transition in responsibility towards children and young people and/or their parents for reporting and recognising disease flare, compared to face-to-face consultations. Optimising the experience of remote consultations though better preparation, information and education for children, young people, parents and HPs is needed.