PhD-thesis
Going remote in general practice: Investigating the transformation of healthcare delivery enabled by remote consultations
Investigating the transformation of healthcare delivery enabled by remote consultations
- Trial lecture starts at 10:15
- Public defence starts at 12:30
Title of trial lecture: Balancing continuity and quality of care with increased access as enabled by remote digital consultations in general practice.
Read the thesis in AURA
Disputation chair: Assocate Professor Dag Tomas Sagen Johannesen, Head of Department of Health and Nursing Science, University of Agder
Assessment committee:
- First opponent: Senior Researcher Dr Joseph Wherton, Nuffield Department of Primary Care Health Schiences, University of Oxford, United Kingdom
- Second opponent: Associate Professor Stefàn Hjörleifsson, Department of Global Public Health and Primary Care, University of Bergen
- Chair of the evaluation committee: Professor Randi Eikeland, Department of Health and Nursing Science, University of Agder
Supervisors in the doctoral work:
- Main supervisor:
- Associate Professor Santiago Gil Martinez, Department of Health and Nursing Science, University of Agder
- Co-supervisors:
- Professor Elin Thygesen, Department of Health and Nursing Science, University of Agder
- Head of Research and Associate Professor Eirik Abildsnes, Kristiansand municipality and Department for Community Medicine and Global Health, University of Oslo
Summary of the thesis
The background for this PhD project is the substantial increase in the use of remote consultations (RCs) – video, telephone, and asynchronous text-based e-consultations – that took place in general practice in the aftermath of the COVID-19 pandemic in Norway. General practice as a medical discipline is unique, compared to secondary healthcare, characterised by a strong GP-patient relationship, continuity of care, and pragmatic reasoning. The influx of RCs has fundamentally transformed the delivery of healthcare in general practice, and this project therefore wanted to explore these significant changes in the conduct of general practice, through investigating GPs’ views and experiences with these new technologies.
The aims for the project thus revolved around capturing various aspects of this topic. Paper I aimed to summarize the scientific knowledge on the topic of video consultations (VCs) between GPs and patients. Paper II aimed to explore GPs’ experiences with VCs and their attitudes towards it in a post-pandemic setting. Paper III aimed to explore GPs’ views on the transformation of healthcare delivery that has taken place due to RCs.
For the thesis itself, the aim was to explore possible factors and mechanisms that might influence this transformation of healthcare delivery. By applying elements from Complexity theory, the findings from the papers is discussed on a holistic system level. This discussion shows how our findings revolve around five central voices related to general practice that may influence the use of RCs: GPs, patients, RC technology, the government, and market forces. The discussion also highlights how uptake of RCs is an unpredictable behaviour, and how self-organisation and an altered understanding of the attractor of general practice seems to have played a central role in uptake of RCs.
The implications of this thesis point to additional main points. In an increasingly digital society, our participants still highlighted the importance of physical consultations to secure core aspects of general practice. RCs have changed the transition from self-care to healthcare – with a lower threshold for contacting the GP, patients’ altered health-seeking behaviour may negatively impact the issue of medical overuse. RCs have also raised a possible dilemma between quantity and quality of consultations in general practice. As a GP myself, I believe it is important that GPs embrace the technological advances and claim a normative role in the development of digital “best practice”. Further research should aim to deepen the understanding of influences on the transformation of healthcare delivery in general practice to ensure a sound balance between quality of care and technological developments.
What to do as an online audience member
The disputation is open to the public. To follow the trial lecture and the public defence online, register on Zoom.
We ask online audience members to join no earlier than 10 minutes in advance. After these times, you can leave and rejoin the meeting at any time.
Opponent ex auditorio:
Deadline for the public to pose questions is during the break between the two opponents. Questions ex auditorio can be submitted to Disputation chair Dag Tomas Sagen Johannesen, copy PhD-adm. Eli Andås.
Contact person
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