HTF 402 National First Nations Telehealth Research Project
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K)
Attachment 5: Interview Guides
Sample Interview Guide for Physicians and Nurses
- Does telemedicine bring changes in your practice?
- Does telemedicine bring changes in the dialysis or nephrology
service?
- Under what conditions would you be willing to pursue the use
of telemedicine?
- Is the use of telemedicine in the context of the actual project
be enlarged? In New Brunswick? In Canada?
- Is the use of telemedicine in the current project an improvement
over what existed before?
- Do you see any other application for telemedicine in your area?
- Under what conditions could such projects be broadened?
- Could such projects be considered cost-effective?
- What would encourage someone to undertake such a project?
- Are you satisfied of the results so far? If yes, why? If not,
why not?
- What inconveniences and constraints have you experienced in
this project?
(Adapted from: - Adaptation de Fortin, Banville: Rapport d'évaluation
des projets pilotes en télécardiologie et en téléradiologie,
CEFRIO, jan 1998).
Community Leaders
A. Impact of telehealth on the community
General
What is your position within the community? How long have you
had this role? What are the main challenges you face?
What are the major health problems your community faces? How long
have these health problems troubled your community? How do these
health problems affect the daily life of your community members
(employment, education, social behavior etc.)?
What percentage of your community members would you say are healthy
or in need of consistent medical attention? In your opinion, what
type of community member is at risk to suffer a medical illness
(age, gender, occupation etc.)?
Do you think telehealth can help your community overcome some
of its problems? Which health concerns, in particular, can telehealth
be used for?
Do you agree that the main health issues in your community are
being addressed in the applications (list them) chosen for this
project?
How have community members been involved in the telehealth project?
Was there much interest for the project? By whom? Is there still
much interest in this project?
Health care quality
Do you expect that telehealth can improve the health care quality
in your community?
Have you received any feedback so far from community members about
the quality of care they or their family members have received
in the telehealth project?
Health care accessbility
Were you satisfied with the implementation of the telehealth applications
within your community? Could the process have been improved?
Do you think that telehealth can speed up the process of access
to care?
Have you heard any feedback about accessibility to health services
from members of your community who are participating in the project?
B. Role of telehealth in service provision and management
To what extent is telehealth appropriated, integrated and sustained
as a part of the community's self-governed health care system,
or integrated into the negotiations of transfers agreements?
To what extent have the telehealth applications become linked
and integrated to provincial initiatives?
To what extent does telehealth improve access of secondary, tertiary
and education providers to local health service providers?
To what extent does telehealth improve health service providers'
awareness and knowledge of local conditions and resources?
C. Overall positive and negative social and economic impacts
and implications
How is telehealth an economic advantage or disadvantage in your
community thus far?
As far as you can tell, has the telehealth project decreased or
increased travel time and costs for community members?
Have the telehealth applications had any negative impact on your
community?
Do you think the telehealth applications chosen for this project
are sustainable? What are the factors necessary to keep the telehealth
applications working in the future?
What needs does your community have that the telehealth applications
are not addressing?
Do you have any other comments about the development of telehealth
in your community?
For Political Figures
What do you think are the main priority areas to address with
telehealth in your jurisdiction?
Do you think that the main health issues in these communities
are being addressed in the applications chosen for this project?
Do you think the telehealth applications chosen for this project
are sustainable? What are the factors necessary to keep the telehealth
applications working in the future?
What needs does this community have that the telehealth applications
are not addressing?
To what extent is telehealth appropriated, integrated and sustained
as a part of the community's self-governed health care system,
or integrated into the negotiations of transfers agreements?
To what extent have the telehealth applications become linked
and integrated to provincial initiatives? What conditions would
facilitate compatibility and integration of these systems?
How do these applications affect the health centres linked to
the remote communities? In terms of continuity of care? Comprehensiveness
of care? Relationships with the community's health resources? Cost
effectiveness?
To what extent does telehealth improve access of secondary, tertiary
and education providers to local health service providers?
To what extent does telehealth improve health service providers'
awareness and knowledge of local conditions and resources?
Do you have any other comments about the development of telehealth
in your community?
For Remote Providers
Personal reaction:
Have you been trained to use telehealth? What skills and competencies
were required in order to use telehealth? Have you acquired the
necessary training? What difficulties might have been avoided with
more training?
- Has the use of telehealth been organized successfully?
- Have there been any administrative difficulties in using telehealth?
- Have there been any scheduling difficulties?
What have been the positive and negative effects on your own work
efficacy when using telehealth?
Have you become more competent and confident in your job when
using telehealth?
Have your colleagues had similar experiences to your own working
with telehealth?
How much does telehealth affect your workload, staff workload,
task allocation and professional practices?
How many active cases are you involved with?
How many telehealth patients do you see per week?
How much time do you spend on non-transferred patients?
How have your services shifted when using telehealth?
Patient reaction:
In your experience seeing patients, to what extent do they find
telehealth acceptable? Have they been comfortable?
- Have they expressed any concerns regarding telehealth? If so,
what were they?
- Have any patients refused to use telehealth? If so, for what
reasons?
How have family members reacted?
Who's using telehealth:
To what extent does telehealth respond to your patients' health
needs?
To what extent are telehealth applications used by eligible patients
in the community?
What specific health conditions are targetted for the use of telehealth?
What is the proportion of telehealth use according to health condition?
Telehealth efficacy:
How long have patients had to wait for medical care through telehealth?
Do the telehealth interventions meet the accepted standards of
care (clinical guidelines)? Have they improved the standard of
care?
Has hospitalization been necessary for any of your patients? If
so, how did telehealth interventions interact with the process?
To what extent does telehealth result in cost increases, decreases
or shifts for health service delivery within the communities?
How many patient transfers have been avoided?
Concerns about equipment:
Is telehealth easy to use? Is the technical quality at an acceptable
level? How would you describe the communication flow?
Have you encountered technical problems when using the equipment?
How often have you required technical support?
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