October 1, 2025

Patient experience of virtual hospital care provided by a multidisciplinary team: protocol for a mixed methods study

Background

Virtual hospitals are defined as the delivery of hospital-level health care via digital services such as videoconferencing technologies, digital platforms, and remote monitoring. The purpose is to leverage virtual technologies to deliver accessible patient-centered care, improve the overall health of communities, and implement improvements driven by real-time access to patient data. Patients and their caregivers have increasingly favored these alternative and complementary service delivery models alongside traditional in-person care. However, this is still a complex issue, and the current literature points to a variety of challenges that need to be overcome to provide optimal models of care.

Objective

This study aims to identify unique challenges to virtual hospitals providing multidisciplinary care for patients at home, and co-design recommendations to improve the patient experience.

Methods

This research is a mixed methods exploratory case study of a virtual hospital in Sydney, New South Wales, Australia. The methods include (1) document analysis: this will be used to identify the current formal processes that govern the virtual hospital; (2) secondary analysis of data: a detailed investigation of existing data collected by the virtual hospital, for example, patient-reported experience measures, patient-reported outcome measures, and other available data; (3) observations of current practices; (4) semistructured interviews; (5) co-designed focus groups; (6) economic analysis; (7) comparative case study; and finally, (8) a triangulation analysis. To synthesize these findings within a unified analytical framework, all data will be subjected to open or axial coding following the Strauss framework, allowing the convergence of themes across codes and methods.

Results

As of April 2025, observations and initial documentation analysis have begun. Multidisciplinary team meetings and clinician shadowing have commenced, along with analysis of Standards of Practice documents.

Conclusions

This protocol outlines a mixed methods case study on a new virtual hospital located in Sydney, New South Wales, Australia. We anticipate our results to provide a comprehensive understanding of patient experience through a range of quantitative and qualitative research activities. We will achieve this by identifying challenges for patients, carers, and health care workers, and documenting informal solutions discovered through our research activities.

https://www.researchprotocols.org/2025/1/e72729

Tim M. Jackson, Kanesha Ward, Saranjit Singh, Rezwanul Rana, Winnifred Li, Chenyao Yu, Jason Levy, Michelle Chen, Mui Chung, Shelley Somi, Kim Offner, Enrico Coiera, Annie A. Y. Lau

 

October 1, 2025

Translating in-person care to telehealth: a secondary analysis of GP consultations on musculoskeletal conditions

Background

The COVID-19 pandemic led to a rapid transition to telehealth, particularly in general practice where continuous care for chronic conditions, such as musculoskeletal (MSK), is provided.

Aim

To determine the appropriateness of telehealth for MSK conditions by identifying whether in-person tasks can be supported remotely via telehealth.

Design & setting

This study is a secondary analysis of the Harnessing Resources from the Internet (HaRI) dataset. This dataset comprises of 281 videos of recorded GP consultations. The dataset includes 10 GPs, across eight separate clinics, and was collected during 2017 in the UK.

Method

Content analysis was conducted to identify the clinical tasks, physical examinations, and physical artefacts used during the consultations. A scoring method applying two key metrics was developed to assess the translatability of clinical tasks to telehealth.

Results

Across the 31 MSK consultations analysed, 12 clinical tasks, five physical examinations, and 12 physical artefacts were observed. Of clinical tasks, 17% (n = 2/12) were deemed to be ‘easily translatable over telehealth’ and 50% (n = 6/12) were deemed ‘relatively easy to be translated over telehealth’. Only 17% (n = 2/12) of tasks were rated ‘moderately translatable over telehealth’, and 17% (n = 2/12) were deemed ‘potentially translatable over telehealth’. No clinical tasks in this study were categorised as untranslatable to telehealth. The average telehealth translatability score was 7.1/10.

Conclusion

Most clinical tasks observed during in-person GP consultations with patients with MSK conditions are translatable to telehealth. Further research is necessary to investigate the long-term efficacy and safety of telehealth utilisation for MSK conditions in primary care.

https://bjgpopen.org/content/9/1/BJGPO.2024.0013

Yifu Li, Simon Chan, Lawrence Lu, Tim M. Jackson, Hania Rahimi-Ardabili, Annie Y. S. Lau

October 1, 2025

Translating primary care to telehealth: analysis of in-person paediatric consultations and role of carers

Background

The usage of telehealth in general practice has risen substantially since the COVID-19 pandemic. Over this time frame, telehealth has provided care for all patient demographics, including the paediatric population (aged ≤18 years). However, the translatability of telehealth (that is, whether in-person tasks can be supported remotely via telehealth) rarely considers the paediatric population or their carers.

Aim

To examine the degree of translatability to telehealth for in-person GP consultations on paediatric patients with consideration of the carers’ roles.

Design & setting

This study screened 281 videos of in-person GP consultations set within UK general practices, and 20 of them were eligible for analysis.

Method

A secondary analysis of in-person GP consultations was undertaken to examine tasks, physical artefacts, examinations, and the interaction between carer, patient, and GP. A novel scoring method revolving around two key metrics, taking into consideration the carer, was designed to analyse whether the tasks performed can be supported via telehealth.

Results

Analysis of 20 eligible consultations revealed 13 distinct physical examinations, 19 physical artefacts, and 17 clinical tasks. Of these 17 clinical tasks, 41% were deemed ‘easily translatable to telehealth,’ 29% ‘moderately translatable with patient-provided equipment’, 12% ‘potentially translatable’, and 18% ‘currently untranslatable’. The average telehealth translatability score was 6.1/10, which suggests possible challenges with telehealth support. Regarding carer involvement, 90% of consultations involved collecting patient history, 70% placation of child, and 40% had physical support during examinations.

Conclusion

Tasks performed during paediatric in-person GP consultations may not be easily translatable to telehealth and caution should be exercised when considering their translatability to telehealth.

Simon Chan, Tasneem Khandaker, Yifu Li, Tim M Jackson, Hania Rahimi-Ardabili and Annie YS Lau
October 1, 2025

Virtual Hospitals and Patient Experience: Protocol for a Mixed Methods Observational Study

Background

Virtual care is increasingly incorporated within routine health care settings to improve patient experience and access to care. A patient’s experience encompasses all the interactions an individual has with the health care system. This includes a greater emphasis on actively involving carers in the decisions and activities surrounding a patient’s health care.

Objective

This study aimed to investigate the variety of health care delivery challenges encountered in a virtual hospital and explore potential ways to improve the patient experience.

Methods

Focusing on acute respiratory, this protocol outlines a mixed methods study exploring the patient experience of a virtual hospital in Australia, Royal Prince Alfred Virtual Hospital (rpavirtual). We will use an exploratory mixed methods approach comprising of secondary data analysis, observations, interviews, and co-design focus groups. Participants will include patients, their carers, and health care workers who are involved in the acute respiratory virtual hospital model of care. Together, the data will be triangulated to explore views and experiences of using this model of care, as well as co-designing recommendations for further improvement.

Results

Findings from this study will identify current barriers and facilitators to implementing virtual care, such as work-as-done versus work-as-imagined, equity of care, the role of carers, and patient safety during virtual care. As of August 2024, a total of 25 participants have been interviewed.

Conclusions

This protocol outlines a mixed methods case study on the acute respiratory model of care from Australia’s first virtual hospital, rpavirtual. This study will collect the experiences of patients, carers, and health care workers to co-design a series of recommendations to improve the patient experience.

Jackson et al.

https://www.researchprotocols.org/2024/1/e58683/

October 1, 2025

Virtual physical examination in teleconsultation: A scoping review

Background

The conduct of virtual physical examination has provided significant information for the diagnosis during a teleconsultation session, especially during the COVID-19 pandemic, where in-person physical examinations have been greatly compromised.

Objective

The aim of this scoping review was to provide a comprehensive overview of the available evidence concerning virtual physical examination (VPE) in all healthcare settings during the COVID-19 pandemic. The review focuses on types of VPE, technological and non-technological approaches, patient and clinician experiences, as well as barriers and facilitators of VPE.

Methods

A literature search was conducted across three databases, namely MEDLINE, Embase, and Scopus. Only studies in the English language with primary research data collected from December 2019 to January 2023 were included. A narrative analysis, highlighting patients’ and clinicians’ experiences, was conducted on the included studies. This scoping review was reported using The PRISMA extension for scoping reviews (PRISMA-ScR) Checklist.

Results

A total of 25 articles meeting eligibility criteria were identified. Three major types of VPE included were musculoskeletal, head and neck, and chest exams. Sixteen studies involved specific technological aids, while three studies involved non-technological aids. Patients found VPE helped them to better assess their disease conditions, or aided their clinicians’ understanding of their conditions. Clinicians also reported that VPE had provided enough clinically relevant information for decision-making in 2 neurological evaluations. Barriers to conducting VPE included technological challenges, efficacy concerns, confidence level of assistants, as well as patient health conditions, health literacy, safety, and privacy.

Conclusions

Patients found virtual physical examination (VPE) helpful in understanding their own conditions, and clinicians found it useful for better assessing patient’s conditions. From the clinicians’ point of view, VPE provided sufficient clinically relevant information for decision-making in neurological evaluations. Major barriers identified for VPE included technological issues, patient’s health conditions, and their health literacy.
Shuk Y.K. Tong, Tim M. Jackson, Annie Y.S. Lau
April 18, 2022

Mitigating the next crisis through knowledge management techniques: A case study of the ‘Horses as Sentinels’ project to respond to the rise of Hendra virus.

The development of new technologies can help mitigate the damage of a crisis. This research provides a case study of the work the ‘Horses as Sentinels’ project is doing to combat the rise of Hendra Virus. This concerning and fatal zoonotic disease has motivated the Australia government to fund major programs to equip veterinarians with the technologies they need to identify and diagnosis this virus. This research investigates how this project is developing the latest knowledge sharing technologies through dozens of workshops in 2022.

*Image from: https://www.news-medical.net/health/Hendra-Virus-An-Emerging-Zoonotic-Threat-in-a-Warming-World.aspx

March 15, 2022

Knowledge sharing during a crisis: A case study of the 2007 Australian Equine Influenza Outbreak.

The availability of information and its transfer is the foundation of any effective crisis response. This research uses a case study of a past crisis response to help understand the flow of information and how it becomes knowledge. The case study used is the 2007 Australian Equine Influenza outbreak. Lead health, government and industry experts active during the time of the outbreak were interviewed and their answers were analysed from the perspective of knowledge management.

*Image from: https://trainermagazine.com/european-trainer-articles/how-equine-influenza-viruses-mutate/2018/9/24

March 8, 2022

How knowledge is shared in the Australian veterinarian industry: A survey.

This study is an extension of the previous ‘Successfully sharing knowledge‘ published paper. Here, the factors: (1) organisational culture, (2) formal processes, (3) top-down support, (4) motivation, (5) clear strategy, and (6) quality of technology are tested by focusing on a single industry. The chosen industry was the Australian Veterinary industry. The previous survey was redesigned and reviewed by a range of industry experts. One of the first of it’s kind to be focused squarely on the Veterinary industry. This research has found the most influential factors on successful knowledge sharing are organisational culture, top-down support and motivation.

February 23, 2022

Successfully sharing knowledge: Empirical evidence on the influence of managerial factors.

Successfully sharing knowledge: Empirical evidence on the influence of managerial factors.

Journal of Knowledge and Process Management

Link: https://onlinelibrary.wiley.com/doi/abs/10.1002/kpm.1703

Abstract:

Knowledge is an intangible and vital resource that is an important source of competitive advantage; however, the technologies that help create, store, and transfer knowledge are hindered by unrealistic expectations and ambiguity, and the measurement of knowledge-sharing activities is both difficult and complex. Compounding this is the deficit of empirical studies on the factors that influence the knowledge-sharing process. We endeavored to provide empirical evidence on these interactions using a survey developed from a prior extensive systematic literature review. The previously identified factors that were in the current study tested comprised (1) organizational culture, (2) formal processes, (3) top-down support, (4) motivation, (5) clear strategy, and (6) quality of technology. In order, the most influential factors were organizational culture, top-down support, motivation, and quality of technology. This study is a promising start to the exploration of the factors used in knowledge sharing and should be expanded to include new industries and contexts.

March 3, 2020

Managerial Factors That Influence the Success Of Knowledge Management Systems: A Systematic Literature Review

Managerial Factors That Influence the Success Of Knowledge Management Systems: A Systematic Literature Review.

Journal of Knowledge and Process Management

Link:

https://onlinelibrary.wiley.com/doi/10.1002/kpm.1622

Abstract:

The purpose of this research is to remove the ambiguity that clouds the analysis of knowledge management systems. This is because of an overall lack of consensus on how knowledge management systems adapt to the new ‘knowledge explosion’ embraced by the booming ‘Big Data’ hype. In this paper, a refreshing synthesis of literature will uncover benefits and identify gaps in current knowledge. These findings will also be of benefit to researchers and industries as it allows for the holistic analysis of a KMS.

This systematic literature review collected 54 papers for qualitative analysis. This analysis led to a synthesis of factors evident in the research and how they could be combined and collected as key categories. Once each factor was categorized; the future directions of research was analysed and documented. The primary factors discussed include: 1) formal processes, 2) company culture, 3) top-down support, 4) motivation, 5) clear goals and 6) quality of KMS. This research has created a baseline for the further evaluation of knowledge management systems’ in the real world.

 

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