The Changing Clinical Encounter: A Hermeneutic Study of How Virtual Care Affects Patient and Provider Experiences of Clinical Encounters (Preprint)

Abstract

Virtual healthcare is changing healthcare delivery with consequent effects on how both patients and providers experience clinical encounters.

The objective of our analysis was to identify themes of change in how patients and providers in a geographically dispersed renal service discussed their experiences with virtual care, including changes during the COVID-19 pandemic.

15 patients and nine providers from different disciplines were interviewed by phone as part of a study of healthcare implementation in the case of a kidney care service in northern British Columbia in Canada. Interview data were analysed using a hermeneutic approach that pays careful attention to reported experience in terms of relationships and contexts of care.

During analysis, the team identified themes related to the clinical encounter itself, and how virtual care had secondary effects on perceptions of care. We identified themes grouped under changes to the structure of care, including formal and informal networks, and the experience of how trust could be maintained in virtual settings.

While the convenience afforded by virtual care over long distances was recognized by participants, there were subtler impacts of virtual care for clinicians in making assessments of patients, and in establishing and maintaining relationships in which information could be freely exchanged.

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