Communication challenges between healthcare providers and patients: scoping review & qualitative study

Background: Since the outbreak of the COVID-19 pandemic, the adoption of teleconsultation has rapidly increased as a measure to prevent virus transmission. While several studies have explored the hurdles to adoption of teleconsultation, there is a limited amount of research on communication challenges that arise between healthcare providers and patients during teleconsultations.

Objective: This thesis aims to identify the types of communication challenges experienced by healthcare providers and patients during teleconsultations in the context of the COVID-19 pandemic. Additionally, it seeks to compare these challenges with those encountered during in-person consultations.

Methods: This thesis is divided into two phases: a scoping review of communication challenges during teleconsultation, and a qualitative study utilizing secondary data of in-person GP consultations.

• Phase 1 involved a systematic assessment of recent literature to gain insights into communication challenges between healthcare providers and patients during teleconsultations in the context of the COVID-19 pandemic.

• Phase 2 evaluated communication challenges experienced by GPs and their older patients (aged 65+) during in-person consultations.

Through this analysis, a comparison of communication challenges during teleconsultations and in-person consultations was conducted.

Results: In Phase 1, the scoping review identified 27 articles, predominantly qualitative studies (12/27, 44%), which highlighted eight factors contributing to communication challenges during teleconsultations, namely: technical issues, lack of non-verbal communication, difficulties in developing rapport, lack of physical examination, language difficulties, difficulties assessing patients’ health literacy, clinician preparation, and spatial issues.

In Phase 2, the secondary study focused on elderly patients (aged 65+) and identified communication challenges in 14 in-person GP consultation cases. The analysis of these cases revealed 10 causes of communication challenges during in-person consultations, namely: misperception of disease, discordance in treatment, patient’s misunderstanding, patient not answering in a way doctors expected, patients forgetting their medical historypatients forgetting tasks from consultation, language barrier, companion’s presence, medical jargon and explanation, and doctor’s misunderstanding.

Conclusions: Our research found several communication challenges both during teleconsultation and in-person consultation. To reduce the impact of these challenges, healthcare providers’ recognition of the communication challenges and their preparation to overcome them are necessary. As the use of teleconsultation is predicted to increase, more research on appropriate use of teleconsultation and ways to overcome communication challenges during teleconsultation is essential.