Barriers to and potential of remote consultations in general practice: Insights from the SARS-CoV-2 pandemic. A qualitative study in Austria

Background Remote consultation and teleconsultation have the potential to transform healthcare delivery by improving patient outcomes, reducing healthcare costs, and increasing patient access to care. However, teleconsultation uptake by Austrian general practitioners (GPs) is rare, even during the SARS-CoV-2 pandemic. Therefore, the aim of this study was to explore the factors behind this rare uptake by understanding the experiences, perspectives, challenges, and fears of GPs in terms of teleconsultations in general and video consultations in particular. Method Semi-structured interviews were conducted with 30 GPs working in different organizational primary care areas in the public sector. We followed the qualitative content analysis approach for data analysis. Results Five super-categories and 19 related subcategories were identified from the interviews. The five super-categories involve aspects regarding methods of remote communication and consultation, topics for remote communication, concerns about telemedicine, and expectations regarding the support needed and potential/expectations of teleconsultations. The most noteworthy finding is that GPs overwhelmingly refer to telephone consultations when talking about remote/teleconsultations. Respondents only mentioned video consultations as a means of remote consultation upon prompting. Moreover, the lack of institutional support and infrastructure for video consultation implementation was a recurring theme, emphasizing the need for investments and resources. However, despite these barriers, GPs see the opportunities for teleconsultations in their daily work. Conclusion As GPs were at the forefront of healthcare provision during the pandemic, their insights shed important light on real-life challenges and opportunities regarding teleconsultations. It became clear that a safe, focused, and supportive environment is needed to implement new technologies such as video consultations, especially in a healthcare system where GPs are responsible for implementation as entrepreneurs themselves. Above all, clinicians and patients need to be involved in creating the necessary e-health strategy and related software development from the beginning.