Introduction:
In Denmark diabetes mellitus type-2 (DM2) is a problem where, among other things, there's a risk of late complications that can reduce quality of life of the patient. Vulnerable patients with DM2 has more frequently no-shows from outpatient consultations than others. The prevalence of DM2 is increasing and requires innovation in health care. Video consultation can be a solution to this. In the region of Northern Jutland video consultation is available for diabetics, but so far there hasn't focus on vulnerable patients with DM2.
Methods:
This project is a mixed methods study with an explorative sequential and a convergent parallel design. Card sorting was carried out with four primary health care nurses, and formed the basis for a questionnaire with 25 primary health care nurses from the region of Northern Jutland participating. Results were summarized with findings from an expert interview.
Findings and results:
It appears that no-shows from consultations are a known phenomenon. There are a number of incentives for implementing cross-sectoral video consultation for the patients, including improved glycemic control, reduced number of non-attendances, improved cross-sectoral collaboration and patient care. Barriers to cross-sectoral video consultation may be changing workflows, time-consuming technology and patients' lack of resources. Patient involvement during implementation and super-users have proven to be beneficial and focus on change management may be needed.
Conclusion:
Primary health care nurses' attitudes towards video consultation reflect opportunities and barriers for cross-sectoral video consultation for vulnerable patients with DM2. Video consultation may accommodate non-attendances and strengthen cross-sectoral cooperation. The patients can potentially achieve better glycemic control and reduced risk of late complications. Barriers can be concerns about changing workflows and patients' lack of resources. Factors that should be focused on due to implemententation are patient involvement, super-users, user-friendly technology, change management and stakeholder analysis.