Abstract
The COVID-19 pandemic raised significant challenges for in-person healthcare provision, leading healthcare providers to embrace digital health like never before. Whilst changes were made as part of a public health response, many have now become permanent fixtures of the healthcare landscape, significantly altering the way care is provided not only for patients, but also for the healthcare professionals that provide care. In abortion care in England and Wales, previously stringent regulations on in-person care provision were relaxed to permit the use of telemedicine and self-administration of medications at home. These changes have since been made permanent. However, there remains opposition to remote abortion care pathways on the basis of safeguarding. Opponents argue that it is not feasible to effectively safeguard patients accessing abortion care remotely. We conducted a qualitative study using semi-structured interviews with abortion care providers in England and Wales. Participants were asked about their views and experiences of the transition to remote care provision, with a particular focus on how they adapted their safeguarding practice. In this article, we present three themes that highlight the changing roles of healthcare professionals in abortion care: (1) a challenging backdrop and resulting apprehension, (2) adaptive practices, and (3) the continued importance of professional curiosity. Across all three themes, participants reflected significantly on how changes were made and what they experienced in the period of transition to telemedicine. In particular, they discussed the changing nature of their professional roles amidst digitalisation. Our findings provide a basis for reflection on the increasing introduction of digital approaches to healthcare provision, highlighting points for caution and emphasising the need to involve professionals in the transition process to ensure vital buy-in. Through this, we articulate two novel understandings of digitalisation: (1) the impact of speed-associated pressures on professional adaptation during digitalisation, and (2) off-proforma safeguarding through telemedicine as a form of invisible non-routine work.
Original language | English |
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Article number | 116835 |
Number of pages | 14 |
Journal | Social Science and Medicine |
Volume | 348 |
Early online date | 28 Mar 2024 |
DOIs | |
Publication status | Published - 1 May 2024 |
Bibliographical note
Copyright © 2024 The Authors.Acknowledgements
We are grateful to all the healthcare providers who took part in this study, and to our study collaborators for their invaluable assistance. We are particularly indebted to Dr Jonathan Lord and Dr Patricia Lohr, and our research assistant Matimba Swana. We are also thankful to the Institute of Medical Ethics for funding the research and to participants who attended a workshop we hosted at Durham University to present initial findings in July 2022.
Keywords
- Abortion
- Digital health
- Digitalisation
- Healthcare workers
- Reproductive health
- Safeguarding
- Telemedicine