Background: Medication history telepharmacy consults are carried out prior to a patient commencing their systemic anti-cancer therapy. At this study institution, this has historically been carried out as an unscheduled telephone consult, however, due to challenges with this model, a scheduled videoconsult model was established. While funding, time efficiency, and completion rate for the videoconsult service compared to the telephone consult service has been examined previously, an implementation evaluation has not been undertaken.
Aim: This study explored staff perceptions of the implementation of the videoconsult model compared to the existing telephone model, to inform model sustainability.
Methods: Semi-structured interviews were conducted with staff (n= 14) who were involved with the videoconsult service, or who provided care for patients who had a videoconsult. Interview transcripts were coded for positive or negative influence and strength using the Consolidated Framework for Implementation Research (CFIR) 2.0, to understand which constructs influence implementation.
Results: Thirty-nine of the 79 CFIR 2.0 constructs, from the four domains of Innovation, Outer Setting, Inner Setting, and Individuals, were identified as positive, negative, neutral, or mixed influences for the telephone and videoconsult models. The strongest enablers out of the 25 positively influencing constructs for the videoconsult model included innovation advantages, support persons assisting in the consult, financing related to funding reimbursement, and telehealth coordinator capability and motivation. Barriers unique to the videoconsult model included the many steps that were involved, compatibility with workflows, and pharmacist resource. Similarities (e.g., space was a barrier) and differences unique to each model were identified.
Conclusion: Findings demonstrate that the videoconsult model should be used where possible, and patient groups who may benefit most from this model have been identified. However, due to the multiple advantages and challenges with each model, further research into a hybrid service of the telephone and videoconsult models is recommended.