Positives from negatives
Jane Sharp charts how an issue that has been debated for years, that of remote consultation and online technology which enables doctor-patient contact, has suddenly turned into reality. What lessons can the qualitative research industry learn from this?
COVID 19 has changed the world for us all. Even if, by sheer luck, we haven't been a victim of the virus itself, the onset of the pandemic has forced previously unimagined new ways of being and working, and most of us are left feeling disturbed, disrupted and a bit adrift. This, however, is a story of positive change that has been accelerated by the rapid onset of the catastrophe.
The NHS has been elevated to hero status by the nation, it is now the single most trusted institution in the UK, and we all rightly celebrate the frontline of dedicated experts who are literally the gatekeepers of our lives.
But beyond the headlines focused on the organised chaos and self-sacrifice within ICUs around the country, a less dramatic, but pervasive technological change has been going on, something that has been debated for some time, but which the crisis has literally accelerated into being, the issue of remote consultation and online technology to enable doctor-patient contact and connection.
We are all aware of recent platforms springing up, offering us access to GPs from our phones, tablets and computers. Surgeries have been trialling remote consultations for some years, and private companies like Babylon and LIVI are springing up offering better access and more efficient contact with our health carers.
Work we have done across the healthcare spectrum reveals that patients, even before COVID, were all for a technologicallydriven shift to more accessible channels to healthcare and their GPs.
The world before
Pre COVID, the medical profession, however, was less convinced. There was a degree of reticence towards the introduction of technology even as doctors acknowledged it was the future of the NHS. Few felt remote access to patients would necessarily benefit their day-to-day working practices and were sceptical of the benefits of technology as a way of letting them do their jobs better or even as efficiently as 'the old way'.
Sound familiar? Without wanting to make too glib a comparison with the lifesaving NHS and what we do, there are some parallels with the research world here.
The reasons for this reticence are both surface and deeper rooted:
The key barrier to replacing face-to-face contact with technology for clinicians is a fear of missing crucial cues via online contact with patients. As with consumer contact, being able to eyeball people, be in the same space as them, pick up non-verbal and subtler cues is vital to diagnosis and treatment.
Healthcare workers exhibit a tigerish sense of loyalty towards the NHS, with all its failings, and making it work against the odds is a source of pride. The system has, they say, tried and tested protocols which are there for a reason, they work. It may be slightly broke, to paraphrase the old adage, but it works, so there's no pressing need to fix it, and the money should be spent elsewhere.
And beyond this pragmatic reticence lurks, perhaps, a deeper sense of unease. Doctors are (now more lauded than unsung) archetypal modest heroes, and they enjoy this status. Saving lives against the odds is what gets them up in the mornings.
And the world after
Post COVID, a lot has changed, and fast. Clinicians and medical staff have witnessed unprecedented forced investment in technology to cope with the need to treat patients remotely. Consultants, doctors and nursing staff who were previously self-confessedly so-so about the introduction of technology into their day-to-day jobs say they have been pleasantly surprised by how easy online contact is when the appetite to provide funds is there.
Of course, the need for face to face contact with patients, will, it is acknowledged, be eternally important. COVID has robbed carers, and indeed all of us, of the opportunity for human contact and connection, and this is mourned, but medics speak of a sense of having more control over regular appointments, less of a sense of chaos and uncertainty with patients not being at the right place at the right time; a sense of focus over the contact itself; less chance for patients to steer conversations off course.
Do we have that sense of increased control now we are doing more online, or less of an opportunity to access the unsaid, tap into the 'feel' in the room? Ad hoc qualitative researchers rarely have regular ongoing contact with individuals but actually, since lockdown, it's been something we've thought about, moving from one longer session to three shorter ones over a week, giving people time to think between conversations. It's interesting and somehow less postured.
Back to medicine, remote consultation enables carers to be more efficient in their work-life balance. Precious working moments can be seized at times when the need to travel into hospitals or clinics would have made this extra time impossible. Female clinicians and carers in particular voice appreciation of these extra available hours which can now be efficiently slotted in between the demands of their real lives and family commitments due to greater connectivity and technology.
So do we find this with research? Are we more efficient online? Or do we lose vital creative thinking time because we spend so much time looking at a screen?
And how are we investing in our industry? Do we need more than just a laptop and access to platforms to do this all properly? Or can our move across to online be pretty straightforward? At home, access to the internet seems to have been one of the biggest headaches, because we are all lucky enough to own basic technology.
There are undoubted parallels to be drawn between healthcare and our industry, online connective technology seems to have slipped pretty effortlessly, and, by and large, successfully, into our healthcare system. Perhaps we all need to ponder the similarities with our industry and be prepared to learn and adapt by comparison.
Sharp and Taylored
14 July 2020
Copyright © Association for Qualitative Research, 2020