A qualitative approach to exploring nurse practitioners' provision of telehealth services during the COVID-19 pandemic in Australia

Background: In adapting to provide socially distanced healthcare during the COVID-19 pandemic, the Australian government encouraged the use of telehealth consultations in circumstances where face-to-face consultations could be avoided. For nurse practitioners, four telephone and four telehealth Medicare Benefit Schedule items were established. 

Aim: To explore nurse practitioners' perspectives on their provision of telehealth services during the COVID-19 pandemic in Australia. Methods: Semi-structured interviews were conducted with nurse practitioners (n = 16) recruited through snowball sampling. Interview data were analysed inductively (Phase 1) and deductively (Phase 2). Reported here in accordance with the Consolidated Criteria for Reporting Qualitative Research guideline. Findings: Telehealth provided a viable alternative to in-person consultations during the pandemic, the most common reasons for presentations were medication prescriptions, provision of medical certificates, and management of chronic conditions. The priorities to include in programs to educationally prepare nurse practitioners to provide telehealth were knowledge of telehealth technology, systems and processes, patient assessment via telephone or video telehealth, limitations of scope of practice, and ensuring cultural safety. 

Discussion: While the rapid transition to telehealth during COVID-19 was perceived to improve patient access to care, it was challenging to provide without having already established the systems and processes required, and without prior telehealth experience or education. 

Conclusions: Since the height of the COVID-19 pandemic, telehealth has become an accepted means of operating for many healthcare services, including those provided by nurse practitioners. The findings suggest that the educational preparation of nurse practitioners to provide care via telephone or telehealth services is important and should be considered as part of the design of tertiary education leading to nurse practitioner endorsement in Australia.