Table 3 Clinician perspectives of the barriers, enablers and perceived usefulness of the home telehealth program

Technology factors

 Limited or inconvenient access to equipment

Families who have access to required technology. Suggestion of having equipment in more convenient locations for clinicians, e.g. from their PC or mobile devices

Having easily accessible equipment reduces the ‘hassle’ of participating in a video-consultation

 Burden of setting up families with equipment, usernames and passwords at a stressful time

Families who are familiar with video communication and have access to the required technology

Simple to set up if family familiar with technology and a consultation can occur rapidly without difficulty

 Comparative ease of telephone use

Clear benefit of using video, e.g. to observe a wound, or breathing pattern

Provides visual information not available in a telephone call

 Discomfort with using technology

Previous experience or a willingness to participate in video-consultations

 Privacy concerns- unable to control home environment, concerns with using the Internet

Having sound proof studios where video-consultations can be undertaken without interruption within the hospital

Ability to include multiple members of the health care team means information can be shared during one conversation

Individual factors

 Personal preference for face-to-face interaction, video-consultations not a suitable substitute

Receptive families who request ongoing home video-consultations. Supportive local clinicians who are willing to participate

Presence of community-based clinicians enables ensures human presence available at family end

 Cultural, linguistic, socio-economic diversities may make communicating via Internet-video difficult

Immigrant families often more familiar with using Internet-video to communicate with family oversees and may be more receptive to receiving health services via home video-consultation

Ability to include multiple family members in a consultation, e.g. Indigenous Australians often leave important decision making to the tribal elder not the parents or caregiver of the child

Service factors

 Establishing routines

Having a coordinator to schedule video-consultations and manage administrative issues

Efficient process of communicating with multiple stakeholders

 Strengthened community support: reduced need for video-consultations with PPCS

Partnering with COH ensures clinicians can remain focussed on clinical care not managing telehealth

Facilitates provision of peer-peer support and education

 Lack of time; focus on hospital inpatients

Suggestion that having routine clinics for home video-consultation may be easier to manage than ad hoc

Ability to provide a consultation across vast distances which would otherwise require many hours of travel time

 Staff shortages