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Better way of working
Despite the best intentions: a reflection on low client numbers for a pilot telemedicine sexual health service
  1. Cameryn C Garrett1,
  2. Maggie Kirkman2
  1. 1Research Fellow, Centre for Women's Health, Gender and Society, Melbourne School of Population Health, The University of Melbourne, Victoria, Australia
  2. 2Senior Research Fellow, The Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia and Honorary Research Fellow, Centre for Women's Health, Gender and Society, Melbourne School of Population Health, The University of Melbourne, Victoria, Australia 
  1. Correspondence to Dr Maggie Kirkman, The Jean Hailes Research Unit, Locked Bag 29, Monash Medical Centre, Clayton, VIC 3168, Australia; maggie.kirkman{at}monash.edu

https://doi.org/10.1136/jfprhc-2012-100359

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    Why was a telemedicine service piloted?

    Young adults in Australia face barriers in accessing sexual health services, including concerns about confidentiality, cost, and limited choice of doctors.1–3 The Melbourne Sexual Health Centre (MSHC) therefore initiated a 1-year pilot of free telemedicine (telephone, computer-linked video) consultations for asymptomatic people under the age of 26 years in rural Victoria.

    How did the service work?

    Clients contacting the service could choose a video or telephone consultation with a sexual health nurse, then receive a mailed sexually transmitted infection (STI) home-testing kit. Clients posted their sample swabs to the laboratory and telephoned MSHC for their results. Those individuals testing positive for chlamydia were contacted by a dedicated nurse to arrange free treatment.

    The service was extensively advertised and high usage was expected. However, during the year-long pilot, there were only 28 clients (aged 14–25 years), none of whom had a video consultation.

    Evaluation of clients’ views by questionnaire (n=18) and interview (n=4) found that they reported being satisfied and that most viewed the service as better than an in-person consultation.4 Primary reasons reported for not having a video consultation were not owning a webcam, finding video too confronting, and the convenience and familiarly of the telephone. Given the high expectations of the service and client satisfaction, the low usage was puzzling. It was decided to interview key informants with the objective of contributing to the evidence base on establishing optimum rural sexual health services.

    What did the key informant interviews tell us?

    Eight people designed and …

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    Footnotes

    • Funding Cameryn Garrett was awarded a Melbourne International Research Scholarship, Melbourne International Fee Remission Scholarship, and an Institute for a Broadband-Enabled Society PhD Top-Up Scholarship to undertake her doctoral research, of which this work forms a minor part. The funders exercised no influence on the research.

    • Competing interests None.

    • Provenance and peer review Not commissioned; externally peer reviewed.