Workload management
Through the intervention, HCPs could receive patients’ BP readings remotely and conduct phone medication titration quickly if warranted. This raised conflicting views from HCPs about the impact on their workload.In the initial stages of the trial, S005 (female, care manager) had to “find pockets of time” to check each patient’s BP readings monthly for fluctuations through the portal and phone calls, “whether it is urgent or not”. Subsequently, a Jobstack function was created and helped the healthcare team prioritize certain patients for closer monitoring and unscheduled teleconsultations. This freed up some time for them to focus on other tasks. Since then, S005, S006 and S007 saw better workload management as they could spend their clinic time attending to patients with more complex needs, while conducting phone medication titration and teleconsultation for patients with stable BP.At individual level, the time that I usually spend for my patient [usual consult] compared to now for this [intervention], it has reduced a little. But overall, if I see it as a whole, for the 120 patients, it does help to ease out the appointment for other patients. If I get a lot of them to be on teleconsult, so I free up some of the appointments for other more complex cases. (S006, male, family physician)On the contrary, the intervention become overwhelming for some HCPs. S002 found an increase in workload as she had to manage patients with clinic appointments and phone follow-up with the trial participants concurrently.It’s quite packed every day… Sometimes [the time] I spend [on] the call is very long, so the patient actually in the clinic was waiting. These are the difficulties. (S002, female, care manager)One family physician felt that the effort involved in teleconsultation and phone medication titration in this pilot trial was not acknowledged but was hopeful that the workload might improve in future.All [done] remotely, [patients] don’t have to come back. So in a way, [they] save time, right? Because they don’t come in and take our slot. But the bad thing is that it is not accounted for, it’s just extra work... Maybe in the initial phase, there will be increased workload, but in the long run once everyone is optimized… there may be a decrease in the workload. (S004, female, family physician)