The role of trust in the patient-healthcare expert remote communication: the case of Greek healthcare private-practitioners

Kalyvis, Vasileios (2017) The role of trust in the patient-healthcare expert remote communication: the case of Greek healthcare private-practitioners. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Rapid developments in the field of information and communication technologies (ICT), in parallel with the steady coverage growth of mobile cellular networks, have shaped a digital meeting space for patients and healthcare experts. However, this space remains largely unexplored. There is a large body of telemedicine research, but it almost always reports technical pilots within institutional settings, overlooking the use of everyday technologies [designed for personal rather than medical communication] in the healthcare sector. Lack of knowledge about the role of trust in the context of remote communication via ICT between patients and healthcare experts reflects a significant research gap addressed in this thesis. I use original, in-depth qualitative evidence to explore the role of trust in the context of ICT-enabled remote communication in healthcare. Sixteen private practitioners based in Greece took part in the research. They were specialised in the fields of physical and mental health. All used ICT to support remote communication with their patients. The emerging theory developed within the framework of the current thesis demonstrates that, in the light of an identified medical-data-gap due to the limited perceived affordances of the ICT selected for computer-mediated communication (CMC), patient’s trustworthiness matters. Physicians hesitate, or even refuse, to proceed with any medical act, such as diagnosis, medication regime, prescription or guidance, in a remote manner, to patients whom they do not trust, especially in terms of their communicational skills. However, it is being demonstrated that this applies only to physicians (meaning those who treat physical symptoms) and not to mental health experts. Finally, there is evidence that, for mental-health experts, the accessibility provided by ICT nurtures trust maintenance and trust development with their patients. This doctoral thesis is innovative in that it sheds light on remote communication between healthcare experts and patients via everyday technologies, with a special focus on the element of trust. Moreover, it is innovative in that it borrows, for the first time, key-theoretical properties from the ‘distant’ discipline of CMC in order to explain patterns regarding healthcare experts’ attitude towards ICTs.