Can culturally safe general practice telehealth overcome barriers to care for Aboriginal and Torres Strait Islander Australians? A qualitative study

Objectives To explore Aboriginal and Torres Strait Islander Australians' perceptions of telehealth general practice consultations and elements required for a culturally safe telehealth consultation.Design Qualitative study.Setting Primary care telehealth in three centres in regional and remote Australia.Participants Seventeen Aboriginal or Torres Strait Islander individuals participated in semistructured interviews exploring the experiences of telehealth in general practice settings. Participants were eligible for inclusion if they were Aboriginal or Torres Strait Islander, over 18 years of age and had experienced at least one telehealth appointment with their general practitioner in the preceding 12 months. Data were collected in the form of short surveys and semistructured interviews. Data collection occurred between June 2022 and August 2023. Data were analysed using thematic and content analysis techniques.Results Participants had experienced telephone (88%) and videoconference appointments (12%). Reasons for choosing telehealth included being unable to attend due to respiratory symptoms and/or COVID-19 restrictions on in-person consultations (reflecting the study period) and issues of access (eg, availability of doctor, convenience of hours). Participants described benefits of telehealth around reduced barriers to care but also described practical and communication challenges experienced during telehealth. Elements of culturally safe telehealth identified included: consultation skills, a pre-existing doctor-patient relationship and local knowledge (including knowledge of the local cultural and community context).Conclusion This study demonstrates the benefits of telehealth and its ability to reduce barriers to care for Aboriginal and Torres Strait Islander Australians. However, the identified disadvantages demonstrate that this modality should be considered as an addition to, rather than a replacement for, face-to-face consultations. The elements identified interact as part of a complex interplay of factors contributing to cultural safety in the telehealth context. These elements provide useful recommendations for practice and policy.