Telehealth Care Model of Home Isolation in Health Region 12 Thailand: An Extension of Voluntary Health Workforce

Abstract

The COVID-19 pandemic situation has affected health workforce in the public health system, health personnel could not provide care to all infected people. The situations led to home isolation equipped with volunteer health workforce in a telehealth care model. The objectives of this qualitative research were: 1) to analyze the roles and operating procedures of health workforce; 2) to analyze success factors, problems and obstacles in the implementation of home isolation telehealth care model; and 3) to synthesize the home isolation telehealth care model in terms of health workforce in Health Region 12 of Thailand. Data were collected through semi-structured in-depth interviews and online group discussions with 30 volunteers and 50 home isolated patients. Data were triangulation verified at every step of data source check, investigator, and methodology. Content analysis was carried out till interpretation, and conclusions reached.

The results revealed that 1) the home isolation telehealth care model was staffed by the combined workforces of health workers and volunteers who helped take care of COVID-19 patients. The volunteers were recruited from lay people, people who had contracted COVID-19 and their relatives. 2) The combined workforces built up shared common goals through group meetings to clarify the objectives and goals of the voluntary work. 3) Training sessions began with forming volunteers’ care attitude ready to be giver to others; followed by the use of language in good communication; knowledge on COVID-19 prevention, care and rehabilitation; tele-patient assessment using information technology and patient database systems to achieve continuity of care. And 4) online patient consultations were operated to reinforce confidence of the combined health workforce. The roles and operating procedures were confined to 4 teams: 1) The central team designed patient database system to assign patients with COVID-19 to patient care team. The databases coordinated and kept track of patients’ symptoms whether they faced severe symptoms, crises, or emergency conditions that required necessary medical equipment support. 2) Patient monitoring team took responsibilities of the assigned patients, making phone calls to assess symptom changes, providing advice, encouraging mental support. This team recorded patient progress in the database. If severe symptoms of COVID-19 were detected, the team needed to notify doctor or pharmacist for appropriate action. 3) The community team was responsible for delivering the actions of the monitoring team to COVID-19 patients, such as providing medical equipment, medicines and food to their homes. And 4) the funeral volunteer team provided necessary ritual ceremony if the patient died. The key factors for success of home isolation telehealth care model included attitude, mindset, and belief in volunteer work, which conveyed peace of mind, complacent feeling and fulfilling in merit making. Problems and obstacles included difficulties of access to the database, communication and tools and the Internet system.