Clinicians' Decision-Making Regarding Telehealth Services: Focus Group Study in Pediatric Allied Health

Background: Many allied health services now provide both telehealth and in-person services following a rapid integration of telehealth as a response to the COVID-19 pandemic. However, little is known about how decisions are made about which clinical appointments to provide via telehealth versus in person. Objective: The aim of this study is to explore clinicians' decision-making when contemplating telehealth for their clients, including the factors they consider and how they weigh up these different factors, and the clinicians' perceptions of tele health utility beyond COVID-19 lockdowns. Methods: We used reflexive thematic analysis with data collected from focus groups with 16 pediatric community-based allied health clinicians from the disciplines of speech-language pathology, occupational therapy, social work, psychology, and counseling. Results: The findings indicated that decision-making was complex with interactions across 4 broad categories: technology,clients and families, clinical services, and clinicians. Three themes described their perceptions of telehealth use beyond COVID-19lockdowns: "flexible telehealth use," "telehealth can be superior to in-person therapy," and "fear that in-person services may bereplaced." Conclusions: The findings highlight the complexity of decision-making in a community-allied health setting and the challenges experienced by clinicians when reconciling empirical evidence with their own clinical experience.