Developing a Podiatric Telemedicine Framework for Service Users and Providers in a Primary-Care Setting

Background: The use of telemedicine has garnered significant traction amidst the COVID19 pandemic. The sudden adoption of certain practices in podiatry was not always supported by empirical evidence, resulting in the development of guidelines and metrics that lacked a foundation in rigorous research. Methods: A modified Delphi composed of three rounds was conducted with 16 stakeholders (service users, foot and ankle health-care providers, and policymakers) from a primary-care setting to develop a podiatric telemedicine framework for a primary-care setting. The first round consisted of focus group discussions, the second round consisted of a questionnaire composed of different statements that emerged from focus group discussions, and the final third round consisted of a questionnaire with statements from the second round that required further reiterations. Statements that achieved an 80% or higher level of agreement were accepted to form part of the podiatric telemedicine framework. Results: Excellent consensus data was obtained to develop the podiatric telemedicine framework. Although podiatric telemedicine for low-risk patients in a primary-care setting is relatively new, stakeholders highlighted the importance of having podiatric telemedicine guidelines and setting service user and provider expectations clear on what podiatric telemedicine has to offer and its pitfalls. Conclusions: The podiatric telemedicine framework developed is recommended to all foot and ankle health-care professionals in a primary-care setting who wish to provide telemedicine consultations. Moreover, it is recommended that a pilot study be carried out to look into the feasibility of this framework being translated and implemented as a guideline related to foot and ankle telemedicine consultations.