Publication Date


Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Constance Hill

Second Advisor

Barbara M. Artinian

Third Advisor

Mary DeNicola


telehealth, urban, primary care, grounded theory, video visit


Problem: Although implementation of in-patient electronic healthcare records is nearly complete in the United States, this achievement has not translated into consumer-to-business telehealth in the primary care setting. Because there are few studies that describe how and why patients select telehealth, the aim of this study was to learn about perceptions of adult patients in an urban setting when telehealth options are available. Research questions included a) How do patients select any type of appointment? b) How do patients perceive and use telehealth options? c) How and when might telehealth be useful in the future?

Methods: A qualitative study design was used to collect data through semi-structured open-ended interviews from 21 patients in a primary care practice. Interviews were transcribed and analyzed using grounded theory methodology.

Results: The theory of weighing options emerged from the data. The process of weighing options explains how patients balance factors of urgency, timing/scheduling, relationships, distance, convenience, and various technical aspects before selecting a telehealth encounter or not. If all the factors show a benefit, then the decision is made to use telehealth. Information obtained from the patient perspective may identify strategies to support increased use of telehealth.

Conclusion: The benefit of this study will be to facilitate awareness among patients about telehealth options. This information can be used by providers and nurses to maintain caring while supporting patients who choose virtual care.


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