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Introduction. Evaluating digital health services from an ethical perspective remains one of the more difficult challenges in telemedicine and health technology assessment. We have previously developed a practical ethical checklist comprising 25 questions covering six ethical themes: privacy, security, and confidentiality; equity; autonomy and informed consent; quality and standards of care; patient empowerment; and continuity of care. The checklist makes ethical analysis more easily accessible to a broader audience, including health care providers, technology developers, and patients. Aim. This project applies the previously developed practical ethical checklist to direct-to-consumer virtual primary care consultation services in Aotearoa New Zealand to conduct an ethical assessment. Method. We first mapped the available services. The ethical framework was then applied to assess these services based on publicly available information. Results. Our findings show that the examined virtual consultation services adequately address ethical considerations, particularly regarding patient data privacy and informed consent. We identified areas for improvement in equity, patient empowerment, and continuity of care. Discussion. The application of this framework raises fundamental questions on how continuity of care, equity, and comprehensive care can be protected when virtual care becomes more ubiquitous. The checklist can help virtual consultation services identify areas of improvement and ensure they meet ethical criteria, thus contributing to quality of care. The framework may be adapted to other digital health services and tools, providing ethical guidance to technology developers, clinicians, and patients and their whānau (family). [ABSTRACT FROM AUTHOR]

Worldwide, populations are ageing and consequently so are the consumer profiles for most organisations. Understanding how best to ensure satisfaction in interactions with older customers, patients, members of organisations, and so on is therefore increasingly important. This paper examines two research questions: (a) How satisfied or dissatisfied are older people with their customer service experience, and what are the factors associated with dissatisfaction? and (b) What prompts older people to want to change service providers? The research questions are addressed using a mixed-methods approach – quantitative analysis of observation logs, supported by illustrative quotes from focus groups. We find that on the whole older people are generally satisfied with their interactions with organisations, although a substantial minority of interactions lead to dissatisfaction or lower-than-expected satisfaction. Dissatisfaction with interactions is mostly associated with impersonal communications, including interactions that are not conducted face to face, and those that are one-off interactions rather than repeated interactions. Media and communications firms prompted the greatest levels of dissatisfaction among older consumers. Dissatisfied older consumers from our sample are more than 12 times more likely to report an intention to switch providers than satisfied consumers. This highlights the potential costs to organisations of poor customer interactions with older people. [ABSTRACT FROM PUBLISHER]

The aim of this process evaluation was to identify consumer perspectives of strengths and weaknesses of programme delivery at three New Zealand community treatment programmes for sexually abusive youth. Qualitative methods were employed, with data being obtained from in-depth interviews with 24 sexually abusive youth and 23 caregivers across three sites. Results indicated that clients value good pre-entry information to reduce barriers to participation; engagement in treatment is facilitated by the quality of the client-therapist relationship, family involvement, culturally appropriate communication and creative and physical activities; and post-treatment support is important. Findings highlight the importance of engaging adolescents and their families actively during the intake period, the treatment phase and post-treatment transition. They also support the use of flexible and integrated approaches to treatment that attend to the cultural context for ethnic minorities. This suggests that programmes should aim to provide wraparound services that promote engagement during the referral phase and offer transitional programmes and aftercare follow-up. Recognition should also be given to issues of cultural difference by ensuring that cultural services for ethnic minorities are integrated into all levels of programme delivery. [ABSTRACT FROM AUTHOR]