Canadian family physicians (FPs) and home health staff (HHS) experience significant barriers to patient-related collaboration about patients they share. This mixed-methods study sought to determine the quality and sustainability of secure audio conferencing as a way to increase care planning about shared patients. Primary data sources included pre-and post-study administration of a published survey and post-study semi-structured interviews and focus groups. Non-parametric statistical procedures were used to analyze survey results and thematic content analysis was undertaken for qualitative data. Results from both quantitative and qualitative analysis were integrated into the overall analysis, in order to draw inferences reflecting both approaches to barriers and benefits of collaborative care planning for FPs and HHS. Both FPs and HHS provided evidence that structural barriers impede their ability to collaborate. HHS and FPs also agreed that joint conferences were beneficial for patients, and that the use of audio conferencing provided an efficient method of collaborative care planning. Limitations included a small sample size and short timeline for the intervention period, given the magnitude of the expected change.

This paper has a dual aim: to situate functionalities among the complex of factors that help shape online interactions and to explore the heterogeneity of audio conferencing and its implications. Following a critical discursive synthesis of the treatment of variables in the literature, attention focuses on the distinctive and diverse characteristics of synchronous audio environments. The existence of a synchronous-asynchronous dichotomy is questioned and the effects of a number of differences are highlighted. As a further illustration, the paper next undertakes a comparison of Lyceum and Wimba Voice Direct. The main features of the two environments are introduced and a detailed analysis of their text and voice chat facilities is carried out. In the last section the benefits of text-based CMC are revisited through the lens of voice chat technology. It is concluded that the benefits of CMC appear to have been overstated and that no general claims can be made about voice CMC, but that collectively, well documented studies could provide a useful source of information on the level of contingency of particular findings.