The Impacts, Dynamics, and Effects of a Spatially Separated Service for Service Providers and Users Experiencing Vulnerability

Abstract

Consumers experiencing vulnerability are prevalent in healthcare contexts across the globe, so it is surprising that such groups do not typically feature in the extant literature on service separation. Telehealth as a spatially separated service offering requires a combined perspective that captures the experiences of both users’ experiencing vulnerability and providers’ delivering the separated service. The inclusion of these actor perspectives with health-related vulnerabilities is essential to fully understand the impacts, dynamics, and effects of a spatially separated service. We address this need by conducting a twelve-month longitudinal qualitative study of an online mental health service in Brazil, drawing on qualitative data from patients experiencing vulnerability and psychologists. Phenomenographic interviews (n = 67) reveal the consequences of spatial separation on service encounter actors, how spatial separation impacts relational dynamics and roles between users experiencing vulnerability and providers over time, and how these service actors overcome challenges from spatial separation for value creation.