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The purpose of this paper is to examine patient engagement in remote consultation services, an increasingly important issue facing Healthcare Operations Management (HOM) given the significant expansion in this and other forms of telehealth worldwide over the last decade. We use our analysis of the literature to develop a comprehensive framework that incorporates the patient journey, multidimensionality, antecedents and consequences, interventions and improvement options, as well as the cyclic nature of patient engagement. We also propose measures suitable for empirical assessment of different aspects of our framework.

We undertook a comprehensive review of the extant literature using a systematic review approach. We identified and analysed 63 articles published in peer-reviewed scientific journals between 2003 and 2022.

We conceptualise patient engagement with remote consultation across three key aspects: dimensions, process, and the antecedents and consequences of engagement. We identify nine contextual categories that influence such engagement. We propose several possible metrics for measuring patient engagement during three stages (before service, at/during service and after service) of remote consultation, as well as interventions and possible options for improving patient engagement therein.

The primary contribution of our research is the development of a comprehensive framework for patient engagement in remote consultation that draws on insights from literature in several disciplines. In addition, we have linked the three dimensions of engagement with the clinical process to create a structure for future engagement assessment. Furthermore, we have identified impact factors and outcomes of engagement in remote consultation by understanding which can help to improve levels of adoption, application and satisfaction, and reduce healthcare inequality. Finally, we have adopted a “cyclic” perspective and identified potential interventions that can be combined to further improve patient engagement in remote consultation.

This paper aims to unravel the puzzle that the United Kingdom’s high-quality government accounting and fiscal architecture is associated with low-quality outcomes, including poor productivity growth, high public debt, public services which do not meet citizen expectations and historically high levels of taxation. It contributes to public sector accounting research in the fields of fiscal transparency and governance.

This paper uses Miller and Power’s (2013) economization framework and Dunsire’s (1990) concept of collibration to explain why being a global leader in public sector accounting reform and in fiscal and monetary architecture has not protected the UK from weak governance. The intersection of economization’s roles of accounting with modes of government accounting clarifies the puzzle.

Whereas accruals government accounting contributes to fiscal transparency, this is not a sufficient condition for well-judged policy and its effective application. Collibration is the dominant mechanism for mediation in the fiscally centralized UK, but it has failed to deliver stable outcomes, in part because Parliament is limited in its ability to hold back inappropriate behaviour by the Executive. Subjectivization has disrupted adjudication because governments at all levels resist constraints on their behaviour, with unpredictable and often damaging consequences.

This paper provides insights through the combined lens of economization and modes of government accounting, demonstrating the practical value of this conceptualization. Although some causes for unsatisfactory outcomes are specific to the UK, there are cautions for accounting and fiscal reformers in other countries, such as Member States of the European Union.