COLLEGE OF MEDICINE AND HEALTH
Medicine, Nursing and Allied Health Professions

Video consultations with GPs could help some patients

Video GP surgeries could curb need for face-to-face visits

Patients consulting their doctor by video link could reduce the need for GP visits but it is not suitable for everyone, a pilot study has found.

People with long-term health problems are most likely to benefit, as they require frequent check-ups but do not necessarily need a physical examination each time.

Working people also reported advantages as the technology can save time spent travelling to and from appointments.

Doctors say face-to-face visits are appropriate when they are delivering bad news or discussing serious health issues. Patients too preferred seeing their doctor in person when discussing personal issues.

The findings are the result of a trial involving 45 patients and six GP practices in Edinburgh and the Lothians.

A Skype-style web-based programme called 'Attend Anywhere' was used for the consultations. Patients were sent an email with a link to take them to a virtual waiting room at the time of their appointment.

The study looked at the duration and content of video consultations. Researchers also carried out telephone interviews with around half of the patients who had taken part in video consultations to gauge their views. They also spoke to all of the doctors and nurses who had taken part in the study.

Doctors reported advantages over telephone consultations as video allows them to pick up on visual cues – such as body language and facial expressions – that can inform an assessment. In some cases, however, seeing a patient in person remains preferable.

Video links were favoured by younger patients, who are more familiar with web-based communications. Video consultations were similar to telephone consultations with regard to duration and content, but shorter and less detailed than a face-to-face consultation.

Some people with mobility problems or mental health problems found the video consultation to be particularly helpful.

Technical problems were common, however. The researchers say improvements in infrastructure are needed so that video consultations can be seamlessly integrated with practice appointment systems.

The research, published in the British Journal of General Practice, was funded by the Scottish Government’s Chief Scientist Office. The research was led by the University of Edinburgh in collaboration with the Universities of Exeter and Warwick.

Professor John Campbell, co-author and lead from University of Exeter, said: “This important work helps inform a rapidly growing area of primary healthcare delivery in the UK. The Government and NHS England are pushing forward with increasing access via digital platforms for NHS services. Whilst this research has identified that face-to-face contact with a GP remains the ‘Gold Standard’, it is clear that there will be increasing use of web-based and video-based GP consultations. Our research has identified that good outcomes can be achieved for patients although the IT infrastructure may prove an important limiting factor, especially for patients in remote and rural communities. We found it interesting that some patients actually preferred a video rather than face-to-face consultation and this will be an important and interesting area to watch in future developments”

Professor Brian McKinstry, of the University of Edinburgh’s Usher Institute, said: “Our study showed that there is real potential for video-consulting particularly for conditions where a visual examination can be helpful  for example when assessing people who have problems with anxiety and depression and have difficulty getting to their general practice”

Dr Helen Atherton, of Warwick Medical School said: ‘Video consultations were superior to a telephone consultation, providing visual cues and building rapport. However it, is clear that to get the most out of this type of consultation there are infrastructure hurdles yet to be overcome.”

Date: 11 June 2019

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