Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care

Hammersley, Vicky; Donaghy, Eddie; Parker, Richard; McNeilly, Hannah; Atherton, Helen; Bikker, Annemieke; Campbell, John; McKinstry, Brian

doi:10.3399/bjgp19x704573

Cited by 280 publications

(308 citation statements)

References 21 publications

(32 reference statements)

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“…39 As discussed by Donaghy et al and Hammersley et al reliable technology is essential for the widespread implementation of video consultations. 40,41 It is likely that changing the consultation type was convenient for the nurses, as solving technical challenges required extra work, as also described by Østervang et al 42 The implementation of this study identified potential challenges in trying to create easyto-use instructions and constant support through the application and video use, and indicated that the use of technology could have been challenging for the nurses.…”

Section: Discussionmentioning

confidence: 69%

Comparison of video and in-hospital consultations during early in-home care for premature infants and their families: A randomised trial

et al. 2020

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Introduction Early in-home care is increasingly being used in Scandinavian countries for clinically stable premature infants. Due to challenges with travel and hospital resources, alternative ways to support parents during early in-home care are being considered. The aim of this study was to test whether the proportion of mothers exclusively breastfeeding, parental confidence and mother–infant interaction increased after early in-home care with premature infants, and to compare the outcomes of in-home care involving the use of video communication and a mobile application with those of in-home care involving in-hospital consultations. Methods This study was conducted in four neonatal wards offering premature infant in-home care in Denmark. Premature infants were randomised using 1:1 block randomisation. During early in-home care, families had planned consultations two to three times a week, during which they received support from nurses: the intervention group had video consultations, while the control group had in-hospital consultations. Results The proportion of exclusively breastfeeding mothers at discharge was 66.7% in the intervention group vs 66% in the control group and decreased to 49.4% vs 55%, respectively, 1 month after discharge. No significant improvements were found in the intervention group compared with the control group. In the intervention group, some video consultations were changed to telephone consultations due to problems with the video function, or to in-hospital consultations due to infants’ requirement for medical services. No significant differences in secondary outcomes were observed. Discussion The study showed similar breastfeeding proportions at discharge. No unfavourable effects of video consultation compared with in-hospital consultation were found, indicating that video consultation could be a viable option and an important supplement during early in-home care. Trial registration ClinicalTrials.gov ID: NCT02581800.

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Section: Discussionmentioning

confidence: 69%

Comparison of video and in-hospital consultations during early in-home care for premature infants and their families: A randomised trial

et al. 2020

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“…In Sweden, the use of digital consultations has been increasing for several years but still represented only 2% of all primary care consultations by 2017 [ 20 ]. A consistent finding has been that introduction of video consulting has been impeded by technical problems [ 23 , 24 ]. The apparent success of BGPaH may be because the whole process of care has been redesigned around a new technology-enabled model with a very strong focus on convenience for patients.…”

Section: Uptakementioning

confidence: 86%

“…For example, Kaiser Permanente has offered video consultations since 2014, but between 2015 and 2017, these accounted for less than 1% of all office consultations [ 15 ]. In the United Kingdom, uptake of video consultations was very low when offered by conventional general practices before the COVID-19 pandemic [ 22 , 23 ]. In Sweden, the use of digital consultations has been increasing for several years but still represented only 2% of all primary care consultations by 2017 [ 20 ].…”

Section: Uptakementioning

confidence: 99%

“…Although there are published frameworks for the evaluation of digital health systems, which include the need for evidence about usability, effectiveness, and safety in real-world implementation [ 27 , 28 ], this evidence is largely absent for video consultation systems. A recent Scottish study concluded that video consultations dealt with fewer problems and achieved lower scores on measures of consultation quality than face-to-face consultations and were most suitable for simple problems [ 23 ]. Babylon has published their own analysis of the safety of the automated triage software used in their digital health platform [ 29 ], but this was not peer-reviewed and the findings have been subject to criticism [ 27 ].…”

Section: Quality and Safetymentioning

confidence: 99%

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Private Video Consultation Services and the Future of Primary Care

Salisbury¹,

Quigley²,

Hex³

et al. 2020

J Med Internet Res

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In many countries, private companies provide primary care services based predominantly on offering video consultations via smartphones. One example is Babylon GP at Hand (BGPaH), which offers video consultations to National Health Service patients, 24 hours a day, and has grown rapidly in London over the last 3 years. The development of this type of service has been controversial, particularly in the United Kingdom, but there has been little formal published evaluation of these services in any country. This paper outlines the main controversies about the use of privately provided video consultation services for primary care and shows how they are informed by the limited evaluations that have been conducted, particularly the evaluation of BGPaH. This paper describes the advantages of these services in terms of convenience, speed of access, the ability to consult without traveling or face-to-face patient-doctor contact, and the possibility of recruiting doctors who cannot work in conventional settings or do not live near the patients. It also highlights the concerns and uncertainties about quality and safety, demand, fragmentation of care, impact on other health services, efficiency, and equity. There are questions about whether private primary care services based on video consultations have a sustainable business model and whether they will undermine other health care providers. During the recent COVID-19 pandemic, the use of video consulting has become more widespread within conventional primary care services, and this is likely to have lasting consequences for the future delivery of primary care. It is important to understand the extent to which lessons from the evaluation of BGPaH and other private services based on a video-first model are relevant to the use of video consulting within conventional general practices, and to consider the advantages and disadvantages of these developments, before video consultation–based services in primary care become more widely established.

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“…(22,33) Lower quality ratings for telephone consultations also occurred in a UK study, associated with shorter consultation times and poorer information exchange. (34) Strengths and limitations…”

Section: Comparison With Existing Researchmentioning

confidence: 99%

Telehealth Consultations in General Practice During a Pandemic Lockdown: Survey and Interviews on Patient Experiences and Preferences

Imlach

McKinlay

Middleton

et al. 2020

Preprint

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BackgroundDuring the first COVID-19 pandemic ‘lockdown’ in Aotearoa/New Zealand (March-May 2020, in which strict ‘stay at home’ measures were introduced), general practices were advised to use telephone and video consultations (telehealth) wherever possible instead of the usual in-person visits. This was a sudden change for most practices and patients. This research aimed to explore how patients accessed general practice during lockdown and evaluate their experiences with telehealth, to inform how telehealth could be most effectively used in the future. MethodsUsing a mixed-method approach, we undertook an online survey and in-depth interviews with adults (>18 years) who had contact with practices during lockdown, recruited through social media and email lists. We present descriptive statistics from the survey data (n=1,010) and qualitative analysis of interview data (n=38) and open-ended survey questions, using a framework of access to health care, from the patient’s perspective.ResultsIn general, patients reported high satisfaction with telehealth in general practice during lockdown. Telehealth was convenient and allowed patients to safely access health care without having to weigh-up the fear of COVID-19 infection against the need to be seen. Telehealth worked best for routine and familiar health issues and when rapport was established between patients and clinicians. This was easier with a pre-existing clinical relationship, but not impossible without one. Telehealth was less suitable when a physical examination was needed, when the diagnosis was unknown or for patients who had a strong preference to be seen in-person. ConclusionsEven in this disruptive lockdown period, that prompted an unexpected and rapid implementation of telehealth services in general practices, most patients had positive experiences with telehealth. In the future, patients want the choice of consultation type to match their needs, circumstances, and preferences. Technological issues and funding barriers may need to be addressed, and clear communication for both patients and clinicians is needed about key aspects of telehealth (e.g. cost, appropriateness, privacy). Maintaining telehealth as an option post-lockdown has the potential to increase timely and safe access to primary health care for many patients.

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Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care

Cited by 280 publications

References 21 publications

Comparison of video and in-hospital consultations during early in-home care for premature infants and their families: A randomised trial

Comparison of video and in-hospital consultations during early in-home care for premature infants and their families: A randomised trial

Private Video Consultation Services and the Future of Primary Care

Telehealth Consultations in General Practice During a Pandemic Lockdown: Survey and Interviews on Patient Experiences and Preferences

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