The Impact of Virtual Consultations on the Quality of Primary Care: Systematic Review

Abstract

Background The adoption of virtual consultations, catalyzed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. Objective This study aims to evaluate the impact of virtual consultations on the quality of primary care. Methods A total of 6 databases were searched. Studies that evaluated the impact of virtual consultations, for any disease, were included. Title and abstract screening and full-text screening were performed by 2 pairs of investigators. Risk of bias was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis of the results was performed. Results In total, 30 studies (5,469,333 participants) were included in this review. Our findings suggest that virtual consultations are equally effective to or more effective than face-to-face care for the management of certain conditions, including mental illness, excessive smoking, and alcohol consumption. Overall, 4 studies indicated positive impacts on some aspects of patient-centeredness; however, a negative impact was noted on patients’ perceived autonomy support (ie, the degree to which people perceive those in positions of authority to be autonomy supportive). Virtual consultations may reduce waiting times, lower patient costs, and reduce rates of follow-up in secondary and tertiary care settings. Evidence for the impact on clinical safety is extremely limited. Evidence regarding equity was considerably mixed. Overall, it appears that virtual care is more likely to be used by younger, female patients, with disparities among other subgroups depending on contextual factors. Conclusions Our systematic review demonstrated that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalizing on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.

Seven days in medicine: 30 Aug to 5 Sep 2023

“…Health outcomes in patients who saw doctors remotely at least matched in-person care outcomes for mental illness, alcohol misuse, weight management, and advice on quitting smoking, showed a review of previous research involving more than 5.4 million patients around the world. Reported in the Journal of Medical Internet Research ,1 the study also found some evidence that remote consultations saved time for doctors, reduced waiting times, and were seen as more convenient but also that patients who were seen virtually felt less well supported in making informed choices.…”

Validating a framework to guide the implementation of high-quality virtual primary care: an international eDelphi study protocol

“…The primary care landscape has undergone an intense transformation since early 2020, further hastened by advancements in digital technologies expedited by the COVID-19 pandemic 1 2. Specifically, virtual consultations ( ie, remote synchronous consultations performed using telephone or online conferencing software) emerged as an innovative approach to patient–provider interaction, with the potential to transform care delivery by improving effectiveness and timeliness of care 3…”

“…1 2 Specifically, virtual consultations ( ie, remote synchronous consultations performed using telephone or online conferencing software) emerged as an innovative approach to patient–provider interaction, with the potential to transform care delivery by improving effectiveness and timeliness of care. 3 …”