Translating primary care to telehealth: analysis of in-person consultations on diabetes and cardiovascular disease

Abstract

BackgroundThe COVID-19 pandemic significantly impacted primary care, resulting in rapid uptake of telehealth. Patients with chronic conditions like Type-2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD) relied heavily on telehealth consultations during this period. It is important to assess whether tasks observed during T2DM or CVD in-person consultations are translatable to telehealth.AimTo explore the extent to which in-person GP consultations are translatable to telehealth for patients with T2DM or CVD.Design & settingThis study screened 281 GP consultations conducted in 2017 within the UK general practice setting for consultations pertaining to T2DM or CVD. Seventeen in-person consultations (in de-identified video and transcript) were selected for further analysis.MethodDetailed reporting of tasks, physical artefacts, and physical examinations observed during in-person GP consultations. A new scoring method applying two key metrics, supporting definitions and examples was designed to assess translatability of clinical tasks, to telehealth.ResultsAcross 17 T2DM or CVD in-person consultations analysed, 23 clinical tasks, 21 physical artefacts, and nine physical examinations were observed. 60% of tasks analysed were deemed easily translatable to telehealth. 26% of tasks were rated as ‘translatable to telehealth’ but may require a patient obtaining their own equipment. 13% of tasks were rated as ‘potentially translatable to telehealth’. No clinical tasks for these cohorts were rated as untranslatable to telehealth.ConclusionMajority of tasks observed during T2DM or CVD in-person GP consultations are translatable to telehealth. Further research is warranted to investigate emergent safety concerns from increased uptake of telehealth.

Shaping the Future of Cardiac Wellness: Exploring Revolutionary Approaches in Disease Management and Prevention

“…Patients can send their ECGs to a cardiologist for review, who can provide a diagnosis and treatment plan remotely. This can improve access to care for patients who live in remote areas or who have difficulty accessing cardiology services [161].…”

Analysis of in-person general practice respiratory consultations: assessing translatability to telehealth

“…thermometer). A separate co-study by co-author JL found that these domains underpinned the analysis of cardiovascular transcripts as well 20 .…”

The BJGP Open Top 10 Most Read Research Articles of 2023: an editorial

“…The authors report that remote consultations are sustainable going forwards, but standards, training, and hybrid models need development. Concerns around the safety and effectiveness of remote consulting were explored by Lane et al 2 in their analysis of 281 in-person consultations on diabetes and cardiovascular disease: 60% of clinical tasks were ‘easily or relatively easily’ translatable to telehealth, with a further 26% ‘moderately translatable’ if patients acquire their own equipment, such as blood pressure machines. Can we expect all patients to accept this, and what happens to the most vulnerable?…”