Use and impact of virtual primary care on quality and safety: The public's perspectives during the COVID-19 pandemic

Abstract

Introduction With the onset of Coronavirus disease (COVID-19), primary care has swiftly transitioned from face-to-face to virtual care, yet it remains largely unknown how this has impacted the quality and safety of care. We aim to evaluate patient use of virtual primary care models during COVID-19, including change in uptake, perceived impact on the quality and safety of care and willingness of future use. Methodology An online cross-sectional survey was administered to the public across the United Kingdom, Sweden, Italy and Germany. McNemar tests were conducted to test pre- and post-pandemic differences in uptake for each technology. One-way analysis of variance was conducted to examine patient experience ratings and perceived impacts on healthcare quality and safety across demographic characteristics. Results Respondents (n = 6326) reported an increased use of telephone consultations ( + 6.3%, p < .001), patient-initiated services ( + 1.5%, n = 98, p < 0.001), video consultations ( + 1.4%, p < .001), remote triage ( + 1.3, p < 0.001) and secure messaging systems ( + 0.9%, p = .019). Experience rates using virtual care technologies were higher for men (2.4 ± 1.0 vs. 2.3 ± 0.9, p < .001), those with higher literacy (2.8 ± 1.0 vs. 2.3 ± 0.9, p < .001), and participants from Germany (2.5 ± 0.9, p < .001). Healthcare timeliness and efficiency were the dimensions most often reported as being positively impacted by virtual technologies (60.2%, n = 2793 and 55.7%, n = 2,401, respectively), followed by effectiveness (46.5%, n = 1802), safety (45.5%, n = 1822), patient-centredness (45.2%, n = 45.2) and equity (42.9%, n = 1726). Interest in future use was highest for telephone consultations (55.9%), patient-initiated digital services (56.1%), secure messaging systems (43.4%), online triage (35.1%), video consultations (37.0%) and chat consultations (30.1%), although significant variation was observed between countries and patient characteristics. Discussion Future work must examine the drivers and determinants of positive experiences using remote care to co-create a supportive environment that ensures equitable adoption and use. Comparative analysis between countries and health systems offers the opportunity for policymakers to learn from best practices internationally.

Association of Virtual Care Expansion With Environmental Sustainability and Reduced Patient Costs During the COVID-19 Pandemic in Ontario, Canada

“…There has been substantial research into the safety and validity of virtual care, 7 and most patients have favorable views of using virtual care (even more so during the pandemic). 8 However, there has been little discussion on the potential environmental and fiscal benefits that society may derive from virtual care. The objective of this study was to estimate the environmental and patientlevel financial benefits associated with the widespread adoption of virtual care during the COVID-19 pandemic.…”

“…There has been substantial research into the safety and validity of virtual care, and most patients have favorable views of using virtual care (even more so during the pandemic) . However, there has been little discussion on the potential environmental and fiscal benefits that society may derive from virtual care.…”

What affected UK adults’ adherence to medicines during the COVID-19 pandemic? Cross-sectional survey in a representative sample of people with long-term conditions

“…Our cohort reported that problems with using remote and digital services served as a barrier to medicines access, so this mismatch in provider and patient expectations needs to be addressed to avoid access problems. A recent review of policy around virtual and remote healthcare suggests that work is needed to address "shortcomings exposed during COVID-19" (Neves et al 2021c). We suggest that more needs to be done to enhance people's capabilities and opportunities, if necessary, beyond the digital sphere through home visits, health visitors or mail, or targeting face-to-face consultations where a benefit is likely to be greatest.…”

Samen sterk door persoonsgerichte en digitale zorg

“…Dit kan leiden tot ongelijkheid in de zorg. 26,27 Ook huisartsen verschillen in hun digitale vaardigheden en interesses. Bij de introductie van digitale ondersteuning moet er voldoende aandacht zijn voor training en scholing.…”