A pilot study conducted by researchers at the University of Edinburgh in collaboration with the Universities of Warwick and Exeter has suggested that video consultations with a GP could be an alternative to face-to-face GP visits. This is a particularly contentious issue in most areas of work, as new technology is often used as a replacement for a human workforce, placing many jobs and livelihoods in jeopardy.
However, this is not the case here.
By taking advantage of the technology widely available to us, we have a viable solution to alleviate the strain on an already overstretched healthcare system. The introduction of video consultations to the repertoire will provide patients with a broader offering to suit their ever-changing needs. This is, therefore, a forward-thinking step in the evolution of primary care services.
The study, published in the British Journal of General Practice and funded by the Scottish Government’s Chief Scientist Office, involved 45 patients and six GP practices across Edinburgh and the Lothians. A Skype-style web-based programme called Attend Anywhere was the platform of choice for the video consultations, even including a virtual waiting room in which patients could wait prior to the start of their appointment. It explored video and telephone consultation and included an analysis of duration and content.
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.” Ultimately, this could be a valuable solution to staffing and accessibility issues in healthcare, helping to uphold a key principle guiding the NHS, namely that a comprehensive, patient-centred health service is available to all.
However, whilst providing a helpful alternative to face-to-face consultations for patients with accessibility issues, mental health conditions, or busy schedules, video consultations will undoubtedly contribute to the public desire for services to be available immediately. This study highlights that we may be on the cusp of a new ‘fast’ service. While already firmly preoccupied with tackling fast food and fast fashion, ‘fast healthcare’ could be the next target as we confront the possibility of making a personal service impersonal and limited to a few arbitrary taps on a keyboard or phone touchscreen.
In the study it is worth noting that although video consultations had their advantages over telephone, both were shorter in duration and less detailed than face-to-face consultations. As such, these technological developments could lead to primary care services drifting away from homogenous standards of care for all. Offering separate technological services versus face-to-face consultations presents the challenge of providing an equally thorough consultation within a tighter time constraint and without the privilege of a physical examination of the patient.
Likewise, there is the danger that viewing patients down a narrow lens (proverbial and literal) could colour the judgements and diagnoses that a general practitioner may come to. In the study, video consultations were superior to telephone in minimising this effect as some doctors reported that the analysis of visual cues, such as body language and facial expression, led to a better assessment of the patient. Yet, in the absence of a physical examination, doctors are still somewhat limited in their capacity to perform a thorough assessment and it is likely that individuals who make use of this alternative service may require a further face-to-face consultation in order to be made the appropriate referral down the line, potentially adding an extra step to what can already be a long referral process.
In addition, when considering the use of new technologies within a field, we must be careful not to cut off those who we are trying to help. What works for one demographic may not fit the needs of another. For instance, new difficulties arise for individuals without access to a personal computer or those who aren’t proficient in the use of information technology. Dr Helen Atherton of Warwick Medical School commented that “it is clear that to get the most out of this type of consultation there are infrastructure hurdles yet to be overcome” in order to seamlessly integrate this new system with existing practice. Therefore, the key to the success of this new service is in implementing it alongside and not in lieu of the current offerings of primary care services, and steps should be taken to ensure that those who do make use of the service have access to sufficient technical support.
Nevertheless, the introduction of an alternative to face-to-face GP consultations is an important step in widening the selection available to patients and remaining progressive in the digital age. It will give patients the freedom to choose between the services that they would like to receive based on what works best for them and their lifestyles, whilst taking steps towards easing the pressure on a system currently operating under continuous financial strain. However, it must be acknowledged that this system is not suitable for all patients, and efforts need to be directed towards integrating it so that it can function alongside pre-existing consultation services. In doing so, remote video consultations could mark the beginning of a new wave in technology-driven medical care.
This post was written by Ebony Coward and edited by Miles Martin