Expanding Video Consultation Services at Pace and Scale in Scotland During the COVID-19 Pandemic: National Mixed Methods Case Study

Expanding Video Consultation Services at Pace and Scale in Scotland During the COVID-19 Pandemic: National Mixed Methods Case Study
J Med Internet Res 2021;23(10):e31374 doi:10.2196/31374

• A national evaluation of the introduction, spread, and scale-up of Scotland’s video consultation services both before and during the pandemic. The research found that the national-level groundwork before the pandemic allowed many services to rapidly extend the use of video consultations during the pandemic, supported by a strong strategic vision, a well-resourced quality improvement model, dependable technology, and multiple opportunities for staff to try out the video option. 
• The bespoke product - Attend Anywhere, had been piloted in 2017 and was scaled up across all health board by February 2020 branded nationally as “Near Me”.

Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics

Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics
Frontiers in Digital Health, 13 August 2021 | https://doi.org/10.3389/fdgth.2021.726095

• Empirical findings have shown that decisions about remote consultation are fraught with contradictions and tensions—for example, between demand management and patient choice—leading to both large- and small-scale ethical dilemmas for managers, support staff, and clinicians. A novel framework, Planning and Evaluating Remote Consultation Services (PERCS) has been developed which focuses attention on the organizational digital maturity and digital inclusion efforts. The authors also present a set of principles for informing its application in practice, including education of professionals and patients.

Unlocking the digital front door - keys to inclusive healthcare

Unlocking the digital front door - keys to inclusive healthcare
National Voices, May 2021

• This report explores how the move to remote service models impacted people and how the Voluntary, Community and Social Enterprise sector (VCSE) has led innovative ways to deliver healthcare and support people during the COVID 19 pandemic. Also available is a literature review and insight data, personal narratives and recommendations for better practice, better policy, and better innovations.

Video / online consultations - Support tools

Resources to support clinicians with online consultations

1. Guidance and support for clinicians/practices
2. Local implementation (incl Attend Anywhere)

3. Guidance and support for patients 

4. Other research

(Updated 19 November 2020)

Virtual geriatric clinics and the COVID-19 catalyst: a rapid review

Virtual geriatric clinics and the COVID-19 catalyst: a rapid review
Age and Ageing, v49(6) November 2020, Pages 907–914, https://doi.org/10.1093/ageing/afaa191

• A rapid review to describe the satisfaction, clinic productivity, clinical benefit, and costs associated with the virtual geriatric clinic model of care. Analysis of 9 studies (n=975 patients) indicates that virtual geriatric clinics demonstrate evidence of productivity, benefit to patients, cost effectiveness and patient satisfaction with the treatment provided.

Functionality matrix for online consultation suppliers

Functionality matrix for online consultation suppliers
Digital Primary Care (NHS E/I and NHSX) on FutureNHS September 2020

• Suppliers currently on the DPS and GP IT Futures frameworks have been asked to share information on their online and video consultation products in order to compile a functionality matrix.

Spark Dynamic Purchasing System (DPS) for remote monitoring

Spark Dynamic Purchasing System (DPS) for remote monitoring

• The Spark DPS, run by the Crown Commercial Services (CCS), aims to support organisations with the procurement of remote monitoring solutions. Buyers can compare viable solutions from suppliers which have been assessed on their suitability to manage outpatients or deliver vital signs monitoring remotely.

Frontline insights on the rapid implementation of video consultations

Frontline insights on the rapid implementation of video consultations What’s needed now?
Q Health Foundation August 2020

• Insight from practitioners as they’ve rapidly rolled out video consultations during COVID-19 pandemic highlighted four factors that enabled such rapid progress in the first few months of the pandemic and six areas for action to build on that progress.

Building the evidence base on video consultations: Three priorities for further research

Building the evidence base on video consultations: Three priorities for further research
Health Foundation 26 August 2020 

• In this blog, we discuss the state of the evidence base on video consultations and set out some priorities for future research, based largely on the insights from Q’s collaborative learning and sharing project on implementing video consultations.

Digital health: the changing landscape of how we access GP services

Digital health: the changing landscape of how we access GP services
AXA PPP Healthcare and the Centre for Economics and Business Research (CEBR) July 2020

• This report explores the scope for general practice services to further embrace digitally delivered care and support to patients. It looks at how offering online consultations as a first point of contact could increase efficiencies by reserving face-to-face consultations for those identified as needing them – a message that has been reinforced since the Covid-19 pandemic.

Satisfaction with remote consultation - TripDatabase search

Search on TripDabase for remote consultation here.

("remote consultation" or "video consultation" or "telephone consultation")

AND

(satisfaction or follow-up or utilisation or outcomes)

The Dr Will Zoom You Now: getting the most out of the virtual health and care experience

The Dr Will Zoom You Now: getting the most out of the virtual health and care experience
National Voices 24 July 2020

• The Doctor Will Zoom You Now was a rapid, qualitative research study designed to understand the patient experience of remote and virtual consultations. The study engaged 49 people over 10 days (June 22nd – July 1st 2020) using an online platform, with 20 additional one to one telephone interviews. Findings are presented in an Insight report and Top Tips report.
• The project was led in partnership with Traverse, National Voices and Healthwatch England and supported by PPL.
• Insight report:
• "In our research with patients we heard that, for many people, remote consultations can offer a convenient option for speaking to their health care professional. They appreciate quicker and more efficient access, not having to travel, less time taken out of their day and an ability to fit the appointment in around their lives. Most people felt they received adequate care and more people than not said they would be happy with consultations being held remotely in future. However, there is no one size that fits all solution. Key to a successful shift to remote consultations will be understanding which approach is the right one based on individual need and circumstance. A blended offer, including text, phone, video, email and in-person would provide the best solution."

How has COVID-19 affected service delivery in GP practices that offered remote consultations before the pandemic?

How has COVID-19 affected service delivery in GP practices that offered remote consultations before the pandemic?
Health Foundation 16 July 2020

• Analysis of 51 GP practices using askmyGP prior to March 2020, and how primary care access, supply and demand has varied during COVID-19. Results suggest practices familiar with conducting appointments remotely were able to adapt quickly to the demands of COVID-19 and undertake more care remotely without significantly impacting the total number of consultations delivered.

Results

Reorganisation of primary care for older adults during COVID-1

Reorganisation of primary care for older adults during COVID-19: a cross-sectional database study in the UK
British Journal of General Practice 13 July 2020; bjgp20X710933. https://doi.org/10.3399/bjgp20X710933

• Data on consultations [n=3 851 304] between 17 February and 10 May 2020 for patients aged ≥65 years drawn from primary care practices within the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network, UK.
• Overall, the rate of consultations dropped by 27.1%. Face-to-face consultations fell by 64.6% and home visits by 62.6%. Telephone and electronic/video consultations made up 18.4% (17.9% teleconsultations, 0.5% electronic/video consults) of appointments in week 8, compared with 56.6% (55.1% teleconsultations, 1.5% electronic/video consultations) of appointments by week 14.
• "There was a high degree of inter-practice variation in terms of adoption of remote consultation means, and considerable unexplained variation within the current model. Categorisation of consultation type relies on how this has been recorded within the original dataset. This may lead to inaccuracies, for example, where a clinician changes between type but does not record the switch."

Abstract

Measuring patient satisfaction with video consultation: a systematic review of assessment tools and their measurement properties.

Measuring patient satisfaction with video consultation: a systematic review of assessment tools and their measurement properties
Int J Technol Assess Health Care. 2020;1-7. 23 June 2020.

• This systematic review critically appraises, summarizes, and compares available questionnaires in order to identify the most suitable questionnaire for qualitative outcome research using video consultation in clinical outpatient care. The search identified twelve studies that used ten different patient satisfaction questionnaires. 

Abstract

Implementing video consultation in care homes

Implementing video consultation in care homes
FutureNHS [Registration required]

• Links to how-to guides which guide you in how to implement virtual consultation in care homes; policy and other documents that are related to video consultation in care homes; and a discussion forum.

Innovation and Communication Media in Virtual Teams – An Experimental Study

Innovation and Communication Media in Virtual Teams – An Experimental Study
IZA DISCUSSION PAPER NO. 13218 (May 2020)

• In a novel real-effort setting, we experimentally study the effects of different communication media on creative performance in a collaborative tasks. We find that creative performance significantly decreases when group members communicate via chat instead of face-to-face. However, we find no significant difference between performances of groups that communicate via video conferences as compared to face-to-face. Thus, we provide evidence that barriers to creativity in virtual teams can be mitigated by real-time video conference communication.

A Step-by-Step Toolkit for Getting Telepsychiatry Ready, Set & Go

A Step-by-Step Toolkit for Getting Telepsychiatry Ready, Set & Go
CWTCH: Connecting with Telehealth to Communities and Hospitals in Healthcare

• The CWTCH (Connecting with Telehealth to Communities and Hospitals in Healthcare) project was funded by the Health Foundation to implement telepsychiatry in the CAMHS in Gwent, South Wales. The initial pilot in Aneurin Bevan UHB offered young people who self-harm, or who live with an eating disorder, the option of remote assessment through a virtual online clinic, in the company of family members.
• The Toolkit is intended to provide a systematic way of approaching telepsychiatry, regardless of the video consultation platform used, in order to overcome potential barriers and enable successful implementation in the mental health setting in the United Kingdom. The purpose of this toolkit is to support mental health professionals to implement telepsychiatry in their own settings.

The use of online and video consultations during the COVID-19 pandemic - delivering the best care to patients

The use of online and video consultations during the COVID-19 pandemic - delivering the best care to patients
NHS X blog by Dr Minal Bakhai, Deputy Director and Clinical Lead for Digital First Primary Care at NHS England and NHS Improvement, 27 May 2020

• Top tips on delivering an effective remote consultation and link to FutureNHS workspace Online Consultations  [Registration required]
• Moving forward beyond COVID-19 - "To inform how we build on the strengths and shape services going forwards, we are undertaking a deep dive evaluation with patients and practices to rapidly learn more about the benefits and unintended consequences, while also working on standardising the data collected to support practices, PCNs and commissioners to obtain robust and timely evidence about the impact of these technologies and support service and solution development."

Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative

Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative
BMJ Open Quality 21 May  2020;9:e000985. doi: 10.1136/bmjoq-2020-000985

• This report outlines a quality improvement initiative to rapidly implement virtual outpatient consultations at the The Royal National Orthopaedic Hospital, London. During the first 6 weeks 87% of consultations were delivered virtually, compared to 7% by phone previously. Satisfaction scores were high for virtual consultations (90/100 for patients and 78/100 for clinicians); however, outside of the COVID-19 pandemic, video consultations would be preferred less than 50% of the time. 

Abstract