Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care

Growing demands on primary care services have led to policymakers promoting video consultations (VCs) to replace routine face-to-face consultations (FTFCs) in general practice. To explore the content, quality, and patient experience of VC, telephone (TC), and FTFCs in general practice. Comparison of...

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Bibliographic Details
Published in:British journal of general practice Vol. 69; no. 686; p. e595
Main Authors: Hammersley, Victoria, Donaghy, Eddie, Parker, Richard, McNeilly, Hannah, Atherton, Helen, Bikker, Annemieke, Campbell, John, McKinstry, Brian
Format: Journal Article
Language:English
Published: England 01.09.2019
Subjects:
Adult
Aftercare
Aged
Appointments and Schedules
Communication
Delivery of Health Care
Female
General Practice
Health Services Research
Humans
Male
Middle Aged
Patient Education as Topic
Physician-Patient Relations
Primary Health Care
Remote Consultation
Scotland
Telephone
Time Factors
United Kingdom
Videoconferencing
Scotland
United Kingdom
health services research
telemedicine
communication
general practice
ISSN:1478-5242, 1478-5242
Online Access:Get more information
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Summary:Growing demands on primary care services have led to policymakers promoting video consultations (VCs) to replace routine face-to-face consultations (FTFCs) in general practice. To explore the content, quality, and patient experience of VC, telephone (TC), and FTFCs in general practice. Comparison of audio-recordings of follow-up consultations in UK primary care. Primary care clinicians were provided with video-consulting equipment. Participating patients required a smartphone, tablet, or computer with camera. Clinicians invited patients requiring a follow-up consultation to choose a VC, TC, or FTFC. Consultations were audio-recorded and analysed for content and quality. Participant experience was explored in post-consultation questionnaires. Case notes were reviewed for NHS resource use. Of the recordings, 149/163 were suitable for analysis. VC recruits were younger, and more experienced in communicating online. FTFCs were longer than VCs (mean difference +3.7 minutes, 95% confidence interval [CI] = 2.1 to 5.2) or TCs (+4.1 minutes, 95% CI = 2.6 to 5.5). On average, patients raised fewer problems in VCs (mean 1.5, standard deviation [SD] 0.8) compared with FTFCs (mean 2.1, SD 1.1) and demonstrated fewer instances of information giving by clinicians and patients. FTFCs scored higher than VCs and TCs on consultation-quality items. VC may be suitable for simple problems not requiring physical examination. VC, in terms of consultation length, content, and quality, appeared similar to TC. Both approaches appeared less 'information rich' than FTFC. Technical problems were common and, though patients really liked VC, infrastructure issues would need to be addressed before the technology and approach can be mainstreamed in primary care.
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ISSN:1478-5242
1478-5242
DOI:10.3399/bjgp19X704573