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

Authors
  • Hammersley, Victoria1
  • Donaghy, Eddie1
  • Parker, Richard1
  • McNeilly, Hannah2
  • Atherton, Helen3
  • Bikker, Annemieke1
  • Campbell, John4
  • McKinstry, Brian1
  • 1 Usher Institute of Population Health Sciences and Informatics.
  • 2 Medical Teaching Unit, University of Edinburgh, Edinburgh.
  • 3 Warwick Medical School, University of Warwick, Coventry.
  • 4 General Practice and Primary Care, University of Exeter Medical School, University of Exeter, Exeter.
Type
Published Article
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
Publication Date
Sep 01, 2019
Volume
69
Issue
686
Identifiers
DOI: 10.3399/bjgp19X704573
PMID: 31262846
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. © British Journal of General Practice 2019.

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