Dr Ian Jackson, Medical Director and Clinical Safety Officer at Refero.
The NHS has now published a £75million tender for the provision of online and video consultations. The tender notice, revealed the NHS is looking for “suitably experienced and qualified” suppliers to join the Digital First, Online Consultation and Video Consultation (DFOCVC) Framework, which aims to deliver commitments in the NHS Long Term Plan to support online consultation in general practice.
The Health Secretary has warned that the UK has reached its “worst point” of the pandemic, and as video consultation approaches its next chapter, there are several factors GPs and secondary care providers can consider when choosing a video consultation provider: choose a system that does not require software patches to be downloaded; choose a system that will work with your current technology – a portal/cloud based; choose a system that emulates current clinical workflow – so clinicians can see a list of patients for their clinic, and can see who is logged in and waiting to be seen.
Importantly, choose a supplier who has commitment and evidence they can integrate into your electronic patient record or patient administration system. You do not want staff having to enter patient data twice on two separate systems to organise a single appointment.
Video consultations can be used in combination with messaging in all manner of care settings and can become a very powerful support platform. With long-term conditions like diabetes and mental health disorders, teleconsultation becomes a communication tool across boundaries. Take the example of diabetes that is managed by a multidisciplinary team across primary and secondary care. If you recruit your population of patients to such a system, they can move away from using the telephone. You remove the analogue one person at a time model to multiple patients being able to message simultaneously. These messages can be triaged centrally and passed on to the most appropriate team member to deal with – be that a Consultant, Specialist Nurse or a GPwSI. In any given day, some issues will be dealt with via messaging or a telephone call, but with the ability to quickly arrange and complete a teleconsult within the same system.
It could also be used for the management of care pathways in outpatient surgeries, like day surgery, oncology, and sexual health. Oncology is an excellent example where the ability to message and teleconsult could make a large difference. Once again you have a population of patients known to a multidisciplinary team. If you move to messaging with ability to provide triage of messages, support is no longer limited to a telephone. Daily check-in messages or follow-up messages after treatment become a reality. Daily reporting of symptoms, feedback of blood results all become possible. Once again, the backup of being able to teleconsult quickly and within the same system brings extra to this dynamic relationship.
The challenge with rolling out messaging, is getting patients on board with the idea, particularly in general practice, where contacting the surgery via phone for test results, booking appointments and all general enquiries, has always been the first port of call.
Of course, the aim isn’t to get everyone using tech this way, it’s to give patients and clinicians more channels of communication. For those who can and want to message, it is available for them. For those who can’t or won’t, the traditional services remain and now have more capacity.
Video appointments rose to the challenge in 2020 and showed healthcare what it is capable of. In 2021, it’s time for the sector to put the technology to good use.