With remote consultations with a doctor becoming more frequent, Trish Greenhalgh explores why this can be difficult and looks at the ways it can be improved.
In a recent study, Trish Greenhalgh's team looked at why some remote consultations by video are efficient, effective and well-received but others are logistically cumbersome, technically inadequate and associated with deficiencies in care, such as missed diagnoses or a poor patient experience.
While it’s impossible to generalise, remote consultations seem to be less suitable for people who
- are very young or very old
- are very unwell with a high-risk condition, such as pneumonia
- have complex health or wider needs
- want or need a physical examination
- have difficulty communicating (though the hard-of-hearing may prefer a video link where neither party wears a mask)
- need supervised check-ups, for example, for controlled drugs
- do not own, or wish to use, technologies like smartphones
- lack privacy at home.
Her research has shown that GP consultations should not be remote by default, but that with attention to infrastructure, training and planning, remote consultations could become a realistic option for a much wider range of people than the healthy young professionals towards whom they were originally targeted.