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Showing results for tags 'Telehealth'.
Found 67 results
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Content ArticleThe combination of emerging patient safety threats and the growing amount of published patient safety research, patient safety resources and accrediting body standards makes it increasingly difficult to prioritise adopting and implementing evidence-based practices. The US Agency for Healthcare Research and Quality's (AHRQ’s) fourth iteration of Making Healthcare Safer intends to address this issue by publishing evidence-based reviews of patient safety practices and topics as they are completed. This intentional release of updated reviews will aid healthcare organisation leaders in prioritising implementation of evidence-based practices in a timelier way. The report will also help researchers identify where more research is needed and assist policymakers in understanding which patient safety practices have the supporting evidence for promotion.
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Content ArticleThis study aimed to determine whether the use of video telemedicine for paediatric consultations to referring hospital emergency departments (EDs) results in less frequent medication errors than the current standard of care—telephone consultations. The authors found no statistically significant differences in physician-related medication errors between children assigned to receive telephone consultations vs video telemedicine consultations.
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EventuntilAiredale’s digital journey: Revolutionising healthcare Starting in 2006, Airedale NHS Foundation Trust digitized patient services, introducing remote health assessments for prisoners. Facing funding challenges for successful pilots, 2010 saw the establishment of the Digital Care Hub with Rachel Binks serving as a key consultant. In 2014, the 24/7 Goldmine service emerged, supporting those in their last year of life with telephonic and video assistance. Goldmine, now a decade strong, is acclaimed for enabling patients to spend their final days at home, supported by grateful families and caregivers. Expanding beyond end-of-life care, MyCare24 was born in 2023 through a joint venture, enhancing service delivery and marketing capabilities nationwide. Airedale NHS Foundation Trust’s digital journey signifies innovation, compassion, and a commitment to reshape healthcare for the future, ensuring tangible, positive impacts on patient care. Register
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Content ArticleContemporary general practice includes many kinds of remote encounter. The rise in telephone, video and online communication for triage and clinical care requires clinicians and support staff to be trained, both individually and as teams, but evidence-based competencies have not previously been produced for general practice. This study aimed to identify training needs, core competencies and learning methods for staff providing remote encounters.
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Content ArticleIn this piece for the BMJ, David Oliver, consultant in geriatrics and acute general medicine, raises concerns about the way in which NHS England is using virtual wards. As well as pointing to the lack of solid evidence for the effectiveness and safety of virtual wards, he highlights lack of clarity in the use of the term, which is often being used interchangeably with 'Hospital at home', a different approach with a more robust evidence base. He also points out that staff working on virtual wards are taking workforce capacity from other parts of the health service and that the approach is placing additional pressure on existing primary and community care staff who are not part of the virtual ward.
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Content ArticleSince the Covid-19 pandemic, there has been a significant increase in telehealth use for patient evaluations. The US Veteran Health Administration (VHA) has tripled phone and video visits across several specialties. Although there are hesitations in phone-call-based communication for procedural subspecialties, phone calls to veterans have proven safe and efficacious after general surgery procedures. Telehealth has additional benefits, including reducing transportation barriers, improving access to care and reducing delays in medical care. This article in the journal Surgery aimed to evaluate clinic access after the establishment of routine telehealth use through phone calls by the surgeon.
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News Article
Patients at risk from virtual GP appointments
Patient Safety Learning posted a news article in News
GP appointments over the phone or online risk harming patients, a new study published in the BMJ has found. An analysis of remote NHS doctor consultations between 2020 and 2023 found that “deaths and serious harms” had occurred because of wrong or missed diagnoses and delayed referrals. Distracted receptionists were also found to be responsible for deaths after they failed to call patients back. The report, led by the University of Oxford, suggested doctors should stop giving phone appointments to the elderly, people who are deaf, or technophobes. As many as a third of GP appointments are now virtual after face-to-face appointments slumped to less than half during the pandemic. Restoring access to face-to-face appointments has been a priority of multiple health secretaries, with Steve Barclay last year promising to name and shame GPs who did not see patients in person. Patient groups said the study was likely to be “just the tip of the iceberg” given the “potential for tragic misdiagnoses because of the limitations of online or telephone consultations”. Read full story (paywalled) Source: The Telegraph, 29 November 2023 -
Content ArticleTriage and clinical consultations increasingly occur remotely. In this study, published in BMJ Quality & Safety, Payne et al. aimed to learn why safety incidents occur in remote encounters and how to prevent them. They found that rare safety incidents (involving death or serious harm) in remote encounters can be traced back to various clinical, communicative, technical and logistical causes. Telephone and video encounters in general practice are occurring in a high-risk (extremely busy and sometimes understaffed) context in which remote workflows may not be optimised. Front-line staff use creativity and judgement to help make care safer. As remote modalities become mainstreamed in primary care, staff should be trained in the upstream causes of safety incidents and how they can be mitigated. The subtle and creative ways in which front-line staff already contribute to safety culture should be recognised and supported.
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Content ArticleThe adoption of virtual consultations, catalysed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. This study aims to evaluate the impact of virtual consultations on the quality of primary care. It found that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalising on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.
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News Article
Tens of thousands of children to be treated in ‘virtual wards’ at home
Patient Safety Learning posted a news article in News
Tens of thousands of children will be treated in “virtual wards” to free hospital beds for more critically ill patients under new NHS plans. The Hospital at Home service will be expanded to include paediatric care in every region of England this month, the health service announced. As part of the service, clinical teams review patients daily and can provide treatments including blood tests, prescribe medicines or administer fluids through a drip. Ward rounds can include home visits or a video call, and many services use technology such as apps and wearable devices to monitor recovery. Professor Simon Kenny, the NHS’s national clinical director for children and young people, said: “The introduction of paediatric virtual wards means children can receive clinical care from home, surrounded by family and an environment they and their parents would rather they be — with nurses and doctors just a call away.” Read full story (paywalled) Source: The Times. 5 July 2023 -
News ArticleComplaints to the national medical practitioner regulator arising from telehealth appointments have increased by 413% in three years, a significant number of these relating to prescriptions. The data provided to Guardian Australia by the Medical Board of Australia comes as the body prepares to release new guidelines for health practitioners and companies that provide telehealth consultations with patients. Guardian Australia understands the guidelines, to be made public by Friday, will state that real-time video or phone consults are “preferred” over real-time text-based consults such as online chat because identification is harder to establish without video. The guidelines will not ban real-time text-based consults but they will mean online quizzes, for example, can not be used to diagnose and prescribe medications to patients. “Prescribing or providing healthcare for a patient with whom you have never consulted, whether face-to-face, via video or telephone is not good practice and is not supported by the board,” the draft guidelines state. “This includes requests for medication communicated by text, email or online that do not take place in real-time and are based on the patient completing a health questionnaire but where the practitioner has never spoken with the patient.” Read full story Source: The Guardian, 20 May 2023
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Content ArticleHealthcare IT News interviewed Wendy Deibert, senior vice president of clinical solutions at Caregility, a telehealth technology and services company, to talk about virtual nursing's role in helping tackle the nursing shortage.
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Content ArticleHTN Now hosted a panel discussion on virtual wards and the future of remote patient care, with guests Tara Donnelly (director of digital care models at NHS England), Sam Jackson (clinical services manager for the Virtual Health Hub at Hampshire Hospitals NHS Foundation Trust) and Jamie Innes (product director at Inhealthcare).
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News Article
Dentists warn of permanent damage from clear braces ordered online
Patient Safety Learning posted a news article in News
Dentists have told the BBC that demand for Instagram smiles has left people with damage from wearing clear braces or "aligners" ordered online. One man said aligners weakened his front teeth, leaving him unable to bite into an apple. Smile Direct Club, the largest company selling clear aligners remotely, says they straighten teeth faster and cheaper than traditional braces. Its aligners have been successful for the majority of users, it says. But some dentists and orthodontists believe customers of so-called remote dentistry are unaware of harm that can be caused by aligners if not fitted by a dentist in person. The General Dental Council (GDC), responsible for regulating UK dentists, says for some cases remote dentistry can be "provided safely". It urges consumers to consult its guidelines. However, Dr Crouch of the BDA believes such guidelines are insufficient compared with "rules and regulation to protect patients". Otherwise, dentists will be left picking up the pieces when "patients have undergone wholly inappropriate treatment". The UK's health watchdog, the Care Quality Commission (CQC) announced last summer any company providing remote orthodontic services will have to register with it. Read full story Source: BBC News, 20 January 2023 -
Content ArticleThis briefing from the Centre of Mental Health summarises evidence from six studies on the use of digital and telephone technology to deliver mental health services. It finds that using remote technology can improve access to mental health support for rural communities, disabled people or people needing a specialist service far from home. It has the potential to increase access and choice in mental health care. But it also risks exacerbating inequalities for people who are digitally excluded.
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Content ArticleThis article by Rebecca Rosen and Trisha Greenhalgh in the BMJ looks at the safety of remote GP consultations. It begins by looking at the case of student David Nash, who tragically died in 2020 after four telephone consultations with his GP; he was denied an in-person appointment for a painful ear infection that led to a fatal brain abscess. One coroner has raised concerns that this is not a one-off incident, noting that in five inquest reports they wrote during the pandemic, they question whether deaths could have been prevented by in-person consultations. The authors look at the recommendations of the ongoing 'Remote by Default 2' study, which is exploring how best to embed remote consulting in future GP services. They highlight better triage of appointment requests, active listening, checking back, increasing the use of video consulting and better training for clinicians as factors that could improve the safety of remote consultation.
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Content ArticleIn this interview for Healthcare IT News, Lisa Hedges, associate principal analyst at Software Advice, discusses the findings of a survey of 1,000 patients on telemedicine usage after the worst of the pandemic. She also talks about the future of telemedicine. The survey found that: more than half of patients are concerned about the quality of care they're receiving through telemedicine. the majority of people prefer virtual appointments for common illnesses. 86% of patients rate their telemedicine experience as positive. 91% are more likely to choose a provider that offers telemedicine. 49% prefer telemedicine visits for mental health treatment, despite it being one of the more remote-ready specialties.
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Content ArticleDuring the Covid-19 pandemic there was a large-scale shift to remote consulting in UK general practice. In 2021, we saw a partial return to in-person consultations, which occurred in the context of extreme workload pressures due to backlogs, staff shortages and task shifting. This study in the British Journal of General Practice looked at media depictions of remote consultations in UK general practice at a time when general practice was under stress. The authors did a thematic analysis of national newspaper articles about remote GP consultations during two time periods: 13–26 May 2021, following an NHS England letter, and 14–27 October 2021, following a government-backed directive, both stipulating a return to in-person consulting. They found that newspaper coverage of remote consulting was strikingly negative and conclude that remote consultations have become associated in the media with poor practice. They recommend proactive dialogue between practitioners and the media to help minimise polarisation and improve perceptions around general practice.
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Content ArticleHughes et al. studied video consulting in the NHS during 2020–2021 through video interviews, an online survey and online discussions with people who had provided and participated in such consultations. Video consulting had previously been used for selected groups in limited settings in the UK. The pandemic created a seismic shift in the context for remote consulting, in which video transformed from a niche technology typically introduced by individual clinicians committed to innovation and quality improvement to offering what many felt was the only safe way to deliver certain types of healthcare. A new practice emerged: a co-constitution of technology and healthcare made possible by new configurations of equipment, connectivity and physical spaces. Despite heterogeneous service settings and previous experiences of video consulting, we found certain kinds of common changes had made video consulting possible. The authors used practice theory to analyse these changes, interpreting the commonalities found in our data as changes in purpose, material arrangements and a relaxing of rules about security, confidentiality and location of consultations.
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Content ArticleA digital transformation is underway in healthcare and health technology. But what exactly do the smart hospitals of the future look like? Are we heading for a fully virtual health experience? Whether it’s AI and machine learning, or another form of innovation – it’s clear to see that health tech, and healthcare, is changing drastically. The words “smart hospital” and “virtual hospital wards” have eased their way into our vocabulary – and they will soon be the driving force of healthcare everywhere. So what would smart hospitals look like? And what should we be expecting between now and 2050? Health Tech World asked some of the leading experts in the field to give us their predictions as well as their expertise on what the healthcare of the next few decades will look like.
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Content ArticleBy placing patients at the heart of care, the future of healthcare looks promising. However, we must remember that technology is not used in isolation and has to be developed and implemented with and for the user.
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Content ArticleThis white paper from the Institute for Healthcare Improvement (IHI) describes a framework to guide health care organisations in their efforts to provide safe, equitable, person-centred telemedicine. The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.
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Content ArticleDr Gordon Hay, service director of A&E/urgent care services at Moorfields Eye Hospital discusses with Digital Health the challenge to minimising hospital visits during the pandemic and how Moorfields Eye Hospital utilised a video conference platform to implement a fully functional virtual A&E service, providing an effective hybrid care delivery model for the future.
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Content ArticleThe first wave of the pandemic necessitated a large scale shift to greater digital engagement with patients, yet progress has not been uniform. While virtual consultations have become increasingly commonplace, communication outside of those appointments is still often analogue and generally sporadic. Cancelling an appointment – or indicating in advance that a specific day or time doesn’t work – remains a complicated, non-digital experience for many patients. With millions now on waiting lists for treatment, and a significant minority having already waited two years, this sort of communication gap becomes more challenging. As such there are arguments that it’s now time for the digital acceleration seen during the pandemic to extend to this area too.
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News Article
GP telephone first system 'here to stay' in Northern Ireland
Patient Safety Learning posted a news article in News
A phone first system adopted by most GP surgeries at the start of the pandemic is "here to stay", the Royal College of GPs (RCGPs) in Northern Ireland has said. However, the RCGP has also accepted patient access needs to improve. The system was introduced in spring 2020. According to GPs, the move, which came without either consultation or prior information, was necessary to minimise the risk of infection of Covid-19. Two years on, there is concern among some members of the public that the system is not working. Speaking to BBC News NI, Dr Ursula Mason accepted that the system wasn't working but said there were not enough GPs to see people. She added that the telephone system, which was being "refined" and "improved" was the best way to manage "growing demand" and to "prioritise the sickest patients to be seen first". "The telephone system allows us to see many more patients, to deal with demand in a better way so I think the telephone system is here to stay," added Dr Mason. "There will be some changes to upgrade it, but it will form a significant part of how we manage demand."
