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News Article
Face-to-face GP appointments in Scotland 'still feel like a treat'
Patient Safety Learning posted a news article in News
Nightclubs have reopened, concerts have been given the go-ahead and football stadiums are welcoming fans - but there are still restrictions on face-to-face GP consultations. Only a limited number of patients are being invited into surgeries, where there continue to be strict rules on physical distancing. Edinburgh GP Dr Carey Lunan says she understands why the situation is confusing. "The difference between a healthcare setting and, say, a restaurant or a football stadium, is that we have people coming into our building who are much more vulnerable and frail and don't have a choice in being unwell," she tells BBC Scotland. "So we have to have higher levels of safety than a setting where people can choose to go, knowing that there may be a little bit of risk." According to the British Medical Association's Dr Andrew Buist, the balance between telephone and in-person consultations should continue to adjust as we move out of the pandemic, guided by evidence. But many patients will "very easily" have their needs met by phone appointments. So-called telephone triage - where patients are assessed over the phone before being invited into the building - has now become the norm. "For a lot of patients it works really well if it's a simple problem and it means not having to take time off work or travel," says Dr Lunan. "It works less well if English isn't their first language or they've not got the privacy at home to have a conversation about something that is a bit more sensitive, if it's a very complex issue or it's just not clear what the diagnosis is." She adds: "We deal with things when someone comes in with problem A, but actually we end up having a conversation about problem B when they are in the room with us. "It is much more challenging to do that kind of health care on the phone and I think we just need to be honest that there are limitations. Dr Lunan says she hopes a return to more face-to-face appointments will come "in the not too distant future. I miss seeing patients if I'm honest," she says. "When we get to the point where we are able to bring in more people we will welcome that because it feels like a treat at the moment." Read full story Source: BBC News, 25 January 2022- Posted
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Content ArticleThe COVID-19 pandemic has led to changes in health service utilisation patterns and a rapid rise in care being delivered remotely. However, there has been little published research examining patients’ experiences of accessing remote consultations since COVID-19. Such research is important as remote methods for delivering some care may be maintained in the future.
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Content ArticleThis study in Clinical Child Psychology and Psychiatry assessed feedback from paediatric diabetes patients and their parents or carers regarding virtual consultations, using a solution focused approach, in a hospital setting. Patients completed an electronic survey following their virtual consultation, and of those surveyed, 86% recommended video consultations to be part of their diabetes care. Qualitative data showed reduced travel time, comfort, reduced need for parking and convenience as the major benefits to patients. The results demonstrated that clinical care was shown to be positive and addressed patients concerns, the majority of respondents (84%) reported that the appointment was about what they wanted it to be about. Using the solution focused model helped overcome the challenges faced with virtual consultations particularly with concerns surrounding safeguarding issues, confidentiality, audio/video difficulties and also helped to support the patient journey.
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Content ArticleThis study in the British Journal of General Practice aims to identify and understand the unintended consequences of online consultations in primary care. The authors interviewed 19 patients and 18 general practice staff at eight general practices using online consultation tools in South West and North West England between February 2019 and January 2020. The study found the following unintended consequences of online consultation: Creation of difficulties for some patients in communicating effectively with a GP. The system disadvantaged digitally-excluded patients. Patient uncertainty about how their queries were dealt with, and whether practices used online consultations as their preferred method for patients to contact the practice. Creation of additional work for some staff. Isolation and dissatisfaction for some staff.
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Content ArticleThis World Health Organization (WHO) policy brief takes stock of how digital health tools have been used during the COVID-19 pandemic, in order to review what has happened, assess how uptake and use of these tools has been facilitated, identify issues that are emerging, and learn lessons for the longer term to support the sustained use of digital health tools.
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Content ArticleThis article published in BMJ Open aimed to explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the Covid-19 pandemic. The authors found that patient and carer experiences of remote care were mixed. Some service users valued the convenience of remote methods as it allowed them to maintain contact with familiar clinicians, but most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments and identification of deteriorating mental well-being. The study highlights the importance of taking a tailored, personal approach to decision making in this area, and the authors state that future research should focus on which types of consultations best suit face-to-face interaction, and for whom and why.
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NHSX to fund and support innovations for 500k people at home
Clive Flashman posted a news article in News
NHSX have revealed that they will fund and support 14 new projects across the country to help half a million people receive care at home using digital technology. This will include remote cardiac rehabilitation services and digital self-management systems, as well as parental support services for families of children with eating disorders. Tara Donnelly, Chief Digital Officer at NHSX, said: “Through our Digital Health Partnership Award, these organisations will have access to the expertise and support they need to adopt or expand their digital capabilities safely and effectively, allowing many more patients with long term conditions to receive their care from the comfort of their homes rather than always having to attend primary and acute settings.” In addition to innovation in digital technology, a number of the projects build on existing services to ensure more patients can benefit from remote services. One of the projects also includes the expansion of secure video services at Great Ormond Street Hospital for Children, which will make it possible for patients and carers, as well as their doctors, to share seizure videos across their neurology service. Cambridgeshire Community Services are also expanding their remote health monitoring service. Read the full article here Source: National Health Executive- Posted
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Content ArticleThis article describes how 55 international and national participants participated in an event that focused on strengthening patient safety within telemedicine through resilience on 16 August 2018 at the Health Innovation Centre of Southern Denmark in Odense, Denmark.
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Content ArticleThis Rapid Evidence Scan from Moore et al. examined the effectiveness of virtual hospital models of care. While no reviews evaluated a complete model, tele-healthcare only and tele-healthcare with remote telemonitoring interventions demonstrated similar or significantly better clinical or health system outcomes including reduced hospitalisations, readmissions, emergency department visits and length of stay, compared to usual care, including those delivered without home visits or face-to-face care. The use of the Internet showed mixed but promising results. The strongest evidence was for cardiac failure, coronary heart disease, diabetes and stroke rehabilitation. Nurses played a central role in home visiting, providing telephone support and education. However, the studies were heterogenous and the results should be interpreted with caution.
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Content ArticleThe Doctor Will Zoom You Now was a rapid, qualitative research study designed to understand the patient experience of remote and virtual consultations. The project was led in partnership with Traverse, National Voices and Healthwatch England and supported by PPL. The study engaged 49 people over 10 days (June 22nd – July 1st 2020) using an online platform, with 20 additional one to one telephone interviews. Participants were also invited to attend an online workshop on the final day of the study. Using insight from the key findings from the research, this website provides useful tools and tips for getting the most out of your appointment.
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Content ArticleThe Remote by Default research study, a collaboration between the Universities of Oxford and Plymouth and the Nuffield Trust, has been exploring how technology can be harnessed to support excellent primary care. Using workshops, interviews, and focus groups of clinicians, service users, and other stakeholders, they have begun to map the multiple interacting influences on the choice of consultation modality.
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News ArticleMany GPs find telephone appointments with patients frustrating and want to see them in person because they fear they will otherwise miss signs of illness , the leader of Britain’s family doctors has said. Prof Martin Marshall told the Guardian that remote consultations felt like working “in a call centre” and risked damaging the relationship between GPs and their patients. Telephone and video appointments had proved useful during the Covid pandemic, when GP surgeries limited patients’ ability to come in for face-to-face appointments, he said. However, while that helped limit the spread of coronavirus, “this way of working has been frustrating for some GPs, particularly when most consultations were being delivered remotely, who have felt like they’ve been delivering care via a call centre, which isn’t the job they signed up for." “Remote consultations have advantages, particularly in terms of access and convenience for patients. But we know that patients prefer to see their GP face to face." “Remote working has been challenging for many GPs, particularly when delivering care to patients with complex health needs,” said Marshall, who is a GP in London. “It can also make it harder to pick up on soft cues, which can be helpful for making diagnoses.” His remarks come as NHS leaders and doctors groups are discussing how far appointments should return to being in person now the pandemic is receding. Read full story Source: The Guardian, 28 March 2021
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Eventuntil2020 saw a huge leap in the delivery of virtual health and care, with encouraging lessons for the current crisis and beyond. But has the speed of innovation been at the expense of inclusive people and patient-centred care? In this free online event from the King's Fund, explore what we can learn from the innovations that have accelerated during the pandemic and how we can align patient and user involvement in the development of future virtual health and care solutions. Register
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Content ArticleIn this month's Letter from America, Lorri Zipperer discusses cautions and capabilities associated with healthcare technologies. Letter from America is a Patient Safety Learning blog series highlighting new accomplishments and patient safety challenges in the United States. This is Lorri's last blog in the series and we'd like to thank Lorri for sharing her insights with us over the last 12 months. Read here all the Letter from America blogs
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Content Article
The rise of telehealth (2 September 2020)
lzipperer posted an article in Telehealth
Telehealth has become more entrenched as a healthcare provision mechanism in response to COVID-19. This Dissent Magazine article cautions its effectiveness long term due to its potential to be established as a profit centre for healthcare organisations. -
Content ArticleTelemedicine has potential to address inequity in healthcare but not until certain barriers are addressed. This article from Joanna Pearlstein in Wired discusses how physicians and care organisations have to be creative and rely on partnerships and local resources, such as school district hot spots or public library broadband access, to make the system reliably work for all their patients.
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News Article
Telemedicine saves chronic pain patients time and money
Patient Safety Learning posted a news article in News
Patients who saw a pain medicine specialist via telemedicine saved time and money and were highly satisfied with their experience, even before the COVID-19 pandemic, according to a study presented at the ANESTHESIOLOGY® 2020 annual meeting. Results of the study confirm many chronic pain patients are confident they will receive good care via telemedicine, while avoiding lengthy commutes and time spent in traffic. "This era of contactless interactions and social distancing has really accelerated the adoption of telemedicine, but even before the pandemic, patient satisfaction was consistently high," said Laleh Jalilian, M.D., lead author of the study and clinical assistant professor at the University of California, Los Angeles (UCLA). "Patients who are being evaluated for new conditions may be better off having office visits initially. But once patients establish a relationship with providers, follow-up visits can occur efficiently with telemedicine, while maintaining patient rapport and quality outcomes. We believe 50% of our visits could be conducted via telemedicine." "Now that telemedicine is more widespread, it may become a valued part of care delivery in chronic pain practices," said Dr. Jalilian. "Clearly many patients benefitted from remote consultations and follow-up appointments using telemedicine. We hope it will encourage policymakers and insurance providers to continue to support these platforms and inspire more innovation in this developing field of research and patient care." Read full story Source: EurekAlert, 5 October 2020- Posted
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News Article
Need for tech to reduce medication error and improve patient safety
Patient Safety Learning posted a news article in News
Omnicell UK & Ireland, a leading provider of automated healthcare and medication adherence solutions, hosted a health summit on the eve of World Patient Safety Day, to discuss the impact of medication errors on patients and the NHS. The session focussed on the role technology can play in preventing such issues. The summit, this year held via webinar, comes off the backdrop of the Department of Health and Social Care disclosing that in England 237 million mistakes occur every year at some point in the medication process. These errors cause serious issues for patient safety, but also place a significant cost burden on an already stretched NHS. The 2019 Patient Safety Strategy published by NHS England and NHS Improvement also found the NHS failed to save 11,000 lives a year due to safety concerns with the cost of extra treatment needed following incidents being over £1bn. A number of high-profile panel members answered a series of questions from the audience on solutions and best practice to improve patient safety with the aim of debating and sharing ideas on how to meet challenges and the impact of COVID-19. One of the panelists, Patient Safety Learning's Chief Digital Office Clive Flashman, agreed with the other panel members that the NHS had become more collaborative and familiar with technology since Covid: “We’ve seen a definite increase in telehealth and telemeds. Covid has forced cultural blockers that were there before to be removed out of necessity. There has been a growth in robotic pharmacy automation to free up staff time from high volume administration tasks to do more complex work that adds value for patients.” But with the second-wave of COVID-19 still a very real threat he advised: “We don’t want to wait until the next wave to learn a lesson – we need to learn lessons now. Quality Improvement Leads should be focussed on what went right and what went wrong over that period between March and May. They need to be looking at what we can learn from that now and what we can do differently next time. If we don’t do that, we won’t succeed in the second wave where we might fail.” Ed Platt, Automation Director, Omnicell UK & Ireland, added: “Challenges within the NHS throughout Covid has forced them to embrace technology and drive innovation." "It’s important that when things go back to normal, we don’t go back to the same status quo. We need to invest in the right infrastructure in hospitals so unnecessary demands and stress are not put on pharmacy, supply managers and nurses so they are free to focus on patient care not administration tasks." Read full story Source: NHE, 17 September 2020 You can watch the webinar on demand here -
Content ArticleIt is often the case that particular healthcare policies and practices change overnight from being discouraged or even forbidden to becoming more or less compulsory. An example of this is the change in how patients can access doctors during the coronavirus pandemic. At the end of July, Matt Hancock gave a speech on the future of healthcare in which he declared “… from now on, all consultations should be teleconsultations unless there is a compelling reason not to.” The following day, Sir Simon Stevens’ letter on the third phase of the NHS response to COVID-19 gave more nuanced messages and acknowledged the place of face to face consultations alongside digital and telephone consultations in some circumstances. Meanwhile, a recent RCGP survey reported that at the present time 61% of appointments are full telephone consultations and 16% are telephone triages. Many changes in how patients can access doctors have the potential to offer great benefits to patients and to ease pressures on health systems; however, what is right in some circumstances is not right for all as Ros Levenson, Chair of Academy Patient and Lay Committee, Academy of Medical Royal Colleges, discusses in her blog.
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Content ArticleDr Steve Barker is joined by Ronald Weinstein, Director/Founder, Arizona Telemedicine Program, and Jeffrey Dunn, Founder/CEO, Redivus Health, to discuss the future of telemedicine within the patient safety and quality improvement space. Telemedicine has become a significant area of investment in recent years and the panelists predict that, in the future, user experience, consolidation, customisation based on relevance to the user, robotics, and health literacy will become top priorities.
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Content Article
Could telemedicine solve the cancer backlog?
Patient Safety Learning posted an article in Telemedicine
Although millions of patients with cancer around the world face delays in diagnosis and treatment because of the diversion of resources during the COVID-19 pandemic, there is a growing expectation that telemedicine may play a central role in easing the backlog. This Lancet Digital Health article explores how telemedicine will be key as healthcare systems move forward in tackling the backlog in not only cancer treatment but also diagnosis, and how augmented intelligence (AI) could be used to help to optimise its use.- Posted
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News Article
All GP consultations should be remote by default, says Matt Hancock
Clive Flashman posted a news article in News
All GP appointments should be done remotely by default unless a patient needs to be seen in person, Matt Hancock has said, prompting doctors to warn of the risk of abandoning face-to-face consultations. In a speech setting out lessons for the NHS and care sector from the coronavirus pandemic, the health secretary claimed that while some errors were made, “so many things went right” in the response to Covid-19, and new ways of working should continue. He said it was patronising to claim that older patients were not able to handle technology. The plan for web-based GP appointments is set to become formal policy, and follows guidance already sent to GPs on having more online consultations. But the Royal College of GPs (RCGP) hit back, saying it would oppose a predominantly online system on the grounds that both doctors and patients benefited from proper contact. Read full article here- Posted
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EventuntilThis webinar will explore virtual care and the use of patient health data through remote patient monitoring. In the UK and US alike, COVID-19 has accelerated the dramatic shift towards utilising digital health services and tools to virtually connect with and care for patients. Remote patient monitoring (RPM) offers providers the opportunity to remotely collect and utilise patients’ personal health data, such as data from their home-use medical devices and wearables, within care delivery efforts. These personal health data are providing deeper insight into patients’ physiologic health metrics, lifestyle decisions and behavioural trends while replacing the clinical data previously collected in-person. As health care organisations need to quickly scale virtual care to thousands of patients, clear best practices and lessons learned have emerged. This episode will deep-dive into the successful operations of the largest, centralised RPM programme, supporting over 3000 clinicians and more than 50,000 enrolled patients. We’ll delve into the most basic and complex challenges around patient-generated health data, patient consent, enrollment workflows, device logistics, patient and provider engagement, and more. This webinar will explore: Core operations and technologies to a holistic virtual care strategy The clinical outcomes, patient and provider satisfaction, and efficiencies created with RPM Best practices in digital health operations, data integration, analytics, and engagement A model and framework for scaling virtual care and RPM to thousands of patients quickly A CPD certificate with 1 CPD credit will be issued to those joining the webinar live as well as those who watch the recording afterwards. Certificates will be issued 7 days after the webinar to those who watch it live and after 30 days for those that watch the recording. Join in the conversation online using #RSMDigiHealthBook hereFollow us on Twitter: @RoySocMed Book here
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Content ArticleClinical negligence claims are often built upon a lack of adequate documentation of what was said and allegations that patients have not been properly counselled about risks and alternatives. Elizabeth Thomas explores in this HSJ article what this means for the increasingly significant role of telemedicine and the steps which can go a long way in reducing the burden on patients and the public purse
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Babylon apology after GP app lets patients see other people's consultations
Patient Safety Learning posted a news article in News
Babylon Health is investigating whether NHS patients were among those affected by a 'software error' that allowed people registered with its private GP service to view recordings of other people's consultations earlier this month. Babylon Health has confirmed that a small number of patients were able to view recordings of other patients' consultations earlier this week. The issue came to light after a patient in Leeds who had access to the Babylon app through a private health insurance plan with Bupa reported that he had been able to view around 50 consultations that were not his own. The patient told the BBC he was 'shocked' to discover the data breach. "You don't expect to see anything like that when you're using a trusted app," he said. "It's shocking to see such a monumental error has been made." Babylon told GPonline that the app used by private and NHS patients is the same, but it had yet to confirm whether the roughly 80,000 patients registered with the company's digital first NHS service GP at Hand were among those affected. The problem is understood to have cropped up when a new feature was introduced for patients who switched from audio to video mid-way through a consultation. Read full story Source: GPOnline, 10 June 2020- Posted
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