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Showing results for tags 'Telemedicine'.
Found 58 results
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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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Content ArticleWhen the Covid-19 pandemic started, video consulting became standard practice for many GPs, who became rapidly acquainted with the technology for video calls. Doctors worked on improving their video consulting technique, not knowing for how long they might have to limit in-person consultations. Now that vaccination has reduced the risks of face-to-face appointments, the vast majority of GP practices rarely use video consultation, and fewer than 1% of consultations were conducted this way in England in May 2023. In this BMJ article, GP Helen Salisbury looks at the reasons for this decline in the use of video calls, arguing that face-to-face consults allow for a more accurate and safe diagnostic process and facilitate building rapport between healthcare professionals and patients.
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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 ArticleThis article in the BMJ highlights a number of recent articles that reflect on the realities facing the health service after the first brutal years of the Covid-19 pandemic. It summarises and links to articles in the BMJ about the elective care backlog, A&E waiting times, remote appointments, Government pressures that stop senior clinicians speaking out about pressures, and the need for credible policy solutions. It also highlights an article outlining how Brexit and the Northern Ireland Protocol have resulted in the UK being denied access to European research funding and meetings.
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Content ArticleThe Covid-19 pandemic triggered a very sudden and widespread shift to remote consulting in general practice. Many patients and healthcare professionals have welcomed the convenience, quality and safety of remote consulting, but there are inherent tensions in choosing between remote and face-to-face care when capacity is limited. This report by the Nuffield Trust explores the opportunities, challenges and risks associated with the shift towards remote consultations, and the practical and policy implications of recent learning.
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Content ArticleAt the start of the Covid-19 pandemic, demand on the NHS 111 system exceeded capacity and only around half of calls were answered during that time. This investigation by the Healthcare Safety Investigation Branch (HSIB) aimed to support improvements in the delivery of NHS 111 and other telephone triage services during a national healthcare emergency. HSIB first identified a potential safety risk associated with NHS 111’s response to callers with Covid-19-related symptoms when concerns were raised through HSIB’s Citizens’ Partnership. The national investigation aimed to understand: the set-up, design and delivery of the Covid-19 telephone triage service accessed by the public by dialling 111 in response to the pandemic. the context and contributory factors influencing the pathway for patients calling NHS 111 with Covid-19-related symptoms. The investigation used four real patient safety incidents involving patients and their families who dialled NHS 111 for advice during the Covid-19 pandemic. All four patients in these reference events—Vincenzo, Ali, Patrick and Dr C—died of Covid-19 having been advised by NHS 111 to stay at home.
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Content ArticleVideo and telephone consultations have, through the course of the pandemic, become a central of daily operations across the NHS. In this blog, Ben Gadd and Amanda Nash of University Hospitals Plymouth NHS Trust share their experiences about how they are being received and the potential lessons we can learn.
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Content ArticleThere has been an increase in the use of video group consultations (VGCs) by general practice staff, particularly since the beginning of the Covid-19 pandemic, when in-person care was restricted. This qualitative study in the British Journal of General Practice aimed to examine the factors affecting how VGCs are designed and implemented in general practice. Through semi-structured interviews with practice staff and patients, the authors found that: in the first year of the pandemic, VGCs focused on supporting those with long-term conditions or other shared health and social needs. most patients welcomed clinical and peer input, and the opportunity to access their practice remotely during lockdown. not everyone agreed to engage in group-based care or was able to access IT equipment. significant work was needed for practices to deliver VGCs, such as setting up the digital infrastructure, gaining team buy-in, developing new patient-facing online facilitation roles, managing background operational processes, protecting online confidentiality, and ensuring professional indemnity cover. national training was seen as instrumental in capacity building for VGC implementation.
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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 ArticleThis survey conducted by the Care Quality Commission (CQC) explored the experiences of people who used community mental health services between September and November 2020. The results show that people are consistently reporting poor experiences of NHS community mental health services, with few positive results. Many people reported that their mental health had deteriorated as a result of changes made to their care and treatment due to the pandemic. Analysis also showed disparities in the experiences of people with different mental health diagnoses, and in the experience of people using different methods to access care, such as telephone consultations. On this webpage you can also access a benchmark report for each NHS trust, which provides detail of the survey methodology, headline results, the trust score for each evaluative question and banding for how a trust score compares with all other trusts.
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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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News Article
Royal Surrey County Hospital to launch virtual ward to free up beds
Patient Safety Learning posted a news article in News
The Royal Surrey County Hospital is preparing to open its first virtual ward. From this summer 15 patients will receive treatment at home using apps and wearable technology, as an alternative to a stay in hospital. The ward will be overseen by a consultant, working with therapists, nursing staff and pharmacists. The hospital, in Guildford, plans to extend the ward to 52 patients by April 2024. Health providers across England have been asked to deliver virtual wards at a rate of 40 to 50 beds per 100,000 people by December 2023. It is hoped they will free up beds more quickly, speeding up admissions from A&E and for elective surgery. Read full story Source: BBC News, 7 June 2022 -
News Article
NHS will not hit virtual wards target, internal data suggests
Patient Safety Learning posted a news article in News
The NHS is on trajectory to fall short of a flagship pledge to have around 24,000 “virtual ward beds” in place by December 2023, internal data has revealed. NHS England’s figures from March, seen by HSJ, suggest the system is instead more likely to have created around 18,500 virtual beds by the 2023 deadline. Senior clinicians, including the Royal College of Physicians and the Society of Acute Medicine, have recently raised concerns about the speed and timing of the roll-out and staffing implications. And now fresh concerns are also being raised about the programme following publication of a new academic study which suggests virtual wards set up by the NHS during Covid made little impact on length of stay or readmissions rates. Alison Leary, professor of healthcare and workforce modelling, London South Bank University, was one of the first senior leaders to publicly voice concerns about the NHS’s virtual wards programme. Professor Leary told HSJ: “I am not surprised [systems are falling] short. Since Elaine [Elaine Maxwell, visiting professor, London South Bank University] and I published our piece in HSJ, I have been contacted by several clinicians who have serious concerns over virtual wards and staffing them.” Read full story (paywalled) Source: HSJ, 31 March 2022 -
Content ArticleLisa Drake, an NHS ex General Practice Manager now working in a digital advisory role, shares some of the missed opportunities for digital ways of working she witnessed when she was a patient herself.
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Content ArticleIn a fundamental sense, the vision for transforming virtual care from that of an exclusive service that benefits only a few to that of a standard for providing equitable care for all echoes the age-old debate between policy variations on the zip code and the genetic code. This commentary from Esha Ray Chaudhuri aims to further develop the key theme of engaging the “reimagining” of virtual care for older ethnic adults—by considering the syndemic nature of COVID-19 and the intersection of cultural interventions in care and equity in virtual care.
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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." -
EventECRI has released its newest list of the Top 10 patient safety concerns confronting healthcare organisations. Healthcare providers, regardless of their practice setting, can start with our Top 10 list and use it to guide their own discussions about patient safety and improvement initiatives. This top 10 report highlights patient safety concerns across the continuum of care because patient safety strategies increasingly focus on collaborating with other provider organizations, community agencies, patients or residents, and family members. Each patient safety concern on this list may affect more than one setting. Join ECRI to learn more about the identified concerns and how your organisation can begin to address them. Register
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Content ArticleThis briefing by The Health Foundation Improvement Analytics Unit looks at recent data around patient preferences for online and face-to-face consultations and examines the impact of the increasing use of online tools on patient access to primary care. The Improvement Analytics Unit examined 7.5 million patient-initiated requests for primary care made using the askmyGP online consultation system between March 2019 and September 2021 at 146 general practices in England. These practices had a combined total list size of 1.35 million patients.
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Content ArticleThe spread of the Covid-19 pandemic presented significant challenges in the management of patients with chronic diseases like multiple sclerosis (MS). This article in Frontiers in Neurology looks at how telemedicine was used as an alternative to face-to-face consultations with MS patients during the pandemic. Recognising the variation in care that occurred as different centres adopted telemedicine, they make a series of recommendations for the use of telemedicine in managing MS patients.
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Content ArticleGeneral practice has always been the foundation and gateway to the NHS, but this part of the healthcare system is now under strain due to greater demand from an increasingly complex patient profile, and a stretched workforce. Lack of staff and coherent planning means that the current model is not fit for purpose, and this has resulted in a recent decrease in patient satisfaction. This proposal by the think tank Policy Exchange outlines the reforms that could help the NHS develop a model of general practice to better meet the needs and interests of patients and healthcare workers.
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Content ArticleIn this interview for Healthcare IT News, Jennifer Ball, Director of Virtual Care at Saint Luke's Health System in Kansas City talks about the benefits of virtual nursing units, and what training and support is needed to set one up.
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Content ArticleThis article in the British Journal of General Practice examined GP perspectives and concerns about safeguarding during the Covid-19 pandemic, focusing on the challenges and opportunities created by remote consultation. GPs interviewed for the study expressed concern about missing observational information during remote consultations, with pooled triage lists seen as further weakening safeguarding opportunities. They were also worried that conversations might not be private or safe. Remote consultations were seen as more ‘transactional’, with reduced opportunities to explore ‘other reasons’ including new safeguarding needs. Remote consultation was seen as more difficult and draining and associated with increased GP anxiety and reduced job satisfaction. However, GPs also recognised opportunities that remote consulting offers, including providing more opportunities to interact with vulnerable patients.
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Content ArticleThis report looks at research commissioned by the Juvenile Diabetes Research Foundation (JDRF) to understand the varying pandemic experiences of different people affected by type 1 diabetes in the UK. It highlights an enormous withdrawal of NHS services during the pandemic, leading to highly unequal access to type 1 diabetes care.
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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
