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Found 67 results
  1. Content Article
    The 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.
  2. Content Article
    This 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.
  3. Event
    Airedale’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
  4. Content Article
    Contemporary 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.
  5. Content Article
    In 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.
  6. Content Article
    Since 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.
  7. News Article
    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
  8. Content Article
    Triage 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.
  9. Content Article
    The 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.
  10. News Article
    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."
  11. News Article
    The government must stop treating women “like children” and permanently allow at home early medical abortions, MPs and health professionals have said. Abortion rules changed after Covid hit the UK in March 2020, with the government allowing abortion pills to be sent via post to be taken at home after a phone consultation. The new system - referred to as “telemedicine” - was due to run out on 25 March but the government declared a six-month extension for at home early medical abortions earlier in the month. MPs are now set to vote on whether to make telemedicine abortion services permanent on Wednesday. Clare Murphy, chief executive of the British Pregnancy Advisory Service (BPAS), told The Independent: “We welcome the vote. MPs have the opportunity to prevent the recriminalisation of women who use Stella Creasy, a Labour MP and campaigner for abortion rights, is one of many MPs calling for telemedicine abortion services to be made permanent. “Despite the best attempts to scare, telemedicine has been shown to be safe, secure and preferable for many patients for a variety of reasons - it’s time to trust women and ensure they can make the right choices for themselves when it comes to their own medical care”, she said. Read full story Source: The Independent, 29 March 2022
  12. News Article
    Just 1 in 10 patients preferred face-to-face GP appointments during the Covid pandemic, with most requesting telephone consultations instead, according to research carried out on behalf of NHS England. The Improvement Analytics Unit (IAU) – a partnership between NHS England and think-tank the Health Foundation – looked at data from 146 England GP practices using the askmyGP online consultation system between March 2019 and September 2021, examining over 7.5 million patient-initiated consultation requests. During the pandemic, GPs suffered a backlash from the media, Government and NHS England over accusations that general practice was closed and GPs were not seeing patients face-to-face. GP leaders suggested that NHS England needed to take the research into account and allow practices to decide their own way of working. The research found that: Before the pandemic, 30% of patients requests specified a face-to-face consultation, dropping to less than 4% at the beginning of the pandemic. But by the end of the study period in September 2021, only 10% of patients requests were for face-to-face GP appointments. Telephone consultations were the most popular option, making up over half (55%) of patient requests in 2020/21. However, less than 1% of patients preferred a video consultation, according to the data. IAU head at the Health Foundation Arne Wolters said: ‘Our analysis shows that patients often choose remote over face-to-face consultations and that GP practices can mitigate the risk of digital exclusion via a blended approach.’ He said that ‘traditional routes to accessing and delivering care’ had been ‘offered alongside an online option and, in planning care, practices were able to take account of factors such as patients’ age, frequency of use, clinical needs and preferences’, at the studied practices." And he added: ‘With patient demand at an all-time high due to the care backlog Read full story Source: Pulse, 18 March 2022
  13. News Article
    Face-to-face GP appointments have continued to fall, despite a rallying cry for doctors to restore normal services. The proportion of GP appointments held in person fell for the third month in a row to 60.3% in January, latest data show. Data published by NHS Digital on Thursday show about 25.6 million appointments were carried out in January. Of these, some 15.4 million were face-to-face. The last time it fell below this level was August 2021, when just 57.6% of appointments were face-to-face. Pre-pandemic, the proportion of GP appointments held in person was about 80%. Dr Nikki Kanani, NHS England’s medical director of primary care, told doctors last month to “restore routine service” following the successful rollout of the booster jab campaign. Writing to GPs, she said: “It is now important that all services across the NHS, including in primary care, are able to restore routine services where these were paused in line with the Prime Minister’s request to focus all available resource on the omicron national mission.” But patient groups say the “situation hasn’t improved” and patients are still struggling to see their doctor in person. Dennis Reed, from patient group Silver Voices, said the figures were “worrying” but not surprising. “I'm still getting complaints on a daily basis that people are struggling to see their GP,” he said. Read full story Source: The Telegraph, 24 February 2022
  14. News Article
    The NHS plans to treat up to 25,000 hospital patients at home in “virtual wards” to help clear the backlog caused by the pandemic, the “living with Covid” plan has revealed. Patients will be offered acute clinical care at home, including remote monitoring and treatment, as an alternative to hospital stays. Consultants or GPs will review patients daily via digital platforms and phone calls. In some cases, patients will be provided with a wearable device to continuously monitor and report their vital signs. The NHS has set a national target of 40 to 50 virtual beds per 100,000 population, which equates to about 25,000 beds across England, according to the “living with Covid” plan published this week. The document said: “The use of ‘virtual wards’ and ‘hospital at home’ models of care have ensured that patients can be safely cared for in their own homes and that additional bed capacity can be freed up in hospitals.” Commenting on the initial rollout of virtual wards, Dr Tim Cooksley, the president of the Society for Acute Medicine, warned a “hasty” rollout could risk patient safety. He said: “Virtual wards do have the potential to be a model of the future. However, it is essential they are appropriately planned, resourced and staffed so they simply cannot be seen as a short-term mitigation measure which can be hastily rolled out mid-pandemic. Incorrect implementation could risk patient safety and significantly impact clinician and patient confidence.” Read full story (paywalled) Source: The Telegraph, 22 February 2022
  15. News Article
    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
  16. News Article
    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
  17. News Article
    Complaints 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
  18. Content Article
    This 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.
  19. Content Article
    In 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.
  20. Content Article
    This 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.
  21. Content Article
    Healthcare 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.
  22. Content Article
    HTN 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).
  23. News Article
    The rapid spread of coronavirus has given the NHS a “kick forward” in the need to accelerate technology and ensure staff are digitally prepared, a GP has said. Neil Paul, a Digital Health columnist and GP in Ashfields, said the need to reduce face-to-face appointments to prevent the potential transmission of Covid-19 has forced the NHS, particularly in primary care, to adopt already available technologies. He said practices “still in the stone ages” and “technophobes” were less prepared for the current situation, but that it would force them to move into the digital age. “It’s absolutely made my surgery go ‘right, how do we do online consults’. I think it actually has given people a real kick forward,” he told Digital Health News. “I think in six months’ time my surgery might be very different in that actually we will be doing a lot of online and telephone consults where previously we may have been a bit reluctant." GP practices across the country have been advised to assess patients online or via telephone and video appointments to mitigate the potential spread of coronavirus. In a letter to GPs last week, NHS England urged Britain’s 7,000 GP surgeries to reduce face-to-face appoints for patients displaying symptoms of Covid-19. The preemptive move means millions of patients will now be triaged online, via telephone or video and contacted via text messaging services. Read full story Source: Digital Health News, 13 March 2020
  24. Content Article
    The 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.
  25. Content Article
    Recovering services from the covid crisis is the big task for NHS leaders for the foreseeable future. HSJ's Recovery Watch newsletter tracks prospects and progress. This week HSJ bureau chief and performance lead James Illman discusses virtual wards and why staffing pressures are ‘likely to be under-estimated’ and are a patient safety risk.
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