Video consultations as an alternative to face to face consultations in primary care

Anthony Heymann, Inbal Moses, Ori Harel

Keywords: Telemedicine, Video, Primary Care , General Practice

Background:

Telemedicine is the use of communications networks for delivering health care services from one geographic location to another.
It is a complex task that carries some inherent difficulties and risks compared to regular consultations. For six months patients in the Meuhedet HMO, patients have been able to book video consultations with their GP who conduct the meeting from within the patient's file in the electronic medical record. The GP can send the patients prescription or referrals electronically as required.

Research questions:

The aim of the study was to identify the characteristics and satisfaction of the video consultation users and identify the barriers and promoters of the use of the service by the patients and physicians.

Method:

This is a mixed methods study including (1) data pertaining to the implementation of the video consultation (2) a patient survey of their video consultation experience (3) a focus group discussion of physicians that participated in the pilot. Data from 26 physicians was collected over a six month period from May 2019

Results:

The patients seemed highly satisfied with their video visits (score 4.63/5.0). During this period, 2150 digital visits were scheduled,40% were completed. There were 20% no-show as opposed to 29% for regular visits. 33% were canceled in advance by patient. The average patient age was 32.8 years compared with 33.8 for regular visits. In 61% of video visits the patients were female compared with 54% for regular visits.
The physicians in the focus group felt that the video service was a positive change, noting improved time management and better access for patients such as for mothers with young children. The medico-legal issue was not regarded as a barrier because physicians felt free to invite the patients for a regular visit if necessary.

Conclusions:

Both physicians and patients were satisfied from the technology which enabled effective physician-patient interaction.

Points for discussion:

What are the goals of the planned qualitative and quantitative research?

Which aspects of these consultations need further research?

The difficulty of researching an intervention or service that is being rolled out nationally in a medical setting

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