Challenge
During the onset of the Covid pandemic in early 2020, the use of online consultations (OCs) in primary care accelerated rapidly – their popularity encouraged not only by government policy initiatives, but by the fact that OCs helped to alleviate the risk of contagion.
OC systems allow people to communicate with their GPs remotely, using the internet. Patients can ask health-related questions and report symptoms; in turn, GPs can choose between responding in writing, via telephone call or video consultation, or as an in-person visit.
However, whilst OCs appear to be convenient for many patients, they can vary wildly in their design and implementation – and until now, there has been a lack of evidence pertaining to how these factors ultimately influence care quality.
In order to ensure that, going ahead, OCs are built to be as effective and safe as possible, it was therefore necessary to take a closer look at the complex impact which certain key variables in OC design can have upon their success.
Solution
The University of Manchester, along with our Chief Medical Officer, Dr Ben Brown, set out to synthesize sixty-three studies of OCs from nine different countries. The research paper has recently been published in the Journal of Internet Medical Research.
The studies covered thirty-one different OC systems, fourteen of which employed Artificial Intelligence (AI). 41% were published from 2020 onward, and 17% were published after the pandemic.
In spite of seeming to offer an effective solution to the increasing workloads and decreasing staff numbers facing healthcare providers globally, it became clear to the researchers that OCs also had some extremely negative potentials.
In some cases, OCs actually exacerbated health inequities and increased inappropriate antibiotic prescriptions.
Outcome
The researchers discovered that OCs decreased staff workload, provided that:
- patients were able to describe their symptoms using free text – as opposed to having to choose a problem from a limited number of categories (via a drop-down menu, for example).
- sufficient resources were allocated during the initial implementation.
- patients used OCs for simple problems.
However, staff workload actually increased if:
- the OCs were not properly integrated with other, existing software or organizational workflows
- patients used OCs to present complex queries
- the OCs demanded that patients describe their queries using multiple-choice questionnaires.
Similarly, health costs decreased when OCs were used for simple queries, and increased when used for complex queries.
Though patients using OCs were more likely to be younger, female native speakers with higher socioeconomic status, OCs also tended to improve access to care for those with mental health conditions, verbal communication difficulties, and barriers to attending in-person appointments.
What all this means is that, although OCs have many positive effects, their use in primary care can also have a negative impact. To avoid the pitfalls, it is essential that OCs improve their design by:
- using the free text format
- incorporating Artificial intelligence
- integrating seamlessly with an organisation’s existing software.
Find out more
The findings of this research formed the foundation of how we designed and developed Patchs, our online consultation software. This is one of the key things that sets us apart from our competitors.
You can read more about Patchs’ features here, and access the full paper at The Journal of Medical Internet Research.