Perhaps we should first address why would we even want to offer remote consultations? It’s all to do with efficiency and patient choice. Efficiency because of the reduced DNA rate, reduced real estate footprint required, reduced carbon emissions from travelling, reduced car parking space required and reduced risk of infection transfer. Patient choice because of less time out of work, school, or your day in general, and the cost savings on travel and car parking. This is explained further in the 6 drivers of remote consultations article.
Secondly, what is a remote consultation? In a remote consultation, appointments take place between clinicians and patients on the telephone or through the internet, such as using video.
Remote Consultations are conducted in a variety of forms, either by a phone call, or a video call, or sometimes remote consulting software. All have their benefits and drawbacks, but what is the best option for virtual consulting?
In the main, remote consultations are conducted by a phone call, the NHS Benchmarking Network report, accounting to 85-95% of remote consultations. This has been due to the quick and easy set up to initiate, that was so all important when COVID struck, but the NHS are now recommending video calls to be used more where possible, due to the added benefits.
So, should video or phone be used for remote consultations? Let’s compare the two.
Phone Call – Remote Consultations
This is where the patient and clinician discuss the matter using the phoneline.
A phone call is quick and easy to conduct as it is just talking between each other using a smartphone or telephone. These can be done in almost any location. This means that the patient doesn’t need to worry about the location as they would for setting up for video consultations, minimising digital exclusion as the majority would have access to a phone of some kind.
However, with phone calls the clinician only gets one sense from the patient – their speech. Lose body language and other important visual cues that you would otherwise have in a face-to-face or video consultation are not observable. This limits the assessment clinicians can make, hence the introduction of video for remote consultations.
Therefore, phone calls for remote consultations are great for calls that only last 5 to 10 minutes, such as patient follow ups, or for those without access to the internet and digital technology. This is what the Consult virtual consulting pod is designed for, to provide a space for clinicians to pop into for phone consultations.
"There are two key types of remote consulting: telephone and video. Telephone consulting is widespread and is the first-line remote consulting method. However, there are some situations where video calling can offer additional clinical information and a greater presence in a call." (NES, 2020)
Video Call – Remote Consultations
This is a virtual consultation in which video and audio is enabled.
Video calls mean so much more to the patient and clinician as you can see each other, making the consultation much more like a face-to-face consultation. This is critical in picking up non-verbal ques from patients that help clinicians determine the patient’s welfare. It also makes the patient feel like they are being looked after better if they can interact with the consultant.
These are also great in helping to run Virtual Wards, as although regular nurse visits are essential, some days a video call can save the nurse a trip and they can still check in with a patient and see they are okay along with monitoring their test results.
Video calls are great for longer consultations such as first assessments, as an optimised set up ensures both the patient and clinician remain comfortable for the duration. The clinician can also share documents and images via screen share to demonstrate explanations.
Patients' are more willing to use remote video consultations as a regular part of their healthcare. 83% of patients using video consultations and 66% of patients who had undergone a telephone appointment said that they were willing to reutilise, a survey from NHS Providers revealed.
NHS Trusts such as Birmingham Healthcare have installed Consult Plus virtual consultation pods which are set up and designed to conduct video consultations with the best possible user experience for clinicians, as well as patients with increased privacy and confidentiality. As The Royal Wolverhampton NHS Trust found, they provide a quick pressure release on the existing real estate constraints and lack of availability of consultation rooms, allowing more appointments per day to increase outputs and help tackle the waiting list backlog.
Remote vs Face to Face Consultations
You may ask why not use face to face for consultations? Here's some help on weighing up the factors to decide what to do...
There are a number of benefits of remote consultations that apply to whichever method is used:
Enables physical distancing: Remote consultation enables services to continue to be provided without potential exposure to infectious diseases and reduces footfall in NHS premises.
Delivers person centered and convenient care: Remote consultation enables people to attend appointments from the location of their choice. This can reduce travel, minimise time taken off work or school, or reduce the need for carers to support. It also helps vulnerable patients and those living in isolated rural areas.
Addresses environmental imperatives: by reducing travel, remote consultation improves the move towards ‘net zero’ and the carbon footprint of services.
Where possible video is recommended for virtual consultations, however patient choice must be considered, always ask the patient on their preference to ensure they are not digitally excluded.
To discover the best choice of virtual consultation booths for telephone or video calls you can book a demo.