In response to coronavirus (COVID-19), video consultations are being introduced rapidly, prompting a variety of questions for improvers: Where might this lead us? What should we be doing now to give the best chance of delivering sustainable, high-quality care across all the settings that could benefit?
In March we heard from Professor Trish Greenhalgh, whose research established the importance of looking beyond the technology alone, with success depending on approaching the shift to video consultations as a complex service change.
We ran a second practical, online event on Thursday 21 May designed to help those tasked with introducing video consultations to learn from leading-edge practice and connect with others on the same journey across the UK and Ireland.
This interactive online event:
- Identified the many different settings in which video consultations are being used.
- Shared practical learning about how to implement video consultations in a way that will enable sustainable, high-quality care, accessible to all.
- Offered a chance to ask questions and connect with others working on this.
We heard from three pioneering Q members in this field who talked about how to maximise video consultations in different settings and took questions from attendees. You can watch their presentations and the Q&A below as well as browse a selection of resources.
Dr Shanti Vijayaraghavan
Dr Shanti Vijayaraghavan has been leading the introduction of video in outpatients over the past 10 years, linked to wider diabetes service design. Shanti is the clinical lead for a Health Foundation funded unit at Barts Health supporting hospitals to introduce video consultations.
- Keep it simple: the Attend Anywhere platform works for many because it creates a virtual waiting room and mimics the outpatient process.
- Be flexible: you can’t do everything with video and some people do have to be seen face to face.
- Address the whole patient pathway, otherwise, the process is cumbersome.
- Build-in time to understand and quantify benefits: don’t expect to see this within six months.
- There have been benefits on the relationships between clinician and patient relationships, including reducing DNA rates.
- Visit the Barts website for more resources.
Professor Alka Ahuja
Professor Alka Ahuja led a Health Foundation-funded project introducing video consultations in CAHMS in Aneurin Bevan Health Board. Alka is now the National Clinical Lead for Technology Enabled Healthcare in Wales, leading the rapid roll-out of video consulting across sectors in Wales.
- There are real benefits of an embedded evaluation.
- Build partnerships and focus to address inequalities among vulnerable and isolated groups.
- Group settings bring different challenges for video consultations.
Clare Morrison is leading the rollout of the Near Me video consulting service. Co-designed with patients, it was initially used in pharmacy as an Innovating for Improvement project, then expanded to outpatients and then extended further with help from Q Exchange. Near Me is now being used across health and social care settings in Scotland.
- The QI approach to video consultations including embedding co-design and systems thinking to inform iterative improvement in design and testing laid strong foundations for future scaling.
- Three components to rolling it out rapidly: technical, processes and training.
- Sustaining this change once COVID-19 passes. The case for continuing video consultations includes: continued physical distancing; convenience for patients; environmental impact.
- Visit the TEC website for more resources.
Click on each of the questions below to reveal and play the video answer.
What measures should be put in place to ensure good video quality?
What are the issues with video inequality and how can they be addressed?
When do I need video, and when will the telephone suffice?
A selection of resources mentioned by the presenters during the webinar.
Slides from Maximising video consultations webinar
Toolkit for implementing video consultations in psychiatry services
Comparing face to face and video consultations
- An Australian article: Doctor, Can You See My Squats? Understanding Bodily Communication in Video Consultations for Physiotherapy
- A publication resulting from the work at Barts: Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services: Linguistic Ethnographic Study of Video-Mediated Interaction