Saturday, June 22, 2024

Expansion of Asynchronous Consultations in UK Healthcare During COVID-19

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The COVID-19 pandemic accelerated the need for innovative healthcare solutions, prompting Aberdeen Royal Infirmary in Scotland to expand its asynchronous consultation services. Initially implemented in dermatology, the service was extended to gastroenterology and pain management clinics. This expansion aimed to reduce in-person visits and improve patient access to healthcare services.

Study Design and Methods

A comprehensive mixed methods study was conducted to evaluate the implementation and impact of asynchronous consultations. The study gathered perspectives from staff, patients, and the public, utilizing National Health Service (NHS) data to provide a well-rounded view. Focus groups and interviews assessed public readiness and staff experiences, while service use data and patient satisfaction surveys offered quantitative insights.

The study involved three web-based and one face-to-face focus group with 22 participants, alongside 14 staff interviews focusing on service design and delivery. NHS Grampian service use data, a patient satisfaction survey with 66 respondents, and six follow-up patient interviews were analyzed descriptively. Thematic analysis informed by theory was applied to the qualitative data.

Results and Implementation Challenges

Despite initial optimism among staff for a seamless technical transition from dermatology to other specialties, several challenges emerged. Delays in technical integration due to the pandemic, misalignment with existing administrative processes, and project management discontinuities complicated implementation. Nonetheless, the pain management and gastroenterology clinics began offering asynchronous consultations by early 2022.

Between May and September 2022, the clinics provided 1,709 digital appointments, significantly reducing travel by an estimated 44,712 miles. The service’s user demographics mirrored the broader NHS Grampian population, indicating no significant disparity based on area deprivation.

User-Usable Inferences

Key takeaways from the study include:

  • Digital appointments can significantly decrease travel and waiting times for patients.
  • Implementation is smoother when minimal disruption to existing administrative processes occurs.
  • Clear communication and the use of terms like “assessment” instead of “appointment” can improve patient acceptance.
  • Ongoing technical support and varied consultation options are crucial for digital inclusion.

Staff and patient feedback underscored the need for informed choice and flexibility in service offerings. Although the majority were satisfied with digital consultations, continuous improvements in communication and support are essential for wider acceptance.

Overall, the study concluded that asynchronous consultations for pain management and gastroenterology are both viable and acceptable. The findings offer valuable insights for healthcare providers looking to adopt similar innovations, highlighting the importance of preparation, support, and patient education.

Original Article: J Med Internet Res. 2024 Jun 4;26:e48092. doi: 10.2196/48092.

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