The Use of Video Conferencing in a Healthcare Setting
Video conferencing (VC) allows two or more locations to connect to each other by using real-time two-way video and audio transmission. The use of this type of technology has grown rapidly over the past 15 years and its use is now commonplace in the medical setting. The cost of VC has also reduced recently and advanced technical skills are not needed to operate the system. As a backdrop to this, demands on healthcare services continue to grow. In addition, many factors, such as advancing age, physical disability and isolated geographic location, may limit a patient’s access to healthcare. The use of VC and similar technology may help to overcome these problems and could be particularly relevant in patient populations where there is a high level of unmet need. The current social distancing rules and restrictions we all face as a result of Coronavirus is a good example of how this technology can provide great benefit to both patients and doctors and the workplace.
The main advantage of VC is the convenience that it offers. Patients no longer need to travel to a clinic for an in-person appointment, thus saving both time and money. For patients in remote geographical or rural locations, this is particularly relevant, as travel to clinics, particularly by public transport, can be time-consuming, inconvenient and expensive. The technology is also valuable for patients who are not well enough to travel, as they are able to remain at home while still being in contact with a clinician. These factors combine to mean that patients are more likely to attend their online appointments than face-to-face consultations.
The use of VC also has less impact on a patient’s daily activities, leading to less disruption in patient’s lives. Some patients, particularly those with disabilities, mobility issues and mental health issues, can find hospital visits stressful, but this can be greatly reduced by the use of VC. Digital technology has also helped to reduce the power imbalance in the clinician–patient relationship and this appears to be especially important for younger patients: rather than having to fit into the clinical world, the clinician fits into the young person’s world. As a result, recipients consider that they have received care that is more personalised to their own preferences and healthcare needs and this improves the relationship between clinician and patient. Other advantages include the facility to have queries answered quickly, which enables the patient to keep their condition under better control, and the ability to communicate easily with the clinical team between appointments.
From a doctor’s point of view, VC allows patients to be seen faster. This is particularly important in an emergency scenario. Here, VC is more effective than a telephone consultation as it allows the doctor to actually see the patient, understand the situation, and instruct the patient in what to do until the emergency services arrive to take over. The visual aspect means that, if necessary, the doctor can actually demonstrate the required action, rather than just issuing instructions over the telephone which may be unclear or misinterpreted.
VC also appears to be a particularly effective tool for patients with long-term conditions and can be used to review, monitor and plan care. Possible applications include providing patients with information about their condition, supporting them in developing strategies that both promote and maintain independence and supporting the psychological and social needs of both patients and their families by allowing better communication.
To date, VC has been used most frequently in the assessment and treatment of mental health conditions and neurological problems such as dementia. Compared to in-person care, users of VC have reported a positive patient experience, an improvement in outcomes and a decrease in the number of days spent in hospital. One study showed that, using valid and reliable instruments, it is feasible to conduct the clinical assessment needed to diagnose dementia via VC. Furthermore, the results of intellectual assessments were no different to those carried out in-person. It is also a viable method of delivering treatments such as cognitive behavioural therapy and pain coping skills. Cancer patients who participated in a VC-based training programme for the latter reported significant reductions in pain severity, physical symptoms, psychological distress and pain catastrophising after completion of the intervention. All of the patients were satisfied with the feasibility and quality of the program and a huge majority felt that it increased their understanding and developed their coping skills. There also appear to be potential benefits for caregivers too in terms of their quality of life, with users of a VC-based support group rating the experience as a positive one and reporting lower levels of stress compared to those who did not use the group.
The convenience that VC offers, particularly to patients, means that its use could be extremely useful in removing barriers to treatment. The technology has been shown to improve access to health services and to increase patient engagement. In the UK, current policy is to increase the use of digital technology for clinician–patient communication in an effort to improve care models and patients’ experience. While VC will never fully replace in-person consultations, it offers an excellent alternative option, in terms of streamlining services, improving communication between doctor and patient, and savings in time and travel costs.
All of our experts at Medicolegal Partners are currently offering the opportunity of consultations with claimants via a videoconference to avoid delay and disruption to their claims and to continue to support our clients during the Coronavirus restrictions. The experts are very familiar with conducting examinations and consultations in this way and understanding how to put the claimant at ease to get the best from the consultation. If we can assist you with either a personal injury or medical negligence claim for either the defendant or claimant, please contact us on 020 7118 0650 or info@medicolegal-partners.com.
Further reading:
Augestad, K.M., Lindsetmo, R.O. Overcoming Distance: Video-Conferencing as a Clinical and Educational Tool Among Surgeons. World J Surg 2009; 33: 1356–1365. https://doi.org/10.1007/s00268-009-0036-0
Mallow JA, Petitte T, Narsavage G, Barnes E, Theeke E, Mallow BK, et al. The Use of Video Conferencing for Persons with Chronic Conditions: A Systematic Review. E-health Telecommun Syst networks. 2016 Jun;5(2):39–56.