Feasibility, acceptability, and content of video consulting in primary care

Background Government leaders have called for increased use of video-consulting (VC) in clinical practice. Although provided by the private sector, it is rarely used in NHS primary care. It is unclear how VC differs from telephone (TC) or face-to-face consulting (FTFC), or how useful clinicians and patients find it. Aim To assess the feasibility and acceptability to patients and clinicians of running a VC service in general practice and to explore differences in duration and content compared with FTFC and TC. Method VC equipment was installed in six GP practices and 13 clinicians were asked to identify patients who required follow-up consultations and who had access to a smart-device or laptop. They were offered the choice of a VC, TC, or FTFC. Consultations were audiorecorded and content analysed using the RIAS system. Patient and clinician views were obtained by questionnaires and interviews. Results One hundred and forty-seven patients were recruited (FTFC = 51, TC = 51, VC = 45). VC users were generally younger. VCs and TCs were shorter (mean VC 5.9, TC 5.6, FTFCs 9.6 minutes), addressed fewer problems (mean VC 1.5, TC 1.7, FTFC 2.0) and had less information exchange than FTFCs. Technical problems were common, but VCs offered significant advantages over TC in terms of non-verbal communication. VC was considered particularly useful to working and housebound people and for those with mental health problems. Conclusion VC has distinct advantages over TC. When integrated into current systems VC will provide an alternative to FTFC. Where formal physical examination is not required (discussing test results, medication changes and mental health) it offers considerable time savings to patients.