Researchers have called for more evidence to understand the safety and effectiveness of video consultation, and its impact on patient access and GP workload. In a paper published in the Journal of the Royal Society of Medicine, the team from the Department of Primary Care and Public Health at Imperial College London said that while there is evidence that video consulting is acceptable to patients and offers many potential benefits, at least to those of younger age, its safety and efficacy in primary care currently remains largely untested.
Lead author Dr Benedict Hayhoe said: “Despite limited evidence for improving access to primary care, and potential for increased workload through supply induced demand, greater use of digital technology remains a key government priority.”
Of particular concern to the researchers, given continued development of antimicrobial resistance, is the possibility of increased antibiotic prescribing.
The researchers examined the websites of seven private companies providing online video consulting with general practitioners. Four of the seven websites specified that they would prescribe antibiotics, with one appearing to use easy access to antibiotics as a marketing strategy. None of the websites made any mention of the appropriate use of antibiotics or of antibiotic stewardship.
Dr Hayhoe said: “The uncertainty inherent in video consulting, where examination is impossible, might be expected to result in increased antibiotic prescription, due to clinicians feeling a need to ‘play it safe’.” He added: “However, this novel mode of patient access also has potential for patient education, by improving health literacy on infection, antibiotics and antimicrobial resistance, where it is currently lacking.”
The paper highlights possible opportunities for collaboration between NHS and private providers to achieve the government’s aim of increased online access to primary healthcare, but questions the possible impact on primary care and the wider NHS.
Dr Hayhoe said: “Evidence for the impact of alternatives to face-to-face GP consulting on workload and access is limited. While availability of affordable online consultations may reduce pressure on NHS primary care, it may conversely increase pressure through supply induced demand, or through defensive practices.”
The impact of private online video consulting in primary care (DOI: 10.1177/0141076818761383) by Louis Peters, Geva Greenfield, Azeem Majeed and Benedict Hayhoe, will be published the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Thursday 1 March 2018.
The link for the full text version of the paper when published will be: http://journals.sagepub.com/doi/full/10.1177/0141076818761383
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