Greater use of remote consultations for non-urgent care has emerged as a potential “silver lining” of the COVID-19 pandemic. But the evidence base for remote consultations is incomplete: how do patients view this change in the way care is delivered? Incisive Health’s recent polling starts to shed light on the answer.
Remote consultations have long been discussed by healthcare leaders as a way to reduce demand for overburdened services. By transferring face-to-face appointments for non-urgent care from physical premises to digital or telephone platforms, health systems can hope to increase the efficiency of services for both clinicians and patients.
During the COVID-19 pandemic, the benefits of remote consultations for social distancing were quickly recognised and acted upon, with whole services shifting to remote consultation models in rapid time. The pandemic seems to have achieved in a few months what health service leaders have been trying to do for years: help premise-based health services to cope by adopting innovative new ways of care delivery.
Whilst this change has been broadly welcomed, our understanding of the impact is limited. How do remote consultations impact on clinicians’ decision making? When is a face-to-face appointment indispensable? How have patients reacted to this change?
Recent polling conducted for Incisive Health across France, Germany, Italy, Spain and the UK starts to answer the last of these questions and suggests that the public is generally supportive of the remote approach. Telephone consultations are now preferred over face-to-face consultations for non-urgent medical advice, selected by 30% of respondents as the most highly rated method in all countries, other than France.
By contrast, only 24% of respondents stated that they would prefer a personal face-to-face appointment, although there is variation. 37% of people in France still prefer to use physical services, higher than any other method.
With benefits to service delivery and emerging public support, remote services are here to stay. But, these have been exceptional times, and the transition to the “new normal” may not be easy. Incisive Health’s polling reveals several lessons which should be kept in mind for longer-term success:
Digital isn’t always best
The past few years have seen an explosion in digital and app-based healthcare services. However, these did not prove as popular as might be expected: 20% of respondents chose an online video appointment as their preferred method, and 15% chose online services/apps. While some policymakers are on a mission to place digital services at the heart of healthcare delivery, we need to recognise that digital solutions won’t work for some patients and in some situations.
One size doesn’t fit all
The desire to use digital services declines with age. Twice as many of those aged 16-34 would prefer to receive non-urgent advice through an online service or app than those aged 55 and over. While telephone consultations seem the most obvious solution for those not raised in the digital age, a range of remote methods, as well as traditional face-to-face appointments, will need be offered to ensure no patients are left behind.
Consultation is key
It will be important for the adoption of remote services, especially digital services, to be done with patients, not to patients. Particular attention should be paid to patients who are more vulnerable, or have more complex needs. We saw a clear correlation between acceptance of digital services and household income across the five countries: 30% of respondents with a household income of £70,000+ would prefer a video consultation, compared to only 17% of those with a household income of £15,000 or less. To ensure that we don’t increase the inequalities these groups already face as we move into the post-COVID world, new ways of working should be built upon robust and meaningful patient engagement.