Should we replace telephone with video consultation to improve patient experience? - The Queen Elizabeth Hospital experience

ABSTRACT

Content The COVID-19 pandemic has mandated rapid adoption of a new approach to outpatient appointments for our Haematology patients, the majority of whom are classed as vulnerable and have been required to isolate for prolonged periods following government guidelines. Within a short space of time remote consultation by telephone replaced the traditional face-to-face outpatient consultation for the majority of our patients. There has been appetite in other departments locally and regionally to consider implementation of video consultation as a replacement for telephone consultation and we were asked as a department to consider implementation to enhance patient experience. We were concerned that adoption of video consultation would create barriers for some, and questioned whether our patients would perceive a benefit of video, compared to telephone consultation. We identified and contacted by telephone 36 consecutive patients who had participated in a general haematology telephone consultation during the final two weeks of June 2020. We designed a survey to assess patient satisfaction of the telephone consultation;access to hardware necessary to participate in video consultation;relevant experience of using video calling / conferencing and their preference when offered further remote consultations. Of the 29 patients who consented to be surveyed, 28 were satisfied with the process and quality of their telephone consultation (97%). We found that 6 patients (21%) did not have access to necessary hardware to participate in video consultation and although the rest had the hardware to participate;only 15 patients (52%) had any prior experience of using video calling / conferencing and would feel confident to use similar software. We asked our patients about their level of preference for video consultation in the future. We found that only 5 patients (17%) would prefer to have a video consultation, with the level of preference falling further to only 2 patients (7%) should the software required to participate not be available to install remotely on a home device. Our results show that our patients have a high level of satisfaction using the telephone as a method of remote consultation. We demonstrate a low level of perceived preference for video consultation and highlight both the high level of unfamiliarity using video calling / conferencing software and inability for a significant proportion to access the necessary hardware to participate in video consultation at all. We conclude as a department, that changing to video consultation from telephone consultation as a standard means of remote consultation will not increase patient satisfaction and will focus our attention and resource allocation on other areas of practice to improve our patient's experiences.