Audit of uptake and user satisfaction of Attend Anywhere video consultations in Haematology outpatients QHB

Abstract

Introduction: Telemedicine clinics have historically been unpopular due to a range of clinical barriers. In March 2020 WHO declared COVID-19 as a global pandemic. This was a paradigm shift in the world of clinical medicine and initiated a rapid transition into virtual clinics as a strategy to minimise face to face (FtF) visits and limit viral spread. At Queen's Hospital Burton, Haematology patients are among the most vulnerable given the immunosuppressive effects of their conditions and treatments. Our outpatient work involves assessment of patients receiving chemotherapy which can be associated with fatal complications. It was felt that telephone consultations may be suboptimal for these assessments, and with the unclear duration of the pandemic, there has been an initiative to recruit more patients to video clinics. The Attend Anywhere' (AA) video consultation system was implemented in June. This drastically reduced the need for FtF visits to reduce infection risks. Objective(s): The primary objective of this audit was to evaluate the uptake of AA over time. We also used the data to assess whether particular patient groups were more likely to engage in video consultations. A concurrent survey was organised in order to assess patient satisfaction with AA. Method(s): A quantitative analysis of data from a consultant-led clinic was obtained from June to December 2020. The clinic letters were examined for patient demographics and to assess the type of consultation undertaken. A separate mixed-method survey of 29 patients was conducted as a part of our audit. Result(s): The results revealed a trend towards video consultations over telephone consultations during the period of time analysed, although the volume of patients undertaking telephone consultations remained higher overall. Despite the proportion of AA consultations being higher in the lower age groups, it remained popular in older age groups. The patient survey showed a high rate of patient satisfaction. A lot of the patients considered AA to be an excellent alternative to FtF and cited other significant benefits in saving time, reducing effort and minimising risk. Video consultations also felt more personal than over the phone and patients felt all their concerns were addressed with high standards of patient care. Conclusion(s): The audit showed that AA consultations are popular with patients in all demographics. They are felt to be safer than telephone consultations. As many appointments are still conducted via telephone, there is further work to be done to encourage more patients onto AA. A number of barriers to AA were noted. There were initially difficulties with staff accessing the software. There were a number of cases where patients either had no computer access, or struggled with the software. Improving communication and information booklets helped to overcome this. The older ages may have had higher representation if they had easier access to a computer, or if the software had been more straightforward. It is felt that a dedicated mobile application may provide a more user friendly system for patients. Whilst the added value of physical examination is missing in AA consultations, especially in new clinic patients, this has been a novel solution to challenges the pandemic has brought. It has helped to ensure continuity and safety in patient care.