“Many GPs and most Patients will have little previous experience of consulting remotely by video link or smartphone. Using an unfamiliar format at a time of high workload and high anxiety increases the risk of making errors of judgement, but this risk can be reduced by paying attention to some basic principles”
RCGP COVID19 Resources
mHealth Insights
Where’s the video?
It’s incredible that it’s taken the COVID Panicdemic and GPs fearing for their own health for the RCGP to begin taking video consulting seriously but can there be a more obvious missed opportunity to produce a video than the RCGP using what are effectively just powerpoint slides to help GPs use this technology?
Here’s a video of a talk I gave in 2014 which is an useful backgrounder on the opportunity for GPs to safely offer documented video consults:
Surely the RCGP could’ve put a easy to watch/share video like this together for quick distribution to GPs and their teams during this lockdown?
Consulting Patients Vs. talking to complete strangers
The ‘Introducing yourself’ slide really highlights why it’s pretty much a catastrophic failure from the outset if we have highly experienced GPs talking to Patients when there hasn’t been some data shared before hand. I wonder why GPs don’t ask themselves why no other successful service provider in 2020 is doing this as surely when they ring utility companies or even to book a haircut or a plumber they realise that the company is using a ‘Customer Relationship Management’ software to improve business relationships and manage the company’s relationship/interactions with you?
A GP introducing themselves and ‘telling the patient what they would like them to call you’ isn’t only an ineffective use of their but it has the potential to immediately reduce a Patients confidence in the GPs medical knowledge because as we know if a Patient sees you are uncomfortable using technology that children have mastered they may lose confidence in how current your medical knowledge is.
In 2020 the RCGP should be telling GPs to never call Patients they don’t know and can’t immediately and easily confirm whom they are talking to. The use of a clinically validated interactive medical history taking questionnaire by the Patient BEFORE the Doctor calls them allows Patients to not just identify themselves, their needs, what they would like you to call them as well as countless other important questions, but it also ensures that the Patient is better prepared for the consultation and the GP can quickly get past the confidentiality issues and move to much more productively addressing the Patients most important medical needs with their introduction eg. “Hi Dave, I’m Doctor Kavanagh. You’re looking well today (because they can see you and your on-file headshot). Thanks for putting so much effort into completing the medical history questionnaire, reviewing your report, that you’ve already received a copy of, has been of great help to me and clearly it seems the thing I can help you the most with today is your XYZ. Would you agree?”
Pacing cues
This slide is clearly written by a GP who has never used a Video Consultation to effectively communicate with a Patient. The RCGP should be summoning Doctors who have actual first hand experience eg. Dr Amir Hannan, Dr Rupert Bankart, any of the GPs that are already using the Engage Consult Consultation system from Engage Health:
Closing the consultation
This advice from the RCGP has fundamentally overlooked the importance of the Doctor sending a copy of their notes and advice to their Patient. Without this the Patient is going to have to rely on recall or will be encouraged to surreptitiously record the consultation for their own records (which can lead to extensive issues with regard to misinterpretation, privacy, medical negligence claims, etc, etc).
The COVID19 pandemic is an opportunity for the GP profession to transform and offer Patients more than just somewhere they must go to to get help and for GPs to focus on the opportunity to work at the top of their licence.
The best way in our experience to close a consult is by providing a Patient with access to a copy of the medical history information they submitted, a summary of the advice the Doctor gave and links to additional sources of information they might find useful (eg. websites, online videos they can watch, etc, etc) and a means of providing feedback to build in a means by which we can learn from Patients on ways to improve the service.