Virtual patient consultation: Stirling Community Hospital, Stirling and Queen Elizabeth University Hospital, Glasgow

A virtual clinic (asynchronous via smart device or home computer) was deployed in which return patients can digitally submit a progress report (including photographs of their condition) for assessment by a clinician.

Situation

Insufficient service capacity to cope with patient demand.

Aspiration

Patients wanting a return appointment are emailed an appointment and invitation to upload images and submit information about their progress and outstanding concerns via a purpose-built application, rather than a conventional face-to-face appointment.

The intention is that this virtual consultation will not only offer added convenience to patients, but also result in shorter consultations, allowing for increased service capacity within direct clinical care sessions.

Solution and impact

NHS Forth Valley and Greater Glasgow and Clyde Health Boards worked with small business Storm –ID, as part of a Small Business Research Initiative (SBRI), to develop a purpose-built application to integrate with NHS booking systems and electronic patient records to achieve an efficient alternative to conventional face-to-face return consultations.

This virtual clinic (asynchronous via smart device or home computer) allowed return patients to digitally submit a progress report (including photos of their condition) for assessment by a clinician.

Functionality

They are given a four-day appointment window for upload and a clinician responds, typically within a week. There is a facility for requesting additional information, but the system is not intended for use as an open channel, rather to function as a patient alternative to requiring a return visit to hospital, saving them time and reducing their carbon footprint.

Capabilities

• Virtual consultation
• Individuals share personal health data and images securely with their GP or other trusted health professionals
• Available on G-Cloud

Scope

The ability to send photographs and personal health data securely from patient to clinician.

Key figures/quotes 

Over the course of six months across both health boards, some 55 patients registered to take part in the digital appointment system pilot. Of these, 43 completed a virtual consultation and nine did not attend. Three appointments were cancelled and one patient did not require a follow-up.

Most patients (96%) had inflammatory dermatoses, with psoriasis and eczema being most common. Following the initial round of virtual consultations, 41 patients required a further appointment, with 26 offered a further virtual consultation. All non-attendees were offered subsequent face-to-face consultations.

Data recorded by the digital platform suggests the median time taken for all healthcare professionals to complete a consultation was 5 minutes 28 seconds.

Feedback was obtained from participating patients. Across both health boards, patient satisfaction was 84%. However, only 18% of patients in one health board would prefer a virtual consultation, versus 87% of patients in the other health board. Reasons for this discrepancy are uncertain but may be related to differing patient groups, diagnoses and demographics.

The total distance theoretically travelled for equivalent face-to-face consultations was 888km, resulting in a total car CO2 emission saving of 107.6kg CO2. The digital appointment system pilot has provided an alternative healthcare interface for dermatology patients with improvements in efficiency, patient experience and environmental impact.

Patients continue to be invited to use the asynchronous virtual appointment system to permit more detailed assessment of its place in the service.

Key contact

Stirling Community Hospital, Stirling, Dr Colin Morton

colin.morton@nhs.scot