Video consultations for mental health services reduce missed appointments and improve user experience

Berkshire Healthcare NHS Foundation Trust modernised their approach to consultations without losing the patient-centred approach by offering video consultations between clinicians and service users. These online consultations provide a range of benefits for service users and staff alike, such as flexible appointment times, less travel, reduced missed appointments, improved time efficiencies and a better service user/staff experience.

Situation

Prior to the implementation of the video consultation service, access to mental health services within the Trust was restricted to face-to-face consultations or telephone contact. Clinical benefits can be lost during telephone consultations as body language and other visual cues cannot be recognised. Furthermore, for patients within the stable monitoring phase of care, face-to-face consultations presented a burden on patients over time as they would have to take time off work to travel to appointments at their own cost - increasing ‘did not attends’ (DNAs) and cost of care.

Aspiration

By introducing video consultations, the Trust sought to reduce waiting times, support easier access to mental health services and provide greater flexibility for patients and staff in how appointments were conducted.

Solution and impact

OneConsultation by Modality was chosen as the solution to facilitate virtual consultations as it works with Microsoft Teams and Skype for Business which was the chosen ‘client desktop’ by clinicians. This means that clinicians within the Trust can easily access and start consultations from their Microsoft Teams or Skype systems.

By introducing online consultation tools within community mental health services, the Trust was able to increase clinicians’ flexibility to work from any location and decrease reliance on the availability of Trust venues and rooms in which to conduct appointments. This has directly impacted on service demand and supports clinicians in meeting appointment times more efficiently.

Benefits and outcomes include:

• reduced travel and carbon footprint for both a clinician and patient
• offering patient choice, such as not having to travel and flexibility to have a consultation during their lunch break on a working day
• faster access to services
• reduction in DNA rates for appointments within mental health
• improved time efficiencies within community mental health teams that can be reutilised with other patients

Certain technical requirements are needed prior to implementation:

• Microsoft Office 365 and Teams based infrastructure already deployed to workforce
• to be using, or have a plan to move required staff to, Windows 10
• a staff base comfortable with the use of Microsoft Teams
• appropriate network speed on sites where online consultations would be conducted
• modern browsers deployed to workforce (not Internet Explorer)

Functionality

OneConsultation is a cloud-based service that supports connectivity between clinicians and patients. Based on Microsoft Office 365 technology, it is a fully managed and fully customisable virtual consultation service that leverages existing Microsoft Teams or Skype for Business deployments, while allowing patients to connect from any modern web browser with no requirement for a download, plug-in or unique web link.

Capabilities

• Video conferencing
• Group video conferencing (multiple clinicians and patients)
• Virtual lobby for patients to wait for the clinician to ‘arrive’
• No confidential information is stored on the application
• Clinicians virtual consultations can be joined via Microsoft Teams or Skype for Business
• Integrates with existing scheduling tools and processes
• Comprehensive reporting and analytics allow for a detailed view of all calls
• Consultations can be recorded by clinicians for future analysis or assessments

Scope

It can be used in an office and home setting to facilitate consultations where face-to-face is not possible.

Key learning points

• Planning and preparing: the project team built on pre-existing information and learning gathered with the implementation and use of Microsoft Teams and used this to inform their requirements for the online consultation software
• Assessing suppliers and procurement: user requirements are critical, but it is key that they are kept simple and focused
• Project team set-up: OneConsultation is reliant on Azure Active Directory (Windows login) accounts being built and exchange centre managing users. It would have been difficult to keep up with the project needs without an IT resource prioritising this work when requested
• Project set-up: consider early which sites and services may be in and out of scope
• Implementation: it was established early in the project that the key learning would be to test devices, internet speed, browser, operating system and general infrastructure which would support online consultations. This would help the project team deliver advice on what devices and which locations services could offer online consultations to patients and what devices and infrastructure patients should be using

Key figures/quotes

In the last 12 months of using OneConsultation the Trust has completed over 90,000 successful video consultations.

Find out more

Read more about the Global Digital Exemplar (GDE) blueprint (requires login)

Key contact

Dr Guy Northover, consultant child and adolescent psychiatrist, lead clinical director, chief clinical information officer, GIRFT national clinical lead CYPMH

Guy.northover@berkshire.nhs.uk