Professor Moyez Jiwa, Chair of Health Innovation in the Faculty of Health Sciences at Curtin University
Wide-ranging investment is needed to increase the number of general practitioners providing video consultations as part of their regular practice, according to Curtin University researchers involved in a study published in the Journal of Medical Internet Research.
The 12-week internet-based project explored the attitudes of Australian doctors toward online video consultation by using six video-recorded actor/patient scenarios depicting different acute and chronic problems.
Approximately one-third of participants were positive about video consultations, another third were ambivalent, and the remaining third were against them, the study found.
Doctors preferred to do a follow up consultation than treat an acute episode online and overall, positive GPs were likely to be young and working in larger practices, it found.
Project lead Professor Moyez Jiwa said the use of online technology was a long way from being routine practice in Australia even though it had the ability to vastly improve access to health care for people living outside of metropolitan areas.
“More investment is needed and we need to recognise that using this technology could improve access to patients across Australia,” said Prof Jiwa, a practicing GP and Chair of Health Innovation in the Faculty of Health Sciences at Curtin.
The investment could come from governments, tech companies, or anybody interested in improving access to healthcare, Prof Jiwa said.
He suggested greater access to the internet, funding for equipment such as webcams and headsets, training medical school students, and encouraging doctors to use the technology as a means of connecting to their patients, are needed.
“We GPs need to roll up our sleeves and work out how we can make this a reality for our patients and especially for those patients in rural areas,” Prof Jiwa said.
Another major barrier to wider take up of GP video consultation is the lack of a Medicare item number for doctors to use such as the one available for specialist video consultations, Prof Jiwa said.
However, doctors should consider the other potential benefits, he said.
“You can create a lot of good will with client satisfaction.”
Video Vignette Study
The real-life patient scenarios in the videos included a 48-year-old male smoker who had run out of his diabetes medication; a 60-year-old female librarian with a cough and sore throat; and a 49-year-old male patient having a heart attack.
Information on medical, family and drug history was given to the doctors before they watched the video.
“We wanted to know using this behaviour if GPs were comfortable to continue with the consultation in these circumstances. But actually there was a fair amount of reticence from doctors to do that,” Prof Jiwa said.
“We found they are happy to do a follow up consultation but when it comes to acute need, they don’t want to do it.”
Based on the results, the researchers recommend video technology deployment focus on follow-up consultations because medical emergencies are unlikely to be offered access to a GP by video.
Study facts and findings
- Of 102 GPs invited to participate in the study, 47 took part in video consultations.
- Doctors were asked to offer a differential diagnosis of the six patients in the videos, and complete a survey documenting their views on the value of a video consultation.
- GPs who took part were younger than the average Australian GP and were more likely to be working in a larger practice.
- Most participants, from 72 per cent to 100, agreed on the differential diagnosis in all video scenarios.
- 91 per cent of participants opposed conducting a video consultation for the patient with heart attack symptoms.
- The most common reason for not conducting a video consultation was the doctor’s inability to examine the patient.
View the paper here: Video Consultation Use by Australian General Practitioners: Video Vignette Study