Could technology transform GP consultations

The way we interact with our general physicians (GPs) could be transformed thanks to a new project exploring whether consultations could viably be conducted via email, text message, telephone or via the internet.

A group of researchers from the Universities of Bristol, Oxford, Edinburgh and Exeter have received funding from the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme to investigate whether there are alternatives to face-to-face consultations that will not only reduce GP workload but also benefit patients.

The research aims to learn lessons about the perceived advantages and disadvantages of alternatives to face-to-face consultations, and why these alternatives have not been used more widely in general practice.

The two-year study, led by Professor Chris Salisbury from the University of Bristol's Centre for Academic Primary Care, will select GP practices with different experiences, including some that make extensive use of alternatives and others which have tried but have failed or had to change their plans.

Professor Salisbury says, ''By focusing on practices which have tried to use alternatives, including some that feel they have done so successfully, we hope to learn how practices have overcome the potential problems, the key factors that made it possible, the benefits they have found and the difficulties they face.

He explains, ''By talking to patients in these practices we can learn more about their views about the pros and cons of alternatives to face-to-face consultations and how these affect the nature of the consultation or the doctor-patient relationship. This research, based on the actual experience of patients and doctors who have used alternatives to face-to-face consultations, offers better insights than earlier research based on the views of people who have never used them.''

One of the reasons the healthcare system has been slow to adopt alternatives to face-to-face consultations is concern from GPs that allowing other forms of contact would substantially increase their workload.

On the other hand, replacing face-to-face consultations with a phone call or email might actually save work. Another concern is that these new forms of contact might benefit some groups of patients more than others, or change the nature of the doctor-patient relationship.

Professor Salisbury adds, ''Our research will address these questions and explore the potential role of different types of consultation method, for different types of problems, different types of patients and in different practice contexts.''

Based on their findings, the researchers will make recommendations to practices and provide resources to help them provide alternatives to face-to-face consultations which are likely to be of most benefit to different groups of patients in different types of areas.