COVID-19 Special report: NHS turns to remote phone and video conferencing solutions

How the move away from face-to-face contact has led to an upsurge in hospital trusts and GP clinics using remote conferencing solutions

Refero is one of a number of technology companies seeing an upturn in interest in its video and telephone conferencing technologies as healthcare operators strive to reduce face-to-face contact between physicians and patients as a result of the coronavirus pandemic

As person-to-person contact in all healthcare settings is limited to just the most-serious cases; technology is coming to the fore as part of the battle to keep services ticking over.

For example, telephone and video conferencing solutions are being utilised across the country, linking patients and medical professionals and enabling consultations to continue, particularly in non-acute primary health and outpatient settings.

To help with this effort, Refero announced earlier this month that it was offering free use of its video conferencing platform to NHS trusts, pharmacies, primary care clinics, and other local and national bodies during the COVID-19 outbreak.

Underpinned by Cisco Webex, the solution enables clinicians to speak to patients remotely via a mobile phone or desktop device.

Its medical director and clinical safety officer, Dr Ian Jackson, explains: “Video can play a vital role during the coronavirus outbreak, across the healthcare sector.

The use of both telephone and video consulting allows clinical staff to help their colleagues while maintaining their own safety – either by consulting from home or from an appropriate office space

“In primary care, for example, large numbers of clinical staff are being recruited back from retirement, and these people will be from an older age group, putting many of them in the at-risk group for COVID-19.

Managing demand

“There will also be others currently working who have risk factors and would otherwise be required to self isolate.

“Primary care operators are trying to reduce the footfall to surgeries and so are using telephone and video consulting to manage as many patients as possible, remotely.

“The use of both telephone and video consulting allows clinical staff to help their colleagues while maintaining their own safety – either by consulting from home or from an appropriate office space.

“These methods are for both patients who might have COVID-19, and those who have the normal clinical issues seen by GPs.

“And secondary care has postponed many elective clinics and is also trying to reduce footfall into hospital.

“Again, there are patients who can be managed and supported at home and teleconsultation adds to hospitals’ ability to manage these.

“Similar to primary care, there are also clinical staff in hospitals who are high risk and so the use of them to support people remotely enables their skills to be utilised safely.”

Refero has seen a huge upturn in requests for its solutions in recent weeks, with a number of trusts and GP practices trialling video conferencing for the first time.

“Since we announced free usage of our teleconsultation platform to public-sector bodies to support the UK response to COVID-19, we’ve seen an unprecedented demand – and we’ve issued over 1,000 new licences and hundreds of GP surgeries have been in contact,” said Dr Jackson.

Both Refero’s telephone and video consultation technologies are NHS approved and more secure and more reliable than traditional conferencing solutions such as Skype.

“GPs use these solutions to talk to patients, other care professionals, and each other,” said Dr Jackson.

“We also provide a messaging function that can be used between patients, clinicians and practices – a safer alternative to consumer technology like WhatsApp.

There are now much-safer options for videoconferencing than public platforms such as WhatsApp

Making the right choice

“What’s more, we’ve recently added a messaging platform, or webchat function, where patients can contact their practices without emailing or calling.

“Using the webchat, patients can make a number of enquiries, from booking appointments to checking symptoms.”

Another company targeting primary care is X-on, which has developed the GP@Home service, enabling doctors to provide patients with the same level of care from their own home as they would from their surgery through phone and video technology.

Digital telephony is enabling hundreds of practices to put in an equitable, futureproof digital front door to primary care

It has also launched Video Connect, which enables GPs to switch from phone to video consultation in a single click.

The product suite integrates with major clinical systems such as EMIS and TPP’s SystmOne, which are used by doctors’ surgeries to hold patient information.

Being able to access this directly while on a phone call helps save time for GPs and surgery staff.

Dr Barry Sullman, Newham GP and Clinical Commissioning Group clinical lead, said: “This is a game changing piece of software that has allowed my practice to perform normally through the COVID-19 crisis.

“Video call quality is extremely high and supports remote diagnosis.

“By being able to diagnose a diverse range of conditions, such as skin rashes reliably, and being able to assess the clinical condition of a patient confidently through high-quality video, face-to-face appointments at the surgery are saved, which, in turn, increases the access capacity of the surgery.

“The technology also records the phone or video call and links it to the clinical record, so that doctors can refer back to the information if required.”

X-on managing director, Paul Bensley, added: “The digital transformation of your local family doctor is taking place at an incredible pace and scale.

“It is vital that we leave no-one behind, and so it is essential that we make sure that the phone can meet the current needs of patients and professionals, but also those for the long-term as they make the move to ‘digital-first’ primary care.

“Digital telephony is enabling hundreds of practices to put in an equitable, futureproof digital front door to primary care.”

Offering advice to trusts and clinics thinking of using telephone and video conferencing Dr Jackson advises:

  • Choosing a system that does not require software patches to be downloaded
  • Opting for a system that will work with current technology – a portal/cloud based solution
  • Choosing a system that emulates current clinical workflow – so clinicians can see a list of patients for their clinic and see who is logged in and waiting to be seen

“Most importantly, though,” he says, “is choosing a supplier which has commitment and evidence that they can integrate into your electronic patient record or patient administration system.

“You do not want staff having to enter patient data twice on two separate systems to organise a single appointment.”

www.doctorinthehouse.net has also launched a recruitment drive for registered doctors, specialist nurses, pharmacists and physiotherapists for its free healthcare service which will link worried patients with healthcare professionals at home or in other remote settings.

The website launched on 31 March and has a goal of supplying 100,000 online assessments and 25,000 appointments over the coming weeks.

Visionable is another company seeing increased demand for its remote conferencing solution.

Chief executive, Alan Lowe, said: “The spread and outbreak of COVID-19 in the UK highlights a need for alternative ways in which patients and clinicians communicate and provide consultations.

“Technologies such as remote conferencing and video collaboration technology can bring many benefits in helping facilitate patient consultations more efficiently, as well as helping to contain the virus and ensuring emergency departments have the resources to help the most vulnerable.”

But, he warned: “This shouldn’t be a knee-jerk reaction to help manage an outbreak. Instead there is a long-term need to rethink how we deliver healthcare overall with the current resources we have and implement technology that works with the complexities of the NHS, at the same time.”

In the long term

And Vidyo, a leader in embedded video technology, has announced a new programme which will enable telemedicine clients to dramatically upscale their use of this innovative software in light of the pandemic.

The programme allows for new or existing clients to increase the time or bandwidth they use by multiples of up to 10 to meet needs as they arise and it is available as an on-premise, hybrid, or cloud-based solution.

X-on has launched the GP@Home service, enabling doctors to provide patients with the same level of care from their own home as they would from their surgery through phone and video conferencing technology

General manager, Enghouse Vidyo, said: “In recent weeks, many organisations have exponentially increased their demand for video communication platforms and we have put a unique programme in place that provides them with increased access to our technology to combat the disruptions many are experiencing.

But, he warned: “This shouldn’t be a knee-jerk reaction to help manage an outbreak. Instead there is a long-term need to rethink how we deliver healthcare overall with the current resources we have and implement technology that works with the complexities of the NHS

“Specifically, the Vidyo Telehealth solution enables clinics and hospitals to protect frontline staff and patients by supporting self isolation and quarantine scenarios, and ensures clinicians, nurses, and physicians can provide remote diagnoses and treatments, often with existing technology.”

He added: “While we hope the impact of the COVID-19 outbreak will be short lived; the potential strain on health systems could be severe in the longer term.

“We know many health organisations are evaluating how best to deliver patient care under difficult circumstances over potentially-extended periods of time.

“And, as health systems prepare for the next few months, solutions like ours are here to support them so they can effectively integrate various forms of telehealth into their patient management strategies.”

But, once a trust or other organisation has chosen its preferred conferencing provider and put the software into action, there are additional considerations.

Among these is the need to be able to action outcomes, whether that be scheduling further treatment or future consultations.

And Intouch with Health is helping with this.

Its award-winning Intouch Platform for patient flow management is used by more than 110 hospitals worldwide to manage more than 30 million appointments a year.

And speaking to BBH this week, chief executive, Mike Sanders, said the company was now leading on the use of virtual clinics, but with a difference as the software is designed to integrate fully with the Intouch Platform.

He explains: “The problem is how do we marry up the patient and the doctor and collate the relevant data from these remote consultations and put that into the necessary systems. That’s the challenge hospitals and other providers will face next.”

Intouch With health enables healthcare operators to link videoconferencing technology with patient records securely

End-to-end care

He adds: “Imagine you have a patient who has had a standard outpatient appointment in their diary for several months and they cannot now attend the hospital because of the restrictions caused by coronavirus.

“The first problem is the hospital is going to have to create that remote appointment and invite the patient to attend, and there’s often no vehicle in place to do this easily

“Let’s imagine they get around that and the patient gets a message. They will log in on the specific day and wait for the appointment, but they do not know if the clinic is running late or the doctor is off sick. There is no one managing the appointment and no way of knowing the patient is the right person.

“Next they might eventually speak to the doctor, but how do they record what they need to do next and make sure it is actioned?

“When a doctor physically sees a patient they have access to a number of systems, which they might not have when working remotely.

“Using our virtual systems we are proposing a fresh approach to this growing method of communication.”

Benefits of the Intouch Virtual Clinics include super-quick deployment and scalability.

But also key are patient authentication, integration into most existing PAS systems, and a virtual waiting room, signaling to the patient any information on the appointment.

And, once any decision has been taken, the platform records this and can incorporate it into whatever host system the organisation is using.

Most importantly is choosing a supplier which has commitment and evidence that they can integrate into your electronic patient record or patient administration system, as well as supporting the virtual consultation solution each individual trust has chosen

Sanders said: “We understand that resources are being stretched by the outbreak of COVID-19 and deploying a new solution in the current environment will be challenging.

“As a result, we have designed Virtual Clinics to be deployed in streamlined phases, in order to enable a swift realisation of some key benefits, while maintaining a realistic approach to the practicalities of the current circumstances.”

Advising trusts looking to implement video conferencing, he said: “Most importantly is choosing a supplier which has commitment and evidence that they can integrate into your electronic patient record or patient administration system, as well as supporting the virtual consultation solution each individual trust has chosen.

“Intouch has partnerships currently in place with Visonable, Healthcare Communications, Modality Systems, and Dr Doctor and will soon be working with Attend Anywhere, so can support a wide range of applications.”

Featured Companies

Intouch With Health (more information, website)

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