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Video consultation use by Australian general practitioners: video vignette study.

Jiwa M, Meng X - J. Med. Internet Res. (2013)

Bottom Line: The survey results also suggest that the deployment of video technology will need to focus on follow-up consultations.The process of establishing video consultations as routine practice will need to be endorsed by senior members of the profession and funding organizations.Video consultation techniques will also need to be taught in medical schools.

View Article: PubMed Central - HTML - PubMed

Affiliation: Curtin University, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia. m.jiwa@curtin.edu.au

ABSTRACT

Background: There is unequal access to health care in Australia, particularly for the one-third of the population living in remote and rural areas. Video consultations delivered via the Internet present an opportunity to provide medical services to those who are underserviced, but this is not currently routine practice in Australia. There are advantages and shortcomings to using video consultations for diagnosis, and general practitioners (GPs) have varying opinions regarding their efficacy.

Objective: The aim of this Internet-based study was to explore the attitudes of Australian GPs toward video consultation by using a range of patient scenarios presenting different clinical problems.

Methods: Overall, 102 GPs were invited to view 6 video vignettes featuring patients presenting with acute and chronic illnesses. For each vignette, they were asked to offer a differential diagnosis and to complete a survey based on the theory of planned behavior documenting their views on the value of a video consultation.

Results: A total of 47 GPs participated in the study. The participants were younger than Australian GPs based on national data, and more likely to be working in a larger practice. Most participants (72%-100%) agreed on the differential diagnosis in all video scenarios. Approximately one-third of the study participants were positive about video consultations, one-third were ambivalent, and one-third were against them. In all, 91% opposed conducting a video consultation for the patient with symptoms of an acute myocardial infarction. Inability to examine the patient was most frequently cited as the reason for not conducting a video consultation. Australian GPs who were favorably inclined toward video consultations were more likely to work in larger practices, and were more established GPs, especially in rural areas. The survey results also suggest that the deployment of video technology will need to focus on follow-up consultations.

Conclusions: Patients with minor self-limiting illnesses and those with medical emergencies are unlikely to be offered access to a GP by video. The process of establishing video consultations as routine practice will need to be endorsed by senior members of the profession and funding organizations. Video consultation techniques will also need to be taught in medical schools.

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Related in: MedlinePlus

Video consultation vignette.
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figure1: Video consultation vignette.

Mentions: Participants answered questions after viewing video-recorded monologs by actor-patients. Video scenarios were produced and validated by a team of 6 GPs. Six videos were produced, each featuring an actor-patient presenting a range of clinical problems. Information on medical history, family history, and drug history were offered at the outset of each video. The range of scenarios is consistent with those reported in the GP activity reports [8,13]. Scenarios are described in Table 1. A screenshot from 1 of the videos is shown in Figure 1. The vignettes ranged from a self-limiting minor illness to a life-threatening medical emergency. Participating GPs provided their demographic details and answered questions about their impressions (see Table 2).


Video consultation use by Australian general practitioners: video vignette study.

Jiwa M, Meng X - J. Med. Internet Res. (2013)

Video consultation vignette.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3713911&req=5

figure1: Video consultation vignette.
Mentions: Participants answered questions after viewing video-recorded monologs by actor-patients. Video scenarios were produced and validated by a team of 6 GPs. Six videos were produced, each featuring an actor-patient presenting a range of clinical problems. Information on medical history, family history, and drug history were offered at the outset of each video. The range of scenarios is consistent with those reported in the GP activity reports [8,13]. Scenarios are described in Table 1. A screenshot from 1 of the videos is shown in Figure 1. The vignettes ranged from a self-limiting minor illness to a life-threatening medical emergency. Participating GPs provided their demographic details and answered questions about their impressions (see Table 2).

Bottom Line: The survey results also suggest that the deployment of video technology will need to focus on follow-up consultations.The process of establishing video consultations as routine practice will need to be endorsed by senior members of the profession and funding organizations.Video consultation techniques will also need to be taught in medical schools.

View Article: PubMed Central - HTML - PubMed

Affiliation: Curtin University, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia. m.jiwa@curtin.edu.au

ABSTRACT

Background: There is unequal access to health care in Australia, particularly for the one-third of the population living in remote and rural areas. Video consultations delivered via the Internet present an opportunity to provide medical services to those who are underserviced, but this is not currently routine practice in Australia. There are advantages and shortcomings to using video consultations for diagnosis, and general practitioners (GPs) have varying opinions regarding their efficacy.

Objective: The aim of this Internet-based study was to explore the attitudes of Australian GPs toward video consultation by using a range of patient scenarios presenting different clinical problems.

Methods: Overall, 102 GPs were invited to view 6 video vignettes featuring patients presenting with acute and chronic illnesses. For each vignette, they were asked to offer a differential diagnosis and to complete a survey based on the theory of planned behavior documenting their views on the value of a video consultation.

Results: A total of 47 GPs participated in the study. The participants were younger than Australian GPs based on national data, and more likely to be working in a larger practice. Most participants (72%-100%) agreed on the differential diagnosis in all video scenarios. Approximately one-third of the study participants were positive about video consultations, one-third were ambivalent, and one-third were against them. In all, 91% opposed conducting a video consultation for the patient with symptoms of an acute myocardial infarction. Inability to examine the patient was most frequently cited as the reason for not conducting a video consultation. Australian GPs who were favorably inclined toward video consultations were more likely to work in larger practices, and were more established GPs, especially in rural areas. The survey results also suggest that the deployment of video technology will need to focus on follow-up consultations.

Conclusions: Patients with minor self-limiting illnesses and those with medical emergencies are unlikely to be offered access to a GP by video. The process of establishing video consultations as routine practice will need to be endorsed by senior members of the profession and funding organizations. Video consultation techniques will also need to be taught in medical schools.

Show MeSH
Related in: MedlinePlus