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Use and impact of virtual primary care on quality and safety: The public's perspectives during the COVID-19 pandemic

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Title: Use and impact of virtual primary care on quality and safety: The public's perspectives during the COVID-19 pandemic
Authors: Neves, AL
Van Dael, J
O'Brien, N
Flott, K
Ghafur, S
Darzi, A
Mayer, E
Item Type: Journal Article
Abstract: Introduction With the onset of Coronavirus disease (COVID-19), primary care has swiftly transitioned from face-to-face to virtual care, yet it remains largely unknown how this has impacted the quality and safety of care. We aim to evaluate patient use of virtual primary care models during COVID-19, including change in uptake, perceived impact on the quality and safety of care and willingness of future use. Methodology An online cross-sectional survey was administered to the public across the United Kingdom, Sweden, Italy and Germany. McNemar tests were conducted to test pre- and post-pandemic differences in uptake for each technology. One-way analysis of variance was conducted to examine patient experience ratings and perceived impacts on healthcare quality and safety across demographic characteristics. Results Respondents (n = 6326) reported an increased use of telephone consultations ( + 6.3%, p < .001), patient-initiated services ( + 1.5%, n = 98, p < 0.001), video consultations ( + 1.4%, p < .001), remote triage ( + 1.3, p < 0.001) and secure messaging systems ( + 0.9%, p = .019). Experience rates using virtual care technologies were higher for men (2.4  ±  1.0 vs. 2.3  ±  0.9, p < .001), those with higher literacy (2.8  ±  1.0 vs. 2.3  ±  0.9, p < .001), and participants from Germany (2.5  ±  0.9, p < .001). Healthcare timeliness and efficiency were the dimensions most often reported as being positively impacted by virtual technologies (60.2%, n = 2793 and 55.7%, n = 2,401, respectively), followed by effectiveness (46.5%, n = 1802), safety (45.5%, n = 1822), patient-centredness (45.2%, n = 45.2) and equity (42.9%, n = 1726). Interest in future use was highest for telephone consultations (55.9%), patient-initiated digital services (56.1%), secure messaging systems (43.4%), online triage (35.1%), video consultations (37.0%) and chat consultations (30.1%), although significant variation was observed between countries and patient characteristics. Discussion Future work must examine the drivers and determinants of positive experiences using remote care to co-create a supportive environment that ensures equitable adoption and use. Comparative analysis between countries and health systems offers the opportunity for policymakers to learn from best practices internationally.
Issue Date: 22-Dec-2021
Date of Acceptance: 23-Nov-2021
URI: http://hdl.handle.net/10044/1/93818
DOI: 10.1177/1357633X211066235
ISSN: 1357-633X
Publisher: SAGE Publications
Journal / Book Title: Journal of Telemedicine and Telecare
Copyright Statement: © The Author(s) 2021. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Sponsor/Funder: Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
NHS North West London CCG
Funder's Grant Number: RDB04
n/a
RDF01
XXKSARAVANAKUMAR
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Telemedicine
primary care
COVID-19
HEALTH
TELEMEDICINE
TECHNOLOGY
LITERACY
COVID-19
Telemedicine
primary care
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Telemedicine
primary care
COVID-19
HEALTH
TELEMEDICINE
TECHNOLOGY
LITERACY
0806 Information Systems
0903 Biomedical Engineering
1117 Public Health and Health Services
Medical Informatics
Publication Status: Published online
Article Number: ARTN 1357633X211066235
Online Publication Date: 2021-12-22
Appears in Collections:Department of Surgery and Cancer
Institute of Global Health Innovation
Imperial College London COVID-19
School of Public Health



This item is licensed under a Creative Commons License Creative Commons