In June a number of the team involved in the rapid roll out of video-enabled services from Scotland had a virtual meet-up with two of the team members from the Region of South Denmark who have been working on the rapid roll out of video-enabled consultation in Primary Care in response to the COVID-19 pandemic.
The call was a good opportunity to share our experiences to date and learn more from one another about our approaches. It is clear that we have similarities in our respective approaches and also in the challenges we face to make digital solutions a part of routine delivery for citizens. In both countries, we are now also focusing minds on how we can maintain a balance of video and in-person consultation.
Dr Margaret Whoriskey, Head of Technology Enabled Care & Digital Healthcare Innovation, Scottish Government led the discussion, setting out the Scottish digital health and care priorities.
Video-consultation is particularly useful in our response to COVID-19 as it enables physical distancing, delivers person centred and convenient care and facilitates communication between health and care providers.
The Danish contributors focused on the usage of video-consultation in Primary Care. In the Region of South Denmark General Practice settings, the use of video-consultation has been supported since 2014, with approximately 75% of the GPs having the equipment at the time of the COVID-19 lockdown. In Denmark, there has been a focus on spreading the idea, and developing a technical solution for video-consultations for a rather long time, COVID-19 created that urgency which we have also seen in Scotland and triggered the fast development of both regional and a national technical solutions for the GPs. The solutions for video-consultations for GPs include:
• booking client
• sms to video
• My Doctor app
Additional resources in Danish:
The Danish contributors emphasised that this expansion has been set in the context of a dedicated team providing support.
There has been an expansion of video-consulting in primary health care by: GPs, specialist doctors, physiotherapists and chiropractors.
Also matching the Scottish experience, the aim is to maintain the use – both regarding consultations, but also for cooperation – providing supported implementation between sectors and between health care practitioners for a more stable future of video-consultations in primary health care.
The Scottish participants outlined the mix of policy and implementation support for video-consultation which has had a dramatic impact on current uptake. The elements of our 3 stage approach target: Technical set up, Service processes and Individual training.
The experience of developing pathways for priority groups and the inclusion (in pathways) of video consultation alongside e.g. remote monitoring as a routine offering have underpinned this work.
In Scotland the team described how the number of video consultations (Near Me) increased from 300 in week 1 (March 2020) to 14,000 in week 12, with a total of around 100,000 consults held over the 12 week period. Our remit in Scotland is wider than healthcare settings only and we have seen increased use in health and social care and the 3rd sector.
At the time of our call high number of calls using Near Me were being recorded in: General Practice, child & adolescent psychiatry, paediatrics, physiotherapy, community mental health, community nursing, clinical psychology and speech and language therapy.
The Scottish delivery partners for the rapid roll out are: NHS boards, National VC team, NHS National Services Scotland, Healthcare Improvement Scotland, Scottish Access Collaborative, Care Inspectorate and NHS Education for Scotland.
Common themes included:
Aligning with clear service priorities
Learning from previous experience
Building on existing relationships & working in partnership
Multidisciplinary team support
Maintaining momentum – learning from users
In Scotland and Denmark the teams are very aware that we need to improve our understanding about the use of video-consultation and how citizens/patients and staff are responding to and experiencing this way of interacting. In both countries evaluation and monitoring work is also underway.
The link to the survey which is part of the evaluation of the Scottish service is here.
Rachel Bourke, Programme Manager, National Services Scotland
Geraldine Jordan, Portfolio Lead, Healthcare Improvement Scotland
Home & Mobile Health Monitoring Lead, Scottish Government TEC programme/ TEC Programme Manager, NHS Lanarkshire
Anita Lerche, Specialkonsulent, Praksis, Region Syddanmark
Bisjlim Braimi, Projekt medarbejder, Digital Innovation, Region Syddanmark