Before introducing an alternative to a face-to-face consultation then you may wish to think how you are going to use it:

Triage and/or initial consultation

Many practices already use the telephone to triage patients and some commercial companies also offer telephone or internet support for this purpose. Another use of an alternative to a face-to-face consultation is to conduct an initial assessment of the patient before conducting a face-to-face consultation. Using an alternative to a face-to-face consultation for an initial assessment is not dissimilar to triage and could be done via the telephone, internet video such as Skype or electronically and, similar to triage, there are software companies that support practice use for this purpose. We have further information of the differing types of an alternative to a face-to-face consultation here.

However, there are a number of things to consider:

What is the benefit of using an alternative to a face-to-face consultation for follow-up?

There is often an assumption that the use of an alternative to a face-to-face consultation is more efficient for both the patient and the practitioner but it is worth thinking about whether it is quicker than seeing the patient face-to-face? Or will it result in a shorter face-to-face consultation following the initial assessment? Bear in mind that even if telephone consultations or e-consultations are shorter, if a proportion of them need to be followed up by a face to face consultation as well they may not actually save time overall. Previous research suggests that telephone triage may change the nature of the work but not necessarily save time. 

Is the system integrated to store details of the consultation or will it take extra time to incorporate the information into the patient’s records? More information can be found here. 

How will you store the details of this consultation and do you have a clear system for recording that the consultation was conducted via an alternative to a face-to-face consultation? This will also enable you to audit the usage and outcomes of the use of an alternative to a face-to-face consultation for triage and whether it has achieved your objectives.

If you are using an alternative to a face-to-face consultation to triage the patient do you have a clear plan for what to do next? If you need to see the patient face-to-face consultation how will you arrange this?

As with all communication with patients, it is important to consider safety and security when using an alternative to a face-to-face consultation so think carefully about information governance and how you would ensure clinical governance?

You need to think about what level of information is required to make a clinical decision and therefore which is the best type of alternative to a face-to-face consultation to assess a patient’s clinical condition? More information can be found here. It is also worth agreeing rules of engagement and protocolising the assessment.

Follow-up consultation

One of the favoured uses of an alternative to a face-to-face consultation is for follow-up of patients. This may be to monitor new medication usage, to ensure patients are engaged in the own health care, or to review patients with complex or mental health needs for example. It also used for ‘safety netting’ checks (e.g. that symptoms have improved and didn’t require further investigation). Suitable types of alternative to a face-to-face consultation include the telephone, SMS texting, email or internet video such as Skype. Think carefully about which approach is most likely to work – the most simple might be best. We have further information of the differing types of an alternative to a face-to-face consultation here.

There are a number of things we suggest you consider if you are thinking about using an alternative to a face-to-face consultation for follow-up:

What is the benefit of using an alternative to a face-to-face consultation for follow-up.

There is often an assumption that the use of an alternative to a face-to-face consultation is more efficient for both the patient and the practitioner but it is worth thinking about whether it is quicker than seeing the patient face-to-face? 

Is the system integrated to store details of the consultation or will it take extra time to incorporate the information into the patient’s records? More information can be found here. 

How will you store the details of this consultation and do you have a clear system for recording that the consultation was conducted via an alternative to a face-to-face consultation? This will also enable you to audit the usage and outcomes of the use of an alternative to a face-to-face consultation for triage and whether it has achieved your objectives.

As with all communication with patients, it is important to consider safety and security when using an alternative to a face-to-face consultation so think carefully about information governance and how you would ensure clinical governance?

You need to think about what level of information is required to make a clinical decision and therefore which is the best type of alternative to a face-to-face consultation to assess a patient’s clinical condition? More information can be found here. It is also worth agreeing rules of engagement and protocolising the assessment.

Administrative purposes

Some practices and practitioners use an alternative to a face-to-face consultation to share information with their patients. This is often done using the telephone, SMS text messaging or via email but other modes could also be used. We have further information of the differing types of an alternative to a face-to-face consultation here.

Alternatives to a face-to-face consultation can be used to share results, offer guidance related to test results, coordinate complex care packages etc. Although this may seem a simple exchange of information there are still things we think you should consider.

How will you store the details of this consultation and do you have a clear system for recording that the consultation was conducted via an alternative to a face-to-face consultation? This will also enable you to audit the usage and outcomes of the use of an alternative to a face-to-face consultation for triage and whether it has achieved your objectives.

As with all communication with patients, it is important to consider safety and security when using an alternative to a face-to-face consultation so think carefully about information governance and how you would ensure clinical governance? 

Supporting Patient Self-Management

One use of an alternative to a face-to-face consultation is for providing patient guidance and information and to supply health education material. Although the telephone can be used for this, a method that ensures that the patient can store, print and/or refer back to the information is preferable. We have further information of the differing types of an alternative to a face-to-face consultation here.

How will you store the details of this consultation and do you have a clear system for recording that the consultation was conducted via an alternative to a face-to-face consultation? This will also enable you to audit the usage and outcomes of the use of an alternative to a face-to-face consultation for triage and whether it has achieved your objectives.

As with all communication with patients, it is important to consider safety and security when using an alternative to a face-to-face consultation so think carefully about information governance and how you would ensure clinical governance?