Innovation in information technology in healthcare is revolutionary for clinicians and patients alike, writes Dr. Claudine Kearney, (Senior Lecturer and Programme Director), RCSI Graduate School of Healthcare Management
As patients become more technologically well informed, there is greater opportunity for the utilization of more novel technologies. “The increase in internet accessibility among the population with smartphones, tablets and other electronic devices has opened new ways for consultation between clinicians and patients” (Kearney, 2022: 158). This facilitates virtual consultation or more basic telephone consultations with patients in their own home or private setting without having long commutes and waiting times attending the hospital or medical clinic (Kearney, 2022).
The more advanced evolving healthcare applications provide greater flexibility on when and how clinicians and patients engage with each other. For the purpose of this article, the focus is on basic telephone consultations and the importance of recognising the challenges and implications of such telephone consultations in terms of consistency, quality and safety of healthcare. Furthermore, the impact of telephone consultations on patients’ must be front and centre to the lead consultant and their team.
TELEPHONE CONSULTATIONS: CHALLENGES AND LIMITATIONS
Since Covid-19 telephone consultations from some hospital consultant teams are still used as a way to address patient needs and avoid long commutes and waiting times in hospital settings, however they have some significant challenges and limitations which consultants need to address. Telephone consultations require proper training and development for each member of the consultants’ team who engages in such appointments with patients. There must be consistency among team clinicians undertaking each consultation with every patient. Any clinician who has not previously met the respective patient face-to-face in clinic and does not know the patient or their medical history should not carry out a telephone consultation,as this could lead to conflicting medical advice from clinicians who are not fully aware of the patients’ medical history. Effective leadership by the respective consultant will ensure each telephone consultation is undertaken with the utmost professionalism, accurate, consistent, timely and complete information communicated with empathy, compassion and humanity.
Appropriate time must be allocated for each consultation, with two-way communication so patients’ questions are clearly addressed. Furthermore, the clinician must have an in-depth knowledge and undertake a comprehensive review of each patient’s diagnosis and treatment plan, and thoroughly read the patient’s file in advance of each consultation. All appointments must be scheduled well in advance of the scheduled call, clearly specifying the date, time and the full name of the clinician that will be making the call.
Telephone consultations should only be used as an option to support face-to-face and telemedicine is not a replacement. Telephone consultations have many challenges in terms of for example, poor telephone connection, the tone of voice and accent of both the clinician and patient, inability to physically observe the patient, and the elimination of non-verbal cues making it more challenging to establish trust. Additionally, they lack richness in information exchange in comparison to face-to-face consultations. Such challenges can leave patients confused with more questions than answers, resulting in unnecessary stress and anxiety at the time they are most vulnerable. Patients are not a box ticking exercise and need to feel this is the right approach for them as opposed to attending clinic or alternative means of appointment for example virtual consultations, in which case the clinician and patient can see each other.
SUMMARY
While telephone consultations can be effective with straightforward acute problems, they are not appropriate in more complicated situations. It is essential that a relationship of trust and respect is established with the same consultantfor telephone consultations to work effectively. However, telephone consultations should only be used in the right context to supplement patient appointments and not as a replacement.
REFERENCES
Note: Further development can be found in Chapter 9 of the following book published by this author:
Kearney, C. (2022) Leading Innovation and entrepreneurship in Healthcare: A Global Perspective, Edward Elgar Publishing.
https://www.e-elgar.com/shop/gbp/leading-innovation-and-entrepreneurship-in-healthcare-9781839104275.html
