Within this context, it goes without saying that Covid-19 has led to a big push towards digital healthcare solutions. Until 2020, the adoption of telemedicine across Europe was fairly slow and limited, but social distancing requirements and the consequent advancements in technology facilitated its accelerated adoption in healthcare systems.
Indeed, a Digital Health Trends survey conducted by Research Partnership and Sermo in March 2021 (with a mix of HCPs in the US, EU5 and China) reported that nearly 70% of HCPs regularly used telemedicine – as well as other digital healthcare solutions, – during the pandemic.
Furthermore, another qualitative study we carried out with patients and HCPs in the US, Germany and China in May/June 2021 reported positive experiences with telemedicine on both sides for convenient, time-saving consultations. HCPs also felt it was helpful to have more time to reassure and empathise with patients, with less time-pressure and more relaxed consultations.
Ophthalmologist, UK (Nov, 2021)
But how is the utilisation of telemedicine fluctuating as the pandemic evolves? A survey we conducted with Medefield in November 2021 (with n=157 HCPs in both primary and secondary care in the EU4 and UK) revealed that physicians are currently increasing their volume of face-to-face interactions with patients and feel mostly positive about this.
Attitudes vary by region, however, with UK physicians spending only 60% of their time in direct face-to-face consultations, versus ~80% in France and Italy. UK GPs in particular, are spending close to 40% of their time in teleconsultations in contrast to lower averages (~25%) in other markets.
The reluctance of UK GPs to return to face-to-face consultations may be the reason for the government’s need to provide incentives.
In October 2021, it was announced that GPs in England will receive £250m to improve their services, but only if they increase the number of patients being seen face-to-face under a new government and NHS action plan.
This drive has been cited as a way to relieve growing pressures on A&Es, which the government is attributing to patients not having access to see GPs in person (although disputed by the Royal College of GPs).
Only 58% of patients were seen face-to-face in August 2021 (the first full month following the ending of restrictions), compared with 54% in January and more than 80% before the pandemic, which correlates with our survey.
A behavioural shift back to face-to-face interactions corresponds with the results from our survey highlighting mixed perceptions on satisfaction with telehealth.
Those physicians reporting lower to moderate satisfaction are now seeing an opportunity to return to face-to-face consultations and overcome some of the perceived underlying telehealth challenges pertaining to managing patient compliance (37%), remote diagnostics (35%) and overall disease management (32%).
The perceived preference for face-to-face consultations is also reflected in our previous research that highlights lingering doubts about telemedicine, most notably the reliability of remote diagnostics for more complex cases, especially if HCPs are dependent on patients correctly and confidently, carrying out self-assessments.
This theme ties in with patient apprehension over aspects such as accurate diagnosis and patient desire for in-person consultations to build rapport with their physicians. Limited online prescription services and data privacy concerns were also cited as concerns from both the HCP and patient perspectives.
Bearing in mind these challenges, is this an indication of a shift back to a primarily face-to-face model? Based on our survey, it would seem not. As illustrated earlier, HCPs are already using a hybrid (mix of face-to-face and virtual) approach approximately 10% of their time in practice.
In addition, more than half of our sample surveyed expect to use this consultation type some of the time to manage patients, in the next three years, with 20% expecting to use it a majority of the time. GPs, especially in the UK, would not expect to return to solely in-person consultations in contrast to other specialities who anticipate more face-to-face interactions.
Another key point from our sampled physicians is that the hybrid model will be strongly based on using the most appropriate consultation type dependent on the circumstance, with many in favour of using teleconsultations for routine follow-up appointments.
Dermatologist, Spain (Nov, 2021)
Cardiologist, Italy (Nov, 2021)
This finding is corroborated by other studies conducted at Research Partnership that show user experience with telemedicine has mainly been positive. Moreover, there is consensus that usage will become established in the future alongside in-person appointments, dependent on the stage of the patient’s journey. In the UK, for example, this scenario is included in the NHS Long Term Plan to optimise and increase the range of digital health tools and services.
Considering what we have learned since the start of the pandemic, it is valid to conclude that technological advances are swift – as seen with some markets trialling telemedicine apps/platforms – and digital health tools will continue to develop and improve at speed.
In this sense, there are expectations that current telemedicine gaps will be filled. Consequently, the hybrid model will extend beyond routine follow-ups and will be utilised confidently for clinical purposes such as diagnosis, resulting in convenience and time benefits, as well as potential health economic cost savings in the long run.