Judy had been back and forth to her GP practice for over two years with ‘spotting’. Initially, the GP practice had prescribed hormone creams. Considering her age, and being ‘well past the menopause’ as Judy puts it, she thought she should have had a gynaecological assessment. However, she continued with the treatment her practice had prescribed.
With no apparent improvement, Judy submitted an eConsult to her practice. During the eConsult, Judy was asked all the questions that were needed to provide the clinician with the relevant information. Some of Judy’s answers triggered the in-built red flags that indicate potential cancer signs, alerting the practice team to Judy’s symptoms. Within a few days, Judy was booked into an urgent appointment to see a gynaecologist, who quickly confirmed that she had cancer.
How online consultation can help GP practices pick up critical symptoms more quickly
GPs are under immense pressure to care for thousands of patients. Serious conditions can be missed because the right questions may not always be asked in a face to face appointment or over the phone. Although in Judy’s mind she clearly needed a gynaecological assessment, her symptoms could easily have been overlooked given the limited information she could provide over the phone to a receptionist.
eConsult is a digital history taker. It has been designed to ask the questions needed for a practice to be able to triage a patient to the right kind of care. In the case of Judy, the right care was an appointment with a gynaecologist who was able to quickly diagnose her cancer. If Judy hadn’t submitted an eConsult there is no telling what the eventual outcome of this would have been, or how long it would have been before her cancer was picked up.
Online consultations are not going to pick up every underlying condition, but the clinician-designed questions, which gather information in a structured way, do collect a full patient history every time. This full history can only increase the opportunity to get the patient to the right care as quickly as possible, improving the level of care being delivered by the practice.
Why we don’t just rely on free-text boxes
Online consultations are relatively new to general practice in the NHS. Both patients and practices are still getting used to them, and to make things harder there is more than one type of online consultation solution.
eConsult is an asynchronous form of online consultation. This means the patient submits their request or symptoms to the practice, the GP practice can then get back to them, detailing the most appropriate care. By asynchronous we mean this isn’t happening at the same time, unlike a telephone call where both the patient and the member of practice staff have to be on the telephone at the same time.
We ask patients a mix of free-text and multiple-choice questions which change in real-time based on already given information. The eConsult is sent directly to the practice to review and they then decide on the most appropriate care for each patient.
Other forms of online consultation can heavily rely on ‘free-text’ boxes. The patient is asked an open question, inviting them to provide information regarding their symptoms or request and this is sent to the practice. The reason we don’t just rely on free-text boxes is that crucial information might be missed. An eConsult is designed to replicate the first 4 minutes of a face to face consultation, not just the first 30 seconds in which the patient explains what they think is wrong.
If we were to only rely on that free text box from the patient there is a much higher probability that the GP would have to phone the patient up to ask for more information. From experience, this method only increases the amount of time needed for both GP and patient.
Confused about what an online consultation is?
Read our quick guide to understand how to use eConsult and access your own healthcare quickly online
Why we ask the questions we do.
There is a reason why we do everything, and the majority of it stems from ensuring patient safety. All of our eConsult question pathways have been designed by a group of over 26 NHS clinicians and patients with expertise from a wide range of clinical backgrounds. The team are real-life clinicians working in the NHS. They know what patients can present with, and the questions have been designed to ensure a full and complete history is taken.
The majority of the time this might mean that the GP can close the consultation remotely, but sometimes it can highlight conditions that might have been missed by a simple conversation on the phone with the reception team, or by filling out a free-text box.
eConsult asks these important questions every single time. It doesn’t get tired, and it doesn’t forget or get stressed.
It might seem easier and quicker for a patient to only write down what they think is the issue in a free -text box. It would also be easier for our developers to build a product that was just a free-text box. We don’t, because that doesn’t guarantee patient safety and it doesn’t help the clinician in the long run. By spending a few more minutes answering all the questions, the practice will be able to more accurately decide on the right care for each patient. In over 70% of cases, this does not require a face to face appointment, saving everyone time.