Articles in the BMJ, JAMA and Lancet

The COVID-19 pandemic has changed everyday life for people across the world. Remote working, zoom meetings and online deliveries have become commonplace. And the medical industry is no different. Hospitals have completely transformed their processes in order to adapt to the ongoing crisis. Prior to 2020, around 90% of GP consultations were face to face. But, at the height of the pandemic, 70% of consultations were taking place remotely. The rapid surge in telemedicine has advantages and disadvantages for modern healthcare and is a hot topic in journals such as the BMJ, JAMA and the Lancet.

Many vulnerable patients who routinely visit hospitals, such as those receiving cancer treatment or those with severe allergies, risk being exposed to – or spreading – the potentially lethal coronavirus. To protect patients and staff, many hospitals have utilised telemedicine or virtual care platforms to handle consultations remotely.

This has been actioned to great effect in some situations, with JAMA Oncology publishing the outcomes of a cohort study in The Princess Margate Cancer Centre, Canada. Their virtual care solution conducted 22,085 visits with high patient satisfaction, reduced the number of ambulatory clinic visits by 50% and saved patients an estimated CAD$3,155,946 in travel costs.

However, some practitioners have deep concerns about the shift away from face-to-face consultations. A feature in the BMJ suggests that telemedicine may not be suitable for those who are deaf, have mental health issues or are living with dementia, and may cause problems for trainees in particular, who have trained in face-to-face consultation skills. A letter in the BMJ from GP John Sharvill queries the loss of the “while I’m here” question many patients present, which often leads to cancer referrals, hunches that may not be as obvious online.

An article in The Lancet highlights the necessity of virtual care during a pandemic and acknowledges the beneficial effects on mental wellbeing. However, the authors cite a study conducted early in the pandemic, suggesting only a minority of patients are able to engage and that telemedicine may be more suitable for less complex complaints. They suggest more publication of real-world experience is required to encourage uptake and sustained use.

While telemedicine is unlikely to replace face-to-face consultations, it’s clear that the platform is here to stay and has a place in modern healthcare. Questions remain on how to promote adoption and usefulness in more complex disease areas, while still protecting health services from unnecessary hospital visits.

Read the full study in JAMA Oncology

Read the Lancet article

Read the feature in the BMJ