Reshaping secondary care consultations after COVID-19: the role of asynchronous consultation methods

COVID-19 has changed many aspects of health care, including how consultations are managed. Remote consultation methods (for example phone or video) were gradually being introduced before COVID-19, but in March 2020 most face-to-face contacts were replaced by remote consultations. Most research around remote consultations has focused on 'synchronous' forms, where patients and clinicians talk online or by phone in real time. There is less research on 'asynchronous' consultations, where patients and professionals are not available at the same time. Examples of this include emails and text messages, but more sophisticated systems have been developed which are more like the flow of information in face-to-face consultations. NHS Grampian in Scotland has been piloting asynchronous consultations using a platform developed by Storm-ID. Patients have a five-day 'appointment' to complete questions online and upload photos. The doctor then looks at these and may request further information, make a diagnosis or treatment plan, invite the person for a phone or face-to-face appointment, or discharge them. As part of its COVID-19 recovery plan, NHS Grampian will roll out an asynchronous platform across more specialties. This research project will explore the roll out of this system at scale. Using telephone/online staff and patient interviews, a patient survey and focus groups, and analysis of consultation and resource use data held by NHS Grampian, the project team will analyse whether it is acceptable to patients and staff, how it changes the nature of the consultation, who is advantaged/disadvantaged by the system, and what can be learned for future roll out in the NHS.