Remote healthcare in the COVID-19 pandemic

The last research roundup provided an overview of recent research around patients who contract COVID-19 having some vascular and coagulopathy symptoms that may or may not cause morbidity and mortality. This month we will continue to look at research on COVID-19, but with a focus on remote consultation and prescribing. As a result of the changes required for lockdowns and social distancing, the way care has been provided in almost all areas of practice has changed, and often GP appointments and clinic reviews are being done remotely. This can be by telephone or by video call and some research and reviews of practice have been done to evaluate service delivery across and within specialities.

This editorial published online in the Journal of Psychotherapy and Psychosomatics near the beginning of the pandemic looked at issues and aspects to consider when conducting what they term ‘telemedicine’ in mental healthcare in the USA (Wright and Caudill, 2020). This mirrors some of the consideration needed to be taken worldwide to ensure safe and effective delivery of mental healthcare remotely. Although some aspects, such as state by state licensing and location, do not apply as importantly in the UK, other aspects identified are relevant. Some of the main issues raised are around confidentiality, security and use of platforms to deliver remote care. The worries around the use of some platforms and security, for example, use of FaceTime or Messenger and whether or not these had approval for confidential use, are applicable here in the UK. Another worry was establishing a confidential service, and verifying the identity of the participants. The authors state that video calling had no benefit over telephone consultations in the effectiveness of delivery of psychotherapy. How to issue prescriptions in these circumstances was also flagged as an issue. Other aspects considered were the administrative and technological capabilities of clinicians, service delivery and the access of the patients themselves.