Telehealth alternatives to in-person consultation found lacking in effectiveness: Alt-Con Study (UK)

It needs work and can’t be top down. That’s the conclusion of the Alt-Con Project and its researchers from several UK universities: Warwick, Bristol, Oxford (Nuffield) and Edinburgh. After examining the use of technological alternatives to GP consultations in eight general practices, they found that there were significant barriers to implementation, including insufficient training of non-clinical staff on these approaches’ benefits. The study includes recommendations to guide a more effective implementation.

Practices have been slow to adopt tech alternatives to F2F consults using telephone, email, e-consultation systems, and online video, despite NHS encouragement and programs such as the GP Access Fund. The paradox is that time devoted to non-F2F consults cuts into GPs time seeing live patients in the office.

  • They were adopted without a clear rationale or clearly thinking through cost-benefit for patients and practice staff.
  • Professor Sue Ziebland from Nuffield found that “…practices introduced alternative consultation methods for very different reasons and to solve problems that the practice had identified. These included a failure to be modern, to work more efficiently, to better serve commuters or dispersed populations, and to ensure appointments were available to those who needed them most.”
  • Other reasons: “the acknowledgment that the previous system was broken and unethical in providing a first-come, first-served system that left patients without appointments that they needed, and “the recognition that reception staff and phone lines were overwhelmed.”
  • Noted by other researchers were that ‘one-size-fits-all’, policy and financial incentive driven approaches were “not the best way forward”.

The study looked at GP practices of different sizes (1,938 to 18,353) covering over 85,000 patients, located in different geographic areas of England (6) and Scotland (2) including urban and rural areas, and with a mixture of patients’ socioeconomic status. 45 staff members and 39 patients were interviewed over eight months.

The University of Bristol Centre for Academic Primary Care has published a web page based on the Alt-Con research, offering guidance for GP practices. 

NHS England’s rejoinder: ‘This is a tiny study based on data that is almost two years old. Online consultations offer a convenient alternative to face-to-face appointments and patients are already seeing the benefits.’ Nuffield Department of Primary Care release, British Journal of General Practice, Daily Mail  Hat tip to former TTA Ireland editor Toni Bunting

Online Masters and Modular Learning in eHealth – last chance to enrol

Build your skills and study while you work!

The University of Edinburgh has a few places left on their Masters programme in Global eHealth. This is studied part time, via interactive online learning, supported by a network of international experts in the field (disclosure, of which this editor is one), and is designed for working professionals with some experience in healthcare, IT or eHealth, who are looking to grow and consolidate their knowledge and skills.  Courses are available as individual 10-week modules, or accumulated for a certificate (6 courses over 1 year), diploma (12 courses over 2 years) or MSc (the latter plus a supervised research project).

Readers may be particularly interested in the courses on ‘mHealth’, ‘Telemedicine & Telehealth, ‘The Business of eHealth’ (summer term), ‘User-Centred Design in eHealth’ and ‘Consumer Health Informatics’.

Applications for the new academic year close on Monday 21st September, so don’t delay applying!

For more information, please visit their website  or contact the programme team on or the programme director

University of Edinburgh MSc in Global eHealth

Deadline extended to 8 September for the Autumn term

We are happy to update our readers on this innovative UoE programme with a message from the director, Dr Claudia Pagliari. Please read ’til the end to learn about sponsoring a student from a low-income country. (Ed. Donna)

This fully supported online learning programme provides a unique opportunity to study health informatics with reference to global health challenges. Combining core courses with a rich portfolio of innovative modules delivered by international experts, the programme provides a foundation in the core principles and practice of health informatics whilst considering how innovations and policies are shaping the technology landscape, strengthening health systems and changing professional and patient behaviour.

The programme is interdisciplinary and is suitable for eHealth designers and implementers, healthcare practitioners, global development professionals, government policymakers, healthcare managers and CIOs, and academic researchers with interests in the role of ICT in health. The supported online learning format provides an opportunity to obtain a rich learning experience, interacting with your tutors and peers, whilst remaining in work. (more…)