Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: From Key Lessons to a Framework for Implementation

Edmond Li, Rosy Tsopra, Geronimo Larrain Gimenez, Alice Serafini, Gustavo Gusso, Heidrun Lingner, Maria Jose Fernandez, Greg Irving, Davorina Petek, Robert Hoffmann, Vanja Lazic, Memarian Ensieh, Tuomas Koskela, Claire Collins, Sandra Milena Espitia, Ana Clavería, Katarzyna Nessler, Braden Gregory O’neill, Kyle Hoedebecke, Mehmet Ungan, Liliana Laranjo, Saira Ghafur, Gianluca Fontana, Azeem Majeed, Josip Car, Ara Darzi, Ana Luisa Neves

Keywords: Primary care, telemedicine, digital health

With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems.

Research questions:
We explored GPs’ perspectives on the main benefits and challenges of using digital remote care.

GPs across 20 countries completed an online questionnaire between June – September 2020. GPs’ perceptions on main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data.

1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and the accompanying legal frameworks.

Main challenges included patient’s preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses.

At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how. Lessons learned during the emergency phase can be used to inform the stable adoption of virtual care solutions, and co-design processes and platforms that are technologically robust, secure, and supported by a strategic long-term plan.

Points for discussion: