A study by researchers at the University of Stirling shows that due to a lack of knowledge and skills, older patients in rural areas are being denied the benefits that modern communication technologies such as text, Web and video can bring in health care delivery.
The survey, jointly led by Professor Stephen Leslie, a cardiologist at Raigmore Hospital and Honorary Professor in the School of Nursing, Midwifery and Health at the University of Stirling, and Dr Amir Hussain at Stirling’s Cognitive Signal Image Processing Research (COSIPRA) Laboratory in the School of Natural Sciences, questioned cardiology patients at Raigmore Hospital, in Inverness, about their use of digital technology.
The findings show that young patients are more likely to use the Web, mobile phones and texting than patients over the age of 50. However, the majority of patients, regardless of age, had access to email.
NHS Highland is looking at the use of digital technology to provide a faster and more cost effective method of healthcare provision, as more than 30 per cent of Raigmore Hospital’s cardiology patients live in remote locations and have to travel more than one hour to attend appointments.
Studies have shown that with support, new technologies can be successfully used amongst the over 50s for clinical care. These include methods such as ‘tele-assistance’, where a patient can receive ‘telemedicine’ by speaking to a physician through video conferencing, with support through email and Web communication.
The survey, which also assessed attitudes towards the use of technology in care, will be used to guide future redesign of communication with NHS cardiology patients.
Professor Leslie said: “There may be several potential barriers to the widespread implementation of communication technology to a general cardiology clinic population, particularly in remote and rural areas.
“Increased use of communication technologies have the potential to improve patient care. Implementation of these can be difficult and patient skills and confidence with them will vary.
“NHS policy makers, clinicians and managers should take note of these findings when attempting service redesign as this is a very important factor to consider.”
Dr Hussain added: “The potential benefits for the delivery of healthcare services by greater use of technology are considerable.
“Traditional face-to-face medical outpatient clinics are a common way of assessing and monitoring patients and have been in place for many years, but many patients are seen in the clinic with little or no positive outcome in terms of treatment decisions, with some patients being seen as a matter of routine. Traditional doctor-led clinics may not be an efficient model of care.
“The benefits of more frequent or convenient communication with a doctor appeared to be more important than potential subtle reductions in quality of consultation. The patients were less affected by the way in which doctors interacted with them and more concerned about whether this interaction occurred at all.”
The research paper is being published in leading journal Telemedicine and e-health in April.
The most recent Scottish Household Survey highlights that less than half of people in remote rural areas find access to hospital outpatient departments ‘‘very or fairly convenient’’.
Public transport is also an issue, with 51 per cent of remote and rural areas stating public transport services are convenient compared with 88 per cent in large urban areas and 79 per cent in accessible small towns.
Distance from specialists and specialist facilities—for example, cardiac catheterisation facilities—is inversely proportional to the likelihood of patients receiving specialist investigation. In some cases (e.g. chronic heart failure) this can result in poorer outcomes for patients in remote areas.