Evaluate when to use virtual consultation

The decision to offer a video consultation should be part of the wider system of triage and management offered in your practice. Such a system should primarily be able to address the patient to the right specialist by using the appropriate communication channel, based on clinical judgement.

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When using remote consultations:

  • Discussing symptoms of minor ailments and concerns, in general when there is low risk of impact upon patient safety and outcome 
  • Deciding if an office visit is necessary 
  • For patients who do not need a physical examination or test and who can communicate via phone or video 
  • Routine chronic disease check-ups, especially if the patient is stable and has monitoring devices at home 
  • Administrative reasons e.g. re-issuing sick notes, repeat medication 
  • Counselling and similar services 
  • Any condition in which the trade-off between attending in person and staying at home favours the latter (eg in some frail older patients with multi-morbidity or in terminally ill patients, the advantages of video may outweigh its limitations)

When it's not recommended to use remote consultation:

  • Heart attack, Stroke, Serious injury (cuts, broken bones) or any medical emergency 
  • Co-morbidities affecting the patient’s ability to use the technology (eg confusion) or deaf and hard-of-hearing patients who find video difficult 
  • Patient who have serious anxieties about the technology and cannot be supported to do so, (eg by a carer or relative) 
  • An internal examination is required
  • You are unsure about the capacity to decide of your patient
  • You do not have access to the patient medical records or you are not the patient usual doctor and you did not get consent to access patient information


If you are not sure whether your patient falls in the above categories, then a video or tele-triage may be booked in before the appointment to help to assess a variety of situations:

  • Patients with potentially serious, high-risk conditions likely to need a physical examination (including groups at high-risk for poor outcomes from coronavirus and who are unwell)
  • When an internal examination (eg gynaecological or colorectal) cannot be deferred
  • Patients ability to use the technology

Think as your patient would do

During the pandemic, because of the huge pressure on doctors and hospitals, the big majority of population, including your current and potential patients, has become used to find out information on institutional websites, social media pages of health professionals or institutions, social media networks or blogs by members of the community, and Coronavirus dedicated apps.


To reach out such a pool of educated patients with remote consultation, you need to plan your campaigns and digital workflow as much professionally as possible. Your IT team, marketing and legal consultants can help you:

  • By recommending the tools that are better suited for the particular audience you expect to connect to.
  • By complying to the local data-privacy and cyber-security regulations. Also check for dedicated guidelines by your specialist’s association.
  • By implementing and supporting the new ways of working, including the changes to clinic templates and appointment notifications.

Get help

You should, of course, spend your time doing what you are best at and concentrate on clinical matters. It is therefore a good idea to dedicate other staff members or teams to handle the technical aspects of online communication. You can consider involving some specific specialist or consultant, or you may alternatively consider any staff that is isolating or even retired staff who may be enthusiast to support virtual clinics and Multidisciplinary Team Meetings.