My mother was a nurse—a community health nurse cum midwife. Therefore, I grew up around clinics and hospitals.
While friends got to stay at home with househelps and other relatives when they were not well, I had to follow my mum to work.
So you can imagine. I grew up with that distinctive antiseptic smell of healthcare facilities unmistakably embedded in my subconscious.
I must say I grew up in a love-and-hate relationship with health facilities. On the one hand, I hated being around so many sick people.
On the other hand, I also believe, unscientifically though, that sometimes just a visit to the hospital was enough to cure one of an ailment.
I have observed that with my children. However, if we are to believe in recent trends, then many of the sights, sounds and smells of visiting the hospital in person will eventually be a thing of the past.
Enter the advocates for remote medical consultation.
I am yet to have a remote session with a doctor so I am not entirely sure what happens during such sessions. The idea of meeting my doctor through a screen might feel oddly impersonal. That is just my honest opinion.
I may be wrong. It seems that is the future of medical care and therefore, one must begin to align. If there is something we have learnt from history, it is that those who fail to embrace the future are eventually left behind.
Those who have experienced remote consultation say the experience is very different. That is to be expected.
After all, the consultation happens in an environment where the patient is most comfortable, such as the one’s home or office, not in the hospital. One difference therefore would be that the patient would be expected to be more relaxed.
The biggest difference though between the traditional face-to-face consultation and the remote option is the level of patient participation in the process.
In a typical remote consultation, the patient is expected to prepare a symptoms list beforehand, have medication within reach, and be mentally more engaged. This is way different from traditional consultations where the doctor does a lot more of the work.
The concept of customer participation in the service delivery process is nothing new. Indeed, the whole idea of a Customer Effort Score (CES) is based on the appreciation that customers participate or exert some kind of effort when receiving a service.
Customers are by no means just docile recipients of service. Customers are active participants in service delivery, with levels of engagement varying depending on the kind of service.
This transformation of patient engagement in remote consultations has become more relevant than ever, especially in the aftermath of that global pandemic that accelerated the adoption of telehealth services worldwide.
A study published in the June 2024 edition of the International Journal of Operations & Production Management delves deep into this very topic, exploring the multifaceted nature of patient engagement in remote consultation services.
The findings of this comprehensive review offer fascinating insights into how healthcare systems can better harness the potential of telehealth.
The Three-Dimensional Nature of Engagement
One of the most striking revelations from the study is that patient engagement in remote consultations is not a one-dimensional concept that can be measured on a simple scale of “engaged” versus “disengaged.” Rather, it operates on three distinct dimensions that interact with each other throughout the patient journey.
Cognitive engagement refers to how mentally present and attentive a patient is during the consultation. For instance, a patient who researches their symptoms beforehand, prepares questions, and actively processes the information provided by the healthcare provider would be demonstrating high cognitive engagement.
Emotional engagement, on the other hand, relates to the feelings and attitudes patients have toward the remote consultation process. Do they feel comfortable with the technology? Do they trust that they are receiving the same quality of care as they would in person?
The third dimension, Behavioural engagement, refers to the tangible actions patients take before, during, and after the consultation—actions like setting up the necessary technology, actively participating in the discussion and following through with prescribed treatments.
The interplay between these dimensions is what truly determines the effectiveness of remote consultations.
A patient might be behaviourally engaged (showing up for the virtual appointment) but emotionally disengaged (feeling sceptical about the process), which could ultimately impact the quality of care they receive. Understanding these nuances is crucial for healthcare providers seeking to optimise their telehealth services.
The Patient Journey
If you have ever taken a flight, you know that the experience is not limited to the time you spend in the air.
It starts from the moment you book your ticket and extends all the way to baggage claim and beyond. Similarly, patient engagement in remote consultations extends far beyond the actual video call with the healthcare provider.
According to the study, the patient journey in remote consultations can be divided into three distinct stages: before service, during service, and after service. Each stage presents its own unique challenges and opportunities for engagement.
Before the consultation, patients need to schedule appointments, set up the necessary technology, and prepare relevant health information. During this stage, healthcare providers can enhance engagement by providing clear instructions, offering technical support, and sending reminders.
During the consultation itself, the quality of the interaction between the patient and the healthcare provider becomes paramount. This is where the three dimensions of engagement—cognitive, emotional, and behavioural—come into full play.
Providers who acknowledge these dimensions and adapt their communication style accordingly are more likely to facilitate meaningful engagement.
After the consultation, the focus shifts to follow-up care, adherence to treatment plans, and the scheduling of future appointments if necessary. This stage is often overlooked but is crucial for the long-term success of remote healthcare delivery.
The Contextual Factors
No two patients are the same. Each brings a unique set of circumstances, preferences, and challenges to the remote consultation.
The study identifies nine contextual categories that influence patient engagement, ranging from demographic factors like age and education to technological factors like internet connectivity and device availability.
For instance, elderly patients might struggle with the technical aspects of remote consultations, while younger patients might find it more convenient.
Patients in rural areas might benefit from not having to travel long distances for care but might face challenges related to internet connectivity. Understanding these contextual factors is essential for tailoring remote consultation services to meet the needs of diverse patient populations.
Measuring What Matters
One cannot improve what one does not measure. The study proposes several metrics for assessing patient engagement at different stages of the remote consultation process. These metrics go beyond simple satisfaction surveys to include measures of preparedness, participation, and post-consultation behaviours.
For example, healthcare providers might track how many patients complete pre-consultation forms, how actively they participate in discussions during the consultation, and how well they adhere to prescribed treatments afterwards.
By collecting and analysing this data, providers can identify areas for improvement and implement targeted interventions.
The Cyclic Nature of Engagement
Perhaps the most innovative aspect of the framework proposed by the researchers is its recognition of the cyclical nature of patient engagement. Each remote consultation experience feeds into the next, with past experiences shaping future expectations and behaviours.
This cyclical perspective underscores the importance of continuous improvement in remote consultation services. By collecting feedback, analysing data, and implementing targeted interventions, healthcare providers can create a virtuous cycle of increasingly effective and engaging remote consultations.
For organisations looking to enhance their telehealth services, this means adopting a long-term perspective rather than viewing remote consultations as a temporary solution or a one-off experiment.
It means investing in training for healthcare providers, improving technical infrastructure, and continuously refining the patient experience based on feedback and data.
A New Frontier in Healthcare Delivery
As we stand at the crossroads of traditional and digital healthcare, understanding patient engagement in remote consultations is not just an academic exercise—it is a practical necessity. The framework proposed in the aforementioned study provides a valuable roadmap for navigating this new frontier.
By recognising the multidimensional nature of engagement, understanding the patient journey, acknowledging contextual factors, measuring what matters, and embracing the cyclical nature of the process, healthcare providers can unlock the full potential of remote consultations.
The future of healthcare is not just about technology; it is about how that technology enables meaningful engagement between patients and providers.
It is clear that there are benefits to having well-designed telehealth services. When done right, remote consultations can offer the best of both worlds: the convenience of digital technology and the personal touch of traditional care.
As we continue to refine and expand remote consultation services, keeping patient engagement at the centre of our efforts will be key to ensuring that this new frontier in healthcare delivery truly delivers on its promise of more accessible, effective, and patient-centred care.
