Are Virtual Consultations Safe? The Risks which Need to be Considered

As the healthcare industry continues to adopt technology, virtual consultations have become increasingly popular, especially after extensive use during the Covid-19 lockdowns. However, the convenience of virtual consultations comes with a set of known risks that must be addressed where possible, with some still yet to be identified as we are still in the early stages of its use. In this blog post, we will explore the various risks associated with virtual consultations, based on a systematic literature review I’ve done as part of my research. 

Misdiagnosis Risk 

One of the significant risks associated with virtual consultations is misdiagnosis. Clinicians may miss critical visual cues that are usually present in face-to-face consultations, leading to inaccurate diagnosis and treatment. The risk of misdiagnosis is higher for paediatricians as they deal with children, and they should therefore maintain high levels of suspicion for severe sickness. Previous clinical experience in conducting face-to-face consultations is crucial to ensure accurate diagnosis, and clinicians ought to avoid making conclusions based only on online assessments if they do not feel safe. 

Patient Technical Skill 

The outcome of the virtual consultation is also dependent on the technical skill of the patient to use the system, their ability to do self-examinations, and their communication skills. Patients who lack technical skills, particularly the elderly and those with learning disabilities,  may struggle with the virtual consultation process, leading to inaccurate diagnosis and treatment. This risk may become less prevalent as more people become familiar with widely used video communication apps like WhatsApp, Zoom and MS Teams, and the virtual care applications become more user friendly. 

Clinician Competence 

Clinician competence with the use of the systems is another risk associated with virtual consultations. Bearing in mind that the majority of clinicians are trained to in face-to-face consultations, and they were suddenly forced to do virtual consultations during the covid-19 lockdowns with no additional training. This did not take into account the distractions clinicians may encounter from the multiple functions of virtual consultations, such as triaging while guiding the patient through IT challenges, which may lead to a lack of focus on their medical competence. 

Treatment Goals 

Virtual consultations may also go against certain treatment goals, particularly those around improving patient mobility, which may encourage them to leave the home. This can lead to a lack of compliance with treatment and a decrease in overall patient outcomes. 

Other Risks 

There are several other risks associated with virtual consultations which I will attempt to discuss in more detail in future blog posts. These include risks to patient confidentiality where patients may not be in a private space during their consultation, safeguarding issues may be missed as the clinician can only see where the patient directs their camera, and patient safety as clinicians may not be able to assess the patient’s environment.  

Additionally, limited physical examination capabilities, misinterpretation of visual cues and body language, limited access to medical records and information, challenges with medication management and monitoring, limited ability to assess patient vital signs, language barriers and communication difficulties, difficulty establishing rapport and trust with patients virtually, and limited options for emergency or urgent care situations are all risks associated with virtual consultations which will be discussed in due course. 

Conclusion 

In conclusion, virtual consultations offer a convenient way for patients to access healthcare services, but they come with a set of risks that must be addressed. Clinicians must have the experience to ensure accurate diagnosis, patients must have the technical skills to use the platform, and both parties must be aware of the risks associated with virtual consultations. Healthcare providers must implement strategies to mitigate these risks and ensure the best possible patient outcomes.