Patient Safety of Remote Primary Care: A Qualitative Study Assessing Risks and Mitigation and Prevention Strategies

Abstract

AbstractBackgroundWhile virtual care delivery has numerous advantages, it can also introduce safety risks and unintended consequences. Considering that it has become an integral part of today’s healthcare service, uncovering its unintended consequences is imperative to ensure patient safety.ObjectivesThis study aimed to identify patient safety risks associated with virtual primary care, as well as strategies to mitigate these risks based on the perspectives of patients and healthcare providers.MethodsThree focus groups were conducted followed by semi-structured interviews with patients, carers and healthcare providers working in primary care. Transcripts were systematically reviewed, and thematic analysis was performed by two independent researchers.ResultsA total of 42 participants took part in the study. Three main areas for patient safety risks associated with virtual primary care were identified, including suboptimal clinical decision-making, negative impact on patients’ access to care, and worsening the workforce crisis. Strategies to mitigate these risks included providing information for patients, training triage personnel, making technical support available, standardising guidelines, setting up systems for feedback, improving continuity of care, communication, and safety netting.ConclusionsPatients and providers now have a heightened awareness of the strengths and pitfalls of virtual care due to their increased familiarity with the use of virtual care technologies. Existing policies need to be updated and new ones devised to minimise risks associated with virtual care and support patient and provider workflows.Public Interest SummaryThe COVID-19 pandemic galvanized an emergent necessity to deliver care virtually in order to reduce disease transmission. However, given the urgency of the crisis, virtual care was being delivered with minimal protective measures for safety.This study examines the lived experiences of both patients and providers around virtual care use in England. Potential risks of virtual care delivery, and strategies to mitigate these risks, are identified from both perspectives. The risks identified vary from the technological learning curve to the challenges associated with modified patient-provider communication. The potential solutions identified range from strategies to improve micro-level patient-provider interactions to larger-scale system changes to improve the continuity of care.Support for patients and providers alike should be allocated to alleviate unnecessary burdens associated with virtual care. Ensuring patient safety necessitates seamless coordination and interoperability between virtual and in-person healthcare to maintain harmony between the two modes of healthcare delivery.