Remote Consultations in General Practice in Ireland: Who is missing out?

This Bulletin summaries the findings from: Ellen McHugh and Sheelah Connolly. “Remote Consultations in General Practice in Ireland: Who Is Missing Out?”, Telemedicine and e-Health. Available at: https://www.liebertpub.com/doi/10.1089/tmj.2024.0503 

Introduction

There is increasing interest in, and use of, telemedicine in healthcare systems across Europe, including in Ireland. Telemedicine, involving remote consultations that take place via telephone or video call, can benefit patients, healthcare providers and the health care system; however, such consultations are not without their limitations. There are concerns that remote consultations take away from face-to-face communication, which is often seen as central to the provision of high-quality healthcare services. Additionally, because remote consultations rely on access to the internet or telephone, some people may be less able to avail of them. Previous research in Ireland and elsewhere has shown that some groups are less likely to use remote consultations, including older people. The present research looked at the characteristics of those who availed of a remote GP consultation in Ireland during the Covid-19 pandemic and in subsequent years.

Data and methods 

Data from three years (2020/2021, 2021/2022 and 2022/23) of the Healthy Ireland survey was used in this research. The Healthy Ireland survey is an annual survey conducted with a sample of the population aged 15 and over living in Ireland. The survey includes a range of questions on the characteristics of the respondents (including their age, sex, and employment status) as well as their use of a range of healthcare services and whether they have a medical/GP visit card and/or private health insurance. In the three years identified above, respondents that reported that they had at least one GP consultation in the four weeks prior to the survey were asked where that consultation took place (in a GP surgery, over the phone, video consultation, etc). In 2020/2021, 1,428 respondents reported having a consultation in the four weeks prior to the survey, the corresponding numbers for 2021/2022 and 2022/2023 were 1,623 and 1,735 respectively. Statistical methods (including regression analysis) were used to examine the characteristics associated with the likelihood of a respondent reporting that their most recent consultation with a GP took place remotely.

Results

At the height of the Covid-19 pandemic (2020/2021), 39% of respondents reported that their most recent GP consultation took place remotely. However, this decreased significantly in the following years, falling to just 10% in 2022/23. While a relatively small proportion of GP consultations took place remotely, some groups were more likely to report a remote consultation than others. In the later periods, for example, women were more likely to report that their most recent consultation took place remotely, while older age groups (e.g. 50+) were less likely to report this. In 2022/23, people with private health insurance were more likely to report that their most recent consultation took place remotely, as were those with a long-term health condition.

Conclusions

Given the emphasis on the potential use of telemedicine in various Irish Government documents, there is a need to understand why there is a relatively low level of remote consultations in general practice in Ireland, and why some groups are more (or less) likely to avail of such consultations. For example, for older people, is there lower use of remote consultations due to a preference for in-person consultations or does the required technology act as a barrier? A greater understanding of the potential barriers to the use of remote consultations and telemedicine more generally is required if telemedicine is to become embedded in the Irish healthcare system.