Our recent Dundee SmartCare event featured the Attend Anywhere
videoconsulting system which is being introduced in Highland,
Grampian, Tayside and elsewhere for outpatient clinics. Just at the
end of the event, it struck me that there was only one person in the
room who had actually conducted patient interviews over the Attend
Anywhere videoconsulting system. It seemed like a good idea to ring
him up, and ask him how well it worked. His name is Navin Mistry, and
he is an Adult Psychologist.
“We were thoughtful about how best to pilot
the system within the department,” he told me. “We decided to start
with face to face interviews as usual, and assess whether patients
were suitable for follow up consultations online. We considered areas
of risk.
"If people are using Attend Anywhere
and in crisis, we need to know what supports are available to them.
That doesn't need to be a barrier, it just means we - together - make
a clear plan about what that support is and how the person would
access it.
"What excites me most is the prospect
of using Attend Anywhere to reach people who just wouldn't be able to
come to a conventional clinic appointment because their depression
and/or anxiety means they can't leave the house by themselves or cope
with public transport. We are opening up treatment to a number of
people who really need help but find it almost impossible to get that
help. "
"Take the example of someone who is agoraphobic. They could
start treatment through Attend Anywhere and progress through stages
to coming in for face to face consultations. This is a big change in
how we currently deliver the service; for our service users and our
clinicians but it's worth remembering that some places have been
using this approach for a long time."Â
Navin was able to give an example of one patient he is seeing
online. The patient lives in Dundee but works elsewhere for an
employer who knows nothing of their mental illness. “It would be
great to think there is no longer a stigma around mental health
problems but, in reality, lots of people still find it challenging
to tell their employer about their difficulties," says Navin.
“We encourage people to get to the point where they can share that
information, but employers’ attitudes vary greatly on this topic.”
So Navin sees his patient online, after conventional office hours.
That works for the patient; they don’t need to ask for regular days
off. It also works for Navin. Using Attend Anywhere means he can
continue to consult after Reception staff have gone home.
Navin’s current patient has good IT skills and was willing to
upgrade their data connection to cope with videocalls and enable the
use of this delivery option. So far there have been few technical
problems … as well as sharing his screen, Navin can do sketches and
hold them up to the camera.
One thing he has had to change is his practice of showing patients
useful materials during face to face interviews. Now he sends them
out in advance, and the patients have a chance to read them before
the videoconsultation.Â
Navin has some ideas of how videoconsulting can be useful for other
patients. “For example, we see students during term time, and then
they go home to another town or another country and their treatment
is interrupted. Using Attend Anywhere, we could keep their treatment
going until they return. We could do the same for people who
regularly work away from home.Â
“I'm making the argument, that by using Attend Anywhere we can
play the long game. If we can make our service more flexible, we can
engage with people sooner. Working people could attend online
appointments, maintain their employment, and avoid their condition
getting worse and reaching crisis point before they ask for help.”
The Dundee Adult Psychological Therapy Service are among the first
clinics to offer online appointments via Attend Anywhere, and have
been pathfinders for the much larger Near Me Tayside initiative
which is making online consultations available to many more
outpatients. Detailed information is available on the Dundee
SmartCare 2019 webpage at https://dva.scot/news/blood-pressure-and-videoconsulting/ÂÂ