General practitioners’ perceptions of using virtual primary care during the COVID-19 pandemic: An international cross-sectional survey study
PLOS Digital Health, vol. 1, pp. e0000029
Abstract
With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. We explored GPs' perspectives on the main benefits and challenges of using digital virtual care. GPs across 20 countries completed an online questionnaire between June-September 2020. GPs' perceptions of main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. A total of 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and accompanying legal frameworks. Main challenges included patients' preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital virtual care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how during the pandemic. Lessons learned can be used to inform the adoption of improved virtual care solutions and support the long-term development of platforms that are more technologically robust and secure.
Authors 27
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Edmond Li corresponding
Affiliation as printed
Institute of Global Health Innovation, Faculty of Medicine, Imperial College London, London, United Kingdom
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Rosy Tsopra corresponding
Inserm · Université Paris Cité · Sorbonne Université · Centre de Recherche des Cordeliers · Assistance Publique – Hôpitaux de Paris · Hôpital Européen Georges-Pompidou · Centre Inria de Paris
Affiliation as printed
Department of Medical Informatics, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
INSERM, Université de Paris, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006 Paris, France
Inria Paris, Paris, France
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Nanyang Technological University · Leiden University Medical Center
Affiliation as printed
Center for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
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Alice Serafini corresponding
Affiliation as printed
Local Health Authority of Modena, Italy
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Gustavo Diniz Ferreira Gusso corresponding
Affiliation as printed
Universidade de Sao Paulo, Sao Paulo, Brazil
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Heidrun Lingner corresponding
Medizinische Hochschule Hannover · German Center for Lung Research
Affiliation as printed
Hannover Medical School, Center for Public, Health and Healthcare, German Center for Lung Research (DZL) / BREATH Hannover, Germany
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María José Fernández corresponding
Red de Investigación en Actividades Preventivas y Promoción de la Salud
Affiliation as printed
Galicia South Health Research Institute, Vigo, Spain
Leiro Health Center, Leiro, Spain
Primary Care Prevention and Health Promotion Network (redIAPP), Spain
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Greg J Irving corresponding
Affiliation as printed
Health Research Institute, Edge Hill University, Ormskirk, United Kingdom
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Davorina Petek corresponding
Affiliation as printed
Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Robert D. Hoffman corresponding
Affiliation as printed
Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Vanja Lazić corresponding
Affiliation as printed
University of Zagreb, Zagreb, Croatia
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Ensieh Memarian corresponding
Lund University · Skåne University Hospital
Affiliation as printed
Department of Clinical Sciences in Malmö, Lund University, Internal Medicine- Epidemiology Research Group, Skane University Hospital, Malmö, Sweden
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Tuomas Koskela corresponding
Tampere University · Tampere University Hospital · University of Tampere
Affiliation as printed
General Practice, Tampere University, Faculty of Medicine and Health Technology and Tampere University Hospital, Finland
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Claire Collins corresponding
Irish College of General Practitioners
Affiliation as printed
Irish College of General Practitioners, Dublin, Ireland
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Sandra Milena Espitia corresponding
Affiliation as printed
Colombian Family Medicine Society, Colombia
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Ana Clavería corresponding
Red de Investigación en Actividades Preventivas y Promoción de la Salud
Affiliation as printed
Galicia South Health Research Institute, Vigo, Spain
Primary Care Prevention and Health Promotion Network (redIAPP), Spain
Primary Care Research Unit. Vigo Health Area, Vigo, Spain
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Katarzyna Nessler corresponding
Affiliation as printed
Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland
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Braden Gregory O’Neill corresponding
Affiliation as printed
MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
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Kyle L Hoedebecke corresponding
Affiliation as printed
Department of Utilization Management, Oscar Health, Dallas, United States of America
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Mehmet Ungan corresponding
Affiliation as printed
Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
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Liliana Laranjo corresponding
The University of Sydney · Macquarie University
Affiliation as printed
Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Saira Ghafur corresponding
Affiliation as printed
Institute of Global Health Innovation, Faculty of Medicine, Imperial College London, London, United Kingdom
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Gianluca Fontana corresponding
Affiliation as printed
Institute of Global Health Innovation, Faculty of Medicine, Imperial College London, London, United Kingdom
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Azeem Majeed corresponding
Affiliation as printed
Department of Primary Care & Public Health, School of Public Health, Imperial College London, London, United Kingdom
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Josip Car corresponding
Nanyang Technological University · Red de Investigación en Actividades Preventivas y Promoción de la Salud
Affiliation as printed
Center for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
Galicia South Health Research Institute, Vigo, Spain
Leiro Health Center, Leiro, Spain
Primary Care Prevention and Health Promotion Network (redIAPP), Spain
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Ara Wardkes Darzi corresponding
Affiliation as printed
Institute of Global Health Innovation, Faculty of Medicine, Imperial College London, London, United Kingdom
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Ana Luísa Neves corresponding
Affiliation as printed
Institute of Global Health Innovation, Faculty of Medicine, Imperial College London, London, United Kingdom
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