Communication Challenges and Mitigation Strategies in Primary Care Virtual Consultations: Qualitative Study

Area of Science:

• Primary Care Medicine
• Health Communication
• Digital Health

Background:

• The increasing adoption of virtual consultations in primary care has significantly altered traditional general practitioner (GP)-patient interactions.
• These shifts introduce novel challenges impacting the quality and safety of patient care.

Purpose of the Study:

• To investigate communication challenges and gaps specific to virtual consultations compared to face-to-face encounters.
• To identify effective mitigation strategies for these challenges from both GP and patient viewpoints.

Main Methods:

• A qualitative study involving 4 online focus groups with 21 UK-based general practitioners (GPs) and patients.
• Analysis utilized a deductive-inductive thematic approach, guided by the extended Shannon-Weaver communication model and the Capability, Opportunity, Motivation and Behavior (COMB) model.
• Reporting adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Main Results:

• Six key communication themes emerged: five aligned with the Shannon-Weaver model (sender-encoder, message, channel, receiver-decoder-feedback, context) and one new theme (patient autonomy and inclusivity).
• GPs noted missing visual cues impacting message clarity; patients reported difficulties describing symptoms, reduced emotional connection, and empathy.
• Mitigation strategies focused on enhancing capability (training), opportunity (triage/tools), and motivation (patient engagement/system adaptability).

Conclusions:

• Virtual consultations present distinct communication gaps that require targeted solutions.
• Actionable strategies, including tailored training, standardized approaches, and flexible models, are crucial for effective and inclusive virtual communication.
• Policy and structured training are essential to ensure safe and effective remote primary care.