Analysis of in- person general practice respiratory consultations: assessing translatability to telehealth

Background: The COVID-19 pandemic saw many GPs adopt telehealth as a consultation modality to minimise disease transmission. Patients presenting with respiratory ailments were particularly affected by this transition, given the overlap of general respiratory symptoms with those of COVID-19. It is unclear if the rapid transition to telehealth has compromised the ability to conduct certain tasks that were possible during in-person consultations. Aim: To investigate the extent to which tasks observed during in-person GP consultations are replicable in telehealth, focusing on patients with respiratory concerns. Design & setting: Twenty- six respiratory consultations were extracted from a database of 281 consultations collated from various general practices in the UK. Method: Interactions between GPs and respiratory patients were assessed through in-depth transcript review and de- identified video analysis. Then, tasks performed and physical artefacts used during the consultations were identified and ranked in terms of their translatability to telehealth, using a newly developed scoring system. Results: Overall, the translatability to telehealth score for these respiratory consultations was 6.7/10, suggesting that many tasks can be replicated over telehealth, but that they might require additional physical artefacts to support this. However, some tasks are not currently amenable to telehealth (for example, auscultation). Conclusion: While many aspects of respiratory consultations are replicable over telehealth, some tasks cannot be replicated at this stage.