What Should You Expect From an Online Health Consultation?
Telehealth has moved from new to normal, and with that shift in technology, patient expectations have also changed. Before booking an online consultation, patients research their symptoms and the treatments associated with them as well as the specific medicines that may be prescribed. It is less clear, however, what patients expect the online consultation process itself to look or feel like, how long it will take, what information will be required from them and who will make the key decisions.
Setting the right expectations for the health service that patients receive is critical to delivering a good patient experience and generating successful commercial outcomes. Giving patients a clear understanding of the health service they receive online will lead to them completing online health questionnaires properly and treating a decline in service resulting from a clinical reason as a failure in service rather than a problem with purchasing a medicine online.
The intake form does more work than patients realise
By structuring the intake for your patient’s online consultation you collect all the material a Doctor would normally spend time gathering in your consultation. This then frees up that Doctor’s time to carry out a proper assessment and have a discussion with you about your online consultation. The form should use conditional logic so that, for example, a patient disclosing a certain condition is then presented with the additional questions that that Doctor would normally ask in person.
A competent intake generally collects the following.
- Presenting concern, duration, severity, and what the patient has already tried
- Current medicines, including over-the-counter products, supplements, and anything prescribed by another provider
- Known allergies and previous adverse drug reactions
- Relevant past medical and surgical history, plus family history where it bears on risk
- Pregnancy status, breastfeeding, and contraception where applicable
- Alcohol, tobacco, and other substance use
- Recent pathology results, observations, or measurements the patient can supply
Why honesty in the form is a clinical safeguard
Patients often omit information from their intake form which they believe will prevent approval for a prescription. In reality, omitting information only increases the chance of harm and may result in the patient being abandoned mid-consultation. By clearly explaining this at the start of the intake form, online operators can reduce the number of incomplete patient histories and late stage declines.
How the clinical review proceeds
After the online form has been filled out completely by the patient, a registered practitioner reviews the intake information against the appropriate prescribing criteria and medical guidelines. The practitioner assesses for any contraindications, potential drug interactions, red flags indicating a different diagnosis or complex medical condition that requires a physical examination by a practitioner, etc.
The Practitioner can then decide to treat the patient, require further information or even pathology, offer an alternative treatment or even decline to treat the patient and refer to another health care provider. Patients should be aware that all of the above outcomes are normal for online consultations and that the decline is based on a clinical judgement that this specific patient may require and not a matter of the platform’s policy.
Comparing consultation formats
| Format | Typical use | Patient effort | Clinical limits |
| Asynchronous questionnaire review | Stable, well defined conditions and repeat supply | Low, completed in own time | No real-time clarification, unsuitable for complex or atypical presentations |
| Telephone consultation | History-led assessments and follow-up | Moderate, requires scheduling | No visual assessment of skin, gait, or affect |
| Video consultation | Initial assessments, visible conditions, medication reviews | Moderate to high, needs connection and privacy | No physical examination, palpation, or auscultation |
| Hybrid with in-person referral | Cases needing examination or procedures | High | Depends on local provider availability |
What a useful treatment discussion covers
Outline the benefits of the treatment, expected time to work, common side effects and less common serious effects. Explain any monitoring required and discuss alternative treatments, even none. Mention the cost of the treatment and the arrangements in place to supply on an ongoing basis. Anyone unsure about how this stage unfolds is best served by reading through the steps of an online health consultation before booking.
Documenting the conversation around the medicines, ensuring that all necessary information is recorded to demonstrate informed consent at a later date. This would include details of all options that were discussed and the reasons behind any medication that was not prescribed (including details of any request for certain medication and reasons why it was not deemed appropriate).
Follow-up is part of the service, not an upsell
An online consultation is incomplete if it ends with the prescription of a treatment. Depending on the prescribed treatment, the practitioner may require follow-up such as a scheduled review after a certain time period, repeat pathology testing etc. He/she may require the patient to report symptoms or even check if the patient is tolerating the treatment well after a few weeks. The time frame for such follow-up would depend on the treatment as well as the patient’s risk profile.
Continuity and handover
Online consults form part of a patient’s ongoing management with their GP or other treating healthcare provider. If suitable, a summary of the consultation is sent to their usual General Practitioner for their consideration and with patient consent. Patients also need to clearly know how to report adverse events outside business hours. Handover of a patient’s care between remote healthcare and in-person healthcare needs to clearly outline what has been tried and why the patient requires face-to-face treatment.
Online health services that include these steps will have better clinical records, fewer arguments, and patients who have a realistic understanding of what they have paid for.
