Remote care and the burden of treatment
Patients, along with their carers and families, have to do work to manage their healthcare. This “burden of treatment” includes things like managing long term conditions, monitoring health, and implementing lifestyle changes.
Research into remote care during the Covid-19 pandemic has focused on patients’ experiences of accessing care, but remote care also has an effect on their burden of treatment. The BMJ and THIS Institute co-hosted a #BurdenOfTreatment Tweetchat to find out what patients, carers, healthcare professionals, and researchers thought about four questions, inviting them to share their experiences of burden of treatment and remote care.
What we found
We discovered that – especially for those people who may have disabilities, or who need to access services that are not local to them for specialist care – remote care can be more convenient. Remote care for routine appointments that don’t need a physical examination could also be convenient, making people feel more in control.
However, there are also barriers to accessing remote care that can make it burdensome, such as hearing impairment, cognitive or language difficulties and lack of access to the necessary equipment. Remote care may also contribute to the burden of treatment through technological failure or delays. Some patients find remote care isolating and some healthcare professionals are uncomfortable with it.
Some issues could be resolved by providing automated devices, but only if technology is used as a tool to facilitate relationships rather than as a substitute for them. Giving patients access to their electronic medical records could be a way of empowering them to be more involved in decisions about their care. There’s also potential for remote care to help coordinate appointments if patients are seeing multiple specialists.
It’s important that the appropriateness of remote care is assessed on a case-by-case basis, and also to seek out opinions from people who are likely to be disadvantaged by remote care. More research is needed into how effective remote appointments are, and to consider whether remote care allows for more joined up working and better patient access to medical records.