Exploring Life with a Long-Term Condition Using Asynchronous Online Communication

Talk Code: 
Dr Andy Ward
Dr Jane Bethea, Dr Ron Hsu
Author institutions: 
University of Leicester Department of Medical Education


Online communication between patients and doctors will play an increasing role in health care in the future. In 2016, NHS England announced that it had allocated £45 million over three years to support the purchase of online consultation systems by practices. Asynchronous communication, such as online messaging, has been suggested as a way of increasing efficiency and reducing error in health care teams. Students need to develop the specific communication skills required to deal with this technology, without losing a patient-centred focus. Using a shared electronic patient record students can explore aspects of a patient’s experience of life with a long-term condition.


Using Patients Know Best – the world’s first fully patient-controlled online medical records system – students work as a group to communicate electronically with a patient over five months. Students are expected to find out about the social, psychological, and emotional impact that living with a long-term condition has on the patient. The students also explore whether the patients have always received patient-centred care. Tutors can monitor communications and intervene where necessary. Feedback is collected from patients and provided to students.


The teaching has enabled students to have early patient exposure in a safe environment. Students and patients have quickly adapted to the technology. The asynchronous nature of the communications has meant that students have had to adapt their approach from more traditional consultation models. Informal feedback from patients, tutors and students has been very positive. A more formal assessment of the interactions is currently being undertaken.


A shared electronic patient record provides an excellent opportunity for medical students to explore holistic elements of a patient’s life with a long-term condition. Communicating electronically appears to require a different set of skills to more traditional consultation methods. The asynchronous nature of the communication provides challenges not addressed in current teaching which generally focus on more traditional models of the consultation. Communicating electronically appears to require a different set of skills to more traditional consultation methods. Research is needed to establish best practice in this rapidly growing area.

Submitted by: 
Andy Ward
Funding acknowledgement: