What patients choose and how GPs respond in online consultations with askmyGP

Problem

It is often assumed that most patients contacting their GP want a face to face appointment. But what do they choose when their practice has an online tool enabling multiple modes for the GP response and they are given a choice? And do GPs give the patient what they request or something else?

Approach

We decided to analyse this problem by using the large dataset (>1m patient requests) automatically collected from askmyGP, an "online consultation" tool. Each patient is offered a preferred method for the GP's response (online message, phone call, video call, face to face appointment). askmyGP also records the actual response used by the GP to resolve the request. So we can analyse the mix of responses requested and whether the GP judgement matches the patient request.We illustrate the patterns of flow by extremely easy to interpret data visualisations using Sankey Charts.

Findings

The majority of patients don't wan't a face to face appointment when given the choice (though numbers vary significantly by practice).GPs do not feel bound by the patients' requested mode: they frequently judge a different response is appropriate for the request.Almost nobody wants a video consultation when given a choice of other, effective, methods.

Consequences

The drive to encourage video consultations appears to be a waste of time.GPs should not assume that patients will only be satisfied by a face to face appointment: they are often satisfied by alternatives. Since alternatives often require less GP time, this has major implications for GP efficiency.GPs do not feel bound by patients' preferred method of contact and their judgement on how to respond frequently overrides patients' requests.Being flexible about how to respond creates more capacity for GPs to give patients a faster, more useful service.