ContactDoctor app: Video-consultations between citizens, municipality health or social care employees and general practitioners.

Abstract

Introduction: The ContactDoctor app enables citizen-centric, interdisciplinary and cross-sector video-consultations to improve quality and integration of care and provide equitable access to healthcare.
 Background: Video-consultations with healthcare professionals, incl. general practitioners (GP), accelerated in 2020-2021 to limit the spread of Covid-19. During that time, the app ContactDoctor was rapidly developed in a successful public-private collaboration.
 A national project was initiated to support wider implementation of ContactDoctor, where the goal is 60/98 municipalities and 700/1600 GP clinics. 
 The project is financed by the Danish Ministry of Health. The ContactDoctor-app is owned by the Organisation of General Practitioners in Denmark.
 Target group: ContactDoctor is intended for elderly and vulnerable citizens, e.g., people with social, psychological, physical problems, in nursing homes, homecare, rehabilitation, emergency teams and living-arrangement offers, who are not able to conduct a video-consultation with their GP without support. In Denmark, these welfare and healthcare areas are decentralised to municipalities. Municipality employees facilitate video-consultations between citizens and GPs and support citizens during the conversation. Citizens’ relatives can participate in the video-consultation too. 
 The project collaborates with interested municipalities concerning implementation. A User Group, consisting of representatives from 10 municipalities and a data-consultant from each region, is closely involved in the development of ContactDoctor and in preparing guidelines and implementation-material. 
 Results: The evaluation design is ‘Model for Assessment of Telemedicine’. Four evaluation reports are published between November 2021-February 2023 and collect different learnings and results from the implementation process or target groups. 
 The following results are derived from two published reports and based on statistical data, 10 different questionnaires and 7 focus-group interviews targeted municipality employees, GPs, and project managers.
 
 By September 2022, the total number of video-consultation via ContactDoctor is 1614. The data is showing a continuous increase, albeit with large differences between the municipalities. Currently, 36 municipalities and 203 clinics is using ContactDoctor.
 Users report great potential in ContactDoctor due to the flexible and integrated format and user-friendliness. ContactDoctor has been used in many different situations: acute, follow-up, medication assessment, physical problems, preparation for doctor's visit. 
 ContactDoctor has the potential to improve quality of care, enable better integrated care and provide equitable access to healthcare services. Users agree that ContactDoctor can lead to faster and more efficient treatment, fewer inconveniences for vulnerable citizens who, due to e.g., anxiety, reduced mobility, find it difficult getting to their GP. 
 Conclusion and learnings: The use of video-consultations is voluntary and the implementation of ContactDoctor is progressing, however slowly despite users reporting it a beneficial supplement to physical consultations. During the pandemic, ContactDoctor was essential, but now several municipality employees recognize that they forget to use it during a busy workday. It requires great awareness and continuous implementation focus before the app is a standard work tool and its full potential in an integrated care approach is reached. This applies to both GPs and municipalities. Without local initiatives in regions and municipalities, including management support and implementation follow-up, the initiative can result in a low degree of use and distribution.