Video Conferencing in Care: Evidence and Deployment

Uses of Video in Care Delivery

The v-connect platform demonstrated the following use cases: virtual outpatient clinics replacing in-person appointments for stable patients; 24-hour clinical hubs providing on-demand access to clinical teams; multi-disciplinary team meetings and case reviews; early supported discharge from hospital; and remote monitoring consultations combined with physiological data. In social care: video-enabled support visits for people with learning disabilities; family and carer connection reducing isolation; and virtual visiting for people in care homes or supported living.

Evidence of Outcomes

Respiratory disease (Airedale NHSFT — 24-hour clinical hub): 45% reduction in emergency department admissions, 9% reduction in length of stay, 50% reduction in bed days.

Primary care and care homes (Bradford): 70% reduction in GP visits to one care home.

Social care and learning disabilities: 33 care packages, 10 with video support — savings of £514,880 in the first year. Patient quote: "I don't feel as anxious as I did before. I feel more confident when speaking to people."

Renal Remote Clinic (Lister Hospital): 40 patients' homes connected, 13 clinics replaced with remote teleclinics, 84 hours and 3,360 miles of patient travel saved.

Essex County Council (LIP): 87% of participants felt improved confidence; estimated cost of a visit reducible by up to 40% if conducted by video.

Deployment Challenges

The silo problem: video technology deployed within a single care pathway generates evidence only within that silo. The systemic benefits — reduced emergency admissions spanning primary, secondary and acute care — are dispersed across budget lines that do not communicate. The organisation making the investment may not capture the savings.

Practitioner adoption: front-line practitioners, once they have used video effectively, typically become advocates. The barrier is the initial co-design investment. A quote from an Acute Care Team Nurse at Airedale NHSFT: "It is surprising how many skills you can use through the telemed system... as a nurse you are quite used to being touchy-feely and being hands on but it is a different way of assessing for me... I still feel like I am helping the patients at the end of the day."

The Appropriate Use of RCTs

Standard RCT methodology is poorly suited to evaluating video-based care platforms: the platform creates a network of contacts that cannot be isolated; personalised care packages evolve and cannot be frozen for a trial; the social learning process is not captured; and freezing development slows adoption. A sociotechnical, action-research-based approach to evidence generation is proposed instead.