Technology for video consultations and assessments

A PC, laptop, tablet or smartphone. The device will need to have sufficient RAM. Operating systems, firewalls and the use of VPN can also impact on how smoothly a video calling program will run.

Specific requirements will depend on which program is used.

Choice of device should be based on a conversation between you and your patient.

Patient preference is important - would they prefer to use a PC, laptop, smartphone or tablet? Consider the patient’s mobility and their ability to hold or move a device during the consultation.

If the patient is alone, they might find it easier to use a laptop, or if they prefer a smartphone or tablet this should be positioned in a fixed place when assessing movement.

Different devices have advantages and disadvantages:

• Desktop PCs may be difficult to use for assessing movement.
• Smartphones and tablets are more portable and can be used for assessments, but have a smaller screen, and soundand camera quality will depend on the device.
• Laptops may be positioned fairly easily and have a better battery life.

What is the purpose of the consultation?
For example:

• If you will be assessing gait, balance or generalised range of movement, a well-placed laptop or tablet (e.g. on a dining table or kitchen worktop) should give you the best view.
• For close-up assessments of joints or skin, using a smartphone can work well as it can be quickly and easily moved to specific body regions.
• A larger, more static screen should be suitable for psychological or family-based interventions.

Built into smartphone or tablet. May be built in or attached to laptop or PC. 

A higher quality camera will improve the clarity of your view of the patient (and improve their view of you), but this will also depend on the camera that they are using. If you are using a webcam, try to use one with a good resolution (at least 720 pixels but ideally 1080 pixels). 

Being able to angle the camera and zoom in and out are useful features. Be aware of the camera settings on your device in case they have been disabled.

Usually built into the device, but an external headset may improve sound quality.

Use a headset for consultations where possible – this will reduce any environmental noise that can be amplified by the microphone, it is better for privacy/confidentiality if you share an office with others, and will be better for patients who are hard of hearing.

Minimum bandwidth approximately 2 Mbps (Megabits per second) upload and download for a one-to-one call, at least 3 Mbps for group calls with more than two people. Latency should also be low, ideally less than 100ms. With faster connections, you are less likely you are to experience sound delays when communicating with the patient, or disruptions to image quality when you are carrying out physical assessments. The patient’s internet connection will also affect the clarity of sound and video.

Check your current internet speed using an online speed test such as the following: https://www.speedtest.net/ 

This is not essential but may be useful if you are using a PC or laptop and want to review notes while carrying out the consultation.

"Have two screens, one that you can see the patient on and another where you can write up the assessment and see previous notes." Occupational Therapist, Neurology

Attend Anywhere is a software program developed by the NHS that allows practitioners to provide consultations at a distance using video. Attend Anywhere is best used for one-to-one consultations. Other programs such as MS Teams (described later on) may be more suitable for group consultations.

You may have also heard about Near Me alongside Attend Anywhere. This is the name for video consultation services in Scotland, and was picked by the Scottish public that helped co-design these services. Near Me uses the Attend Anywhere software to provide video consultations. If you want to know more about Near Me, have a browse of their website.

Attend Anywhere is one of the most common software programs used, and you are likely already using it. If, however, this software is new to you, have a look at the resources below that introduces Attend Anywhere and how it works.

• Short video introduction to Attend Anywhere.
• Short demo of Attend Anywhere.
• Demo of Attend Anywhere that includes the patient’s side.
• A video demonstration for Attend Anywhere from University Hospitals Plymouth NHS Trust including clinicians sharing their experiences of video consultation .
  
• You can also get more information directly from the Attend Anywhere website.

Your patient may ask about Attend Anywhere and how to use it. You can send them the resources listed above as well as some of the patient-specific resources below.

• Online PDF patient guide on how to use Attend Anywhere.
• Troubleshooting patient guide for Attend Anywhere.

AccuRx is another common software program used for video consultations. This software works as an attachment for whatever system you use at your practice, such as SystemOne or EMIS. AccuRx is also best used for one-to-one consultations.

• Short AccuRx demo for SystemOne
• Short AccuRx demo for EMIS
• Text guide for getting started with AccuRx

If you have further questions about AccuRx, check out their help centre. It has a variety of different tutorials from sending email to troubleshooting:

The AccuRx help centre also has information for patients.

MS Teams (i.e. Microsoft Teams) is a software program developed as part of the Microsoft Office 365 applications. It is a digital platform that can be used for secure chats, meetings, and file sharing. MS Teams can be used to communicate with your colleagues as well as your patients. It can host multiple individuals during meetings, which makes it useful for group consultations. MS Teams can also be used for one-to-one consultations if preferred over other software.

A 10-minute general tutorial for MS Teams

A 30-minute MS Teams tutorial in the context of general practice

Zoom is another common digital platform that can be used for video consultations, meetings, and presentations. Zoom can also host multiple individuals, which can be used for both one-to-one and group consultations.

A quick Zoom tutorial for healthcare

A 15-minute Zoom tutorial for healthcare