An audit on the provision of telemedicine in primary care in Malta during the COVID-19 pandemic

Abstract

BACKGROUND: Telemedicine is defined as the use of wireless technology to exchange medical information, and is assuming an increasingly central role in the provision of primary healthcare. The aim of this audit is to provide an overview of the teleconsultation service being provided from a Telemedicine centre on the Mediterranean island of Malta (EU).

METHODOLOGY: Data was gathered using the Electronic Patient Records (EPR) system on all documented teleconsultations conducted from 1st-14th November 2021 by GPs/GP trainees (n=2,625). Reasons for consultation and outcomes were noted. Data was transferred to a spreadsheet and analysed using Microsoft Excel™.

RESULTS: Adult (17-64 years) calls comprised 51.5%, elderly (65+ years) 38.7% and pediatric (0-16) 9.8% of all teleconsultations. Calls averaged 375 per day, with Mondays and the morning (8am-1pm) shifts being the busiest. Calls related to clinical problems comprised 62.5% of all teleconsultations; 23.5% were for advice on COVID-19 or influenza vaccines, 8.5% were of an administrative nature (e.g. booking appointments), and 5.5% were for treatment-related advice. Around 2 out of every 3 clinical-related calls comprised COVID-19, respiratory or gastrointestinal problems, in all age groups. Importantly, 75% of all calls did not require further action by the GP beyond the teleconsultation.

DISCUSSION & KEY RECOMMENDATIONS: The telemedicine service relieved pressure off district health centers, allowing the latter to focus on those cases requiring more urgent face-to-face clinical assessment. Recommendations: encourage more widespread use of telemedicine service; ensure EPR documentation of all telecalls by all GP/GP trainees; increased use of video-conferencing; replicate audit on a longer timeframe.