Technology for video consultations and assessments

Hardware considerations

Hardware refers to the physical components of a computer system. This includes the devices within the computer (or tablet or smartphone) itself and peripheral devices connected to it, such as a webcam or external speaker.

Below is a list of hardware that you will need for video consultations, however you may also want to consider what other technological equipment your patient has that could feed into your assessment – such as smartphones, activity trackers like Fitbits, pedometers or peak flow meters.

Device

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.

Camera

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.

Microphone and speaker

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.

A stable and secure internet connection

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/  

A second monitor

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

Software considerations

Software refers to the programs that are run on a computer (or tablet or smartphone), including the operating system and additional programs. If you are carrying out video consultations, you will need a video calling software program that is compatible with your device (such as Attend Anywhere or Zoom). (Note: if you are using a tablet or smartphone you will need to download an app first).

Various platforms seem to be used including those more widely used with the general population. However, I am limited by what our organisation considers to be secure which is not what patients are more familiar with.

Occupational Therapist, Neurology


When selecting a program for video consultations, you will likely be limited to those your organisation considers secure. While your organisation’s technology guidelines should be followed, your patient may not be familiar with it. You will need to take steps to ensure your patients have the opportunity to be familiar with the technology that is used by your organisation.

Practitioners use a wide range of programs for video consultations. We are not able to advise on which is best, but guidance on four of the most frequently used platforms in health and social care (Attend Anywhere, AccuRx, MS Teams and Zoom) is given below.

If you notice that many of your patients prefer a software program outside of your organisation’s guidance, you may have the option to use that instead if your organisation confirms it is secure. Talk to your manager, information governance department, or IT department to ask about using new software.

Attend Anywhere

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.

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.

AccuRx

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.

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

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

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

Technology tips

Consider appointing one or more digital champions in your organisation. Staff who are most familiar and confident with the platforms you will be using can provide support and help with queries: 

An approachable peer who has the IT skills is usually more helpful and accessible than a designated IT department support.

Medic, Paediatrics

Test all the equipment you will be using before the consultation – make sure your internet, video and audio are working, and that you are familiar with the platform you will be using. If the platform is unfamiliar, have a practice call if possible (ideally using the same device you will be using with the patient):

All new software needs to be tested and staff well trained and practiced before using it with patients. Not knowing which button to press or being unsure about how things work may affect the patient’s confidence in the clinician.

Physiotherapist, Musculoskeletal

Digital Care Services Catalogue (DCS).

NHS England has produced guidance on online and video consultation tools

Link to NHS England