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Virtual online consultations: advantages and limitations (VOCAL) study
  1. Trisha Greenhalgh1,
  2. Shanti Vijayaraghavan2,
  3. Joe Wherton3,
  4. Sara Shaw1,
  5. Emma Byrne3,
  6. Desirée Campbell-Richards2,
  7. Satya Bhattacharya2,
  8. Philippa Hanson2,
  9. Seendy Ramoutar2,
  10. Charles Gutteridge2,
  11. Isabel Hodkinson4,
  12. Anna Collard2,
  13. Joanne Morris2
  1. 1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  2. 2Barts Health NHS Trust, London, UK
  3. 3Blizard Institute, Barts and the London School of Medicine and Dentistry, London, UK
  4. 4Tower Hamlets Clinical Commissioning Group, London, UK
  1. Correspondence to Professor Trisha Greenhalgh; trish.greenhalgh{at}


Introduction Remote video consultations between clinician and patient are technically possible and increasingly acceptable. They are being introduced in some settings alongside (and occasionally replacing) face-to-face or telephone consultations.

Methods To explore the advantages and limitations of video consultations, we will conduct in-depth qualitative studies of real consultations (microlevel) embedded in an organisational case study (mesolevel), taking account of national context (macrolevel). The study is based in 2 contrasting clinical settings (diabetes and cancer) in a National Health Service (NHS) acute trust in London, UK. Main data sources are: microlevel—audio, video and screen capture to produce rich multimodal data on 45 remote consultations; mesolevel—interviews, ethnographic observations and analysis of documents within the trust; macrolevel—key informant interviews of national-level stakeholders and document analysis. Data will be analysed and synthesised using a sociotechnical framework developed from structuration theory.

Ethics approval City Road and Hampstead NHS Research Ethics Committee, 9 December 2014, reference 14/LO/1883.

Planned outputs We plan outputs for 5 main audiences: (1) academics: research publications and conference presentations; (2) service providers: standard operating procedures, provisional operational guidance and key safety issues; (3) professional bodies and defence societies: summary of relevant findings to inform guidance to members; (4) policymakers: summary of key findings; (5) patients and carers: ‘what to expect in your virtual consultation’.

Discussion The research literature on video consultations is sparse. Such consultations offer potential advantages to patients (who are spared the cost and inconvenience of travel) and the healthcare system (eg, they may be more cost-effective), but fears have been expressed that they may be clinically risky and/or less acceptable to patients or staff, and they bring significant technical, logistical and regulatory challenges. We anticipate that this study will contribute to a balanced assessment of when, how and in what circumstances this model might be introduced.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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