**2. Background**

The utilisation of technology and other innovative channels used to link up with patients has evolved over the past ten (10) years. However, this has been accelerated eminently during COVID-19 [6, 9]. Lockdown restrictions and regulations, fear of contracting the virus at a health care facility has also changed health seeing behaviour among patients. The use of virtual platforms such as telephones for

*Telephone Consultations by Medical Scheme Patients Consulting General Medical Practitioners… DOI: http://dx.doi.org/10.5772/intechopen.98496*

consultations has also been well received by physicians, who have used them widely, and they have been highly rated by patients [9]. A survey conducted in 2020 of 120 patients surveyed showed that 95% were satisfied/very satisfied with the telephone visits [3]. The study also surveyed 26 physicians and found that 84.6% of them considered telephone visits were useful to prioritise patients.

#### **2.1 Virtual consultation- general practitioners**

Virtual consultations (also called telemedicine consultations) have been in place for decades, with many healthcare systems advocating a digital-first approach, even before the COVID-19 pandemic [7, 10]. The has, however, further accelerated the use k [11, 12]. At the beginning of the pandemic, many health professionals, including General Practitioners (GPs), specialists and others, resorted to the use of video consultations to reduce patient flow in their practices and facilities as a risk measure to limit infectious exposures [8].

The General Practitioner (GP) data for England shows a rapid increase in telephone consultations relative to face-to-face consultations [12]. The authors found that the number of telephone consultations increased from more than 850 thousand to more than 2 million per week between March 2 and May 18 2020, while the number of video consultations was higher in March than in April or May when it was around 10,000 per week [12]. Richardson *et al.,* a large proportion of teleconsultations (96 percent) in France found) were billed by private practitioners, with GPs billing 80 percent of all teleconsultations, followed by psychologists (6 percent), paediatricians (2 percent), gynaecologists (1.3 percent), dermatologists (1.1 percent), and endocrinologists (1.1 percent) (1.1 percent). In the Netherlands, teleconsultations are expanding, with 72 percent of GPs surveyed said they had begun using video consultations with patients in 2020.

#### **2.2 Funding of telephone consultations – Medical schemes**

Update and use of technology have also been evident in medical schemes, where some medical schemes continue to fund these. However, not all medical schemes6 fund telephone consultations related to COVID-19 [5, 9]. Medscheme affiliated or contracted schemes provide some evidence of schemes that do fund telephone consultation with effect in 2020. According to their newsletter publication, the administrator, in partnership with their affiliate solution providers, has developed a digital platform to facilitate virtual consultations [13]. The **Table 1** below depicts various rates for various schemes. The fees range between R281 and R437.

#### **2.3 Legislative requirements**

There are legislative restrictions on the use of virtual consultations [9]. Some of these have made the implementation of virtual consultation in low-income countries difficult. Some present challenges are related to data security and privacy requirements [8]. A number of countries have also evolved and developed protocols and guidelines for adopting video consultations. These developments and improvements have taken a leapfrog jump in countries like the UK and the US. Clinicians in many developed countries are working closely with regulators in terms of compliance to standards on the use of non-medical, electronic platforms and applications such as Skype, WhatsApp, and FaceTime in addition to medical ones [8].

<sup>6</sup> A **medical scheme** is a non-profit organisation, governed by a board of trustees, and must be registered with the Council for **Medical Schemes**.


**Table 1.**

*Telephone consultation fees – Medscheme affiliated schemes tariff rates.*
