Introduction: The COVID-19 situation has helped to accelerate the use of video for meetings and consultations in the healthcare sector. In Denmark, for the joint video infrastructure, VDX, this has meant that its use has grown significantly in regions, municipalities and general practice. It was a development that was anticipated - but not at the speed and to the same extent that was the reality during 2020. This means that VDX is now, to a great extent, a critical infrastructure with increasing use in the direct patient and citizen contact through various patient and citizen-oriented applications such as ‘MinLæge’ (‘MyDoctor’).
Aims: To increase access to language interpretation, interpretation via video was introduced in 2009 in the Danish healthcare system and a national and joint video infrastructure (VDX) was established to build a secure bridge between video conferencing systems from different suppliers. In 2019, the Danish Ministry of Health and the Danish Organization of General Practitioners (PLO) launched the application ‘MinLæge’ to strengthen the digital collaboration between the patient and their GP. At the beginning of 2020, a pilot project within the framework of MedCom, was planned to uncover opportunities and limitations when using video consultations between the patient and the GP. Due to COVID-19 it was promptly decided that all GPs should offer video consultations to their patients.
Highlights: To minimise the spread of COVID-19 in the waiting rooms, the open access to the medical clinics was suspended. Danish Regions and PLO urgently negotiated a temporary agreement on remuneration of GP video consultations and an urgent implementation of the technical solution was initiated in close collaboration between PLO, the ‘MinLæge’ supplier Trifork and MedCom as the owner of VDX. A virtual waiting room in the ‘MinLæge’ application was developed, which allowed the patient to connect to MinLæge ahead of the consultation. This ensured an efficient workflow in the clinic. Furthermore, the solution involved the integration of VDX as a video engine in the ‘MinLæge’ application. To accommodate the increasing use of VDX, the technical capacity of the infrastructure was doubled 10-fold over a few weeks. For example, on 13 January 2020, 299 video meetings were held in VDX, whereas on 13 January 2021, 4,598 meetings were held in VDX.
Conclusions: Since the shutdown of the Danish society on 11 March 2020, VDX has hosted more than 980,000 video meetings, of which more than 500,000 are GP video consultations. Quick implementation was possible through the reuse of already established digital solutions, close cooperation between private suppliers, organisations and public parties, as well as sufficient government funding.
Implications: Video consultations are here to stay. In Danish Regions’ political goals and GP’s financial agreement, it is stated that one-third of patient consultations should be converted to virtual meetings. A number of other public, patient-oriented applications, like ‘MinLæge’, have incorporated VDX as the video engine. At the same time, health professionals demand more knowledge regarding the effects of video consultations on the relationship between patient and doctor.