Digital health and remote digital consultations: views and experiences in sexual health clinic attendees Dr Jake Bayley Consultant Physician Barts Health

Background Digital health is becoming increasingly important for the NHS May lead to improved patient satisfaction and better access Little data around attitudes of sexual health (GUM) attendees Some trials in HIV positive patients – mainly resource poor areas and apps for medics rather than patients. Some small studies done (none in UK) about accpetability – good outcomes. Useful in rural arreas ?India and Australia. No data on acceptability for GUM attendees

Methods Self-directed questionnaires in the waiting room (before appointment) for 2 weeks in November 2015 Data on demographics, education level, use of websites or apps on phone for sexual health consultations Across 5 sexual and reprodcutive health clinics across East London 10 initial questionnaires were piloted for acceptability

Results 230 questionnaires returned (11% return rate) 74% aged 18-34 48% white, 23% black, 13% Asian 87% employed (part or full time), 16% students 2,500 patients seen in two weeks across all clinics

Results 85% would be happy to use a website to find information about sexual health and local clinics Much more likely if educated to A-level or higher (136/150 versus 33/46, p=0.001) Only 39% would be happy with a native app More likely if has had an STI in last 12 months (22/40 versus 58/165, p=0.02)

  Overall Currently have a device for video consultation (i.e. Skype or FaceTime) 84% (173/207)

  Overall Currently have a device for video consultation (i.e. Skype or FaceTime) 84% (173/207) Give consent for face to face remote digital consultation 51% (105/207)

  Overall Currently have a device for video consultation (i.e. Skype or FaceTime) 84% (173/207) Give consent for face to face remote digital consultation 51% (105/207) Find web cam use acceptable for remote appointments 40% (81/202)

Educated to GCSE level or less Educated to A-level or higher p-value   Overall Educated to GCSE level or less Educated to A-level or higher p-value Currently have a device for video consultation (i.e. Skype or FaceTime) 84% (173/207) 67% (31/46) 90% (137/152) 0.001 Give consent for face to face remote digital consultation 51% (105/207) Find web cam use acceptable for remote appointments 40% (81/202)

Educated to GCSE level or less Educated to A-level or higher p-value   Overall Educated to GCSE level or less Educated to A-level or higher p-value Currently have a device for video consultation (i.e. Skype or FaceTime) 84% (173/207) 67% (31/46) 90% (137/152) 0.001 Give consent for face to face remote digital consultation 51% (105/207) 37% (17/46) 56% (85/152) 0.01 Find web cam use acceptable for remote appointments 40% (81/202)

Educated to GCSE level or less Educated to A-level or higher p-value   Overall Educated to GCSE level or less Educated to A-level or higher p-value Currently have a device for video consultation (i.e. Skype or FaceTime) 84% (173/207) 67% (31/46) 90% (137/152) 0.001 Give consent for face to face remote digital consultation 51% (105/207) 37% (17/46) 56% (85/152) 0.01 Find web cam use acceptable for remote appointments 40% (81/202) 26% (12/46) 46% (68/147) 0.02

Conclusions Limitations Non-English speakers Lower education attainment under sampled No sexuality data Majority of sexual health attendees do not want to use an app or have a digital remote appointment Digital health revolution may serve certain populations better than others Must be mindful of all populations in any service re-design