Online Consent for Upper Limb Procedures

Online consent – a rapidly changing landscape?

In 2018 Mark Broadbent, co-founder of ConsentWise, presented the findings of an online consent audit to the British Orthopaedic Association. It was then presented at Lisbon’s EFORT in 2019.

At the time he concluded that online consent could not replace the traditional process, but that approximately 50% of patients found it to be an improvement on the existing experience.

As each year passes it is evident that a higher proportion of the population is comfortable with technology, or has been pushed into using similar tools due to the Coronavirus outbreak. We believe it is now the minority who will be unable to engage.

Online Consent for Surgery – Abstract

As the use of online patient information becomes common practice, it was proposed that the next logical step would be adding the option of “online consent”. Standardised consent forms were created, with guidance from the BOA (http://www.orthoconsent.com). It was felt that this offered the patient the ability to sign a form, within their own timescale, confirming they had read and understood the information provided. This online form would not replace the current NHS consent, rather act as a supplement. This study was organised to determine whether this online method is an acceptable, and therefore viable, method of consenting patients for elective upper limb surgery. 

56 patients undergoing elective upper limb surgery between 1/11/16 – 31/5/17 at Inverclyde Royal Hospital were asked to complete an online consent form, via the senior authors patient information website, in addition to the standard written consent form.

Patients were subsequently followed up by telephone questionnaire.

Of the 56 people included in the study, 48 completed the questionnaire. 62.5% participants completed the online consent form, 37.5% did not. Of those completing the form 50% preferred the consent process involving the healthcare professional, 16.7% preferred the online method, and 33.3% had no preference. 

Our study demonstrated that there are still a significant proportion of patients who are unable to access online information. Therefore at this time online consent forms should not replace the consent process in the hospital environment, but should be used to supplement the process.