Winter sunrise

Primary care Youth clinic

It is such a benefit to be able to work flexibly

Åsa Söderlund

Västerbotten County is Sweden’s second largest county and occupies one-eighth of the country’s area. There are currently six physical youth clinics located in different towns in the county. But how do you reach young people in rural areas? A digital youth clinic provides a completely new setting when it comes to accessibility.

Roughly one year ago, the Region Västerbotten launched its digital youth clinic. What lessons have been learned in the meantime? What tips could they give to others who want to introduce online consultations? And what does remote working involve, almost 100 miles from the clinic you are connected to? We booked a meeting in their app to talk about this, and more besides, with psychologist Eva Holmberg and midwife Lilo Lindquist.

How did you get started with your digital youth clinic?

We were part of a major digitalisation assignment which was initiated in May 2017 by our then primary care director. The aim was, above all, to provide accessible and equitable high quality care in a county with long distances.

The app is run by the youth clinic in Umeå and was started in October 2017. At first, we offered drop-in consultations and made progress through trial and error, both in terms of opening hours and professional roles. We currently have two midwives, one dietician and one psychologist staffing the unit. We have also replaced the drop-in activity with letting young people book appointments for video consultations.

What do the staff think about meeting young people via video?

Many needed a little time to get used to it at first, but once we got underway, it went really well. But It’s important to remember that you can’t have the same expectations of an online meeting as in a meeting in person. The setting is quite different, and it is not as easy to establish a rapport and read body language. However, there are far more dimensions to it than a meeting over the phone.

“We’re quite sure that we are reaching out to more young people.”

Do you promote your digital clinic in other ways?

We have had targeted mailing via Facebook to reach young people in municipalities that lack a physical youth clinic. In addition, we have posted information on the youth clinics’ websites.

What do young people think of your digital youth clinic?

Young people think it works great, they don’t mind and they’re used to talking via Skype. They have rated video consultations highly, and we often get to hear comments like “Oh, how smoothly and easily it went!”. It’s really great!

How has the technology worked?

At first, there was some technology hassle, mainly because a lot of the staff were using old computers and outdated technical equipment. Computers were slow and had to be restarted. We have now acquired new ones, but it’s important that these are restarted regularly too, preferably every day. A computer that is on a full week at a stretch can easily start to get sluggish.

Have booked consultations worked better than drop-in?

Yes, based on the spontaneous responses we have had, we would estimate that about eight out of ten young people prefer booked consultations to drop-in. We have also seen an increase in the number of video calls made. One advantage is that it’s clearer who you will talk to in a booked consultation, as the photo, name, and title of our staff are shown when you book.

Those who want to talk to a psychologist seem to appreciate appointment booking the most. Perhaps it’s more important for them to have some time to prepare for the conversation. But we don’t really have enough statistical data to answer the question whether we reach new target groups.

The staff also have a greater opportunity to prepare for booked consultations, for example, by reading through records. We are then better able to keep track of the case.

Do you reach new target groups with your digital clinic?

Our goal is mainly to reach more young people in sparsely populated areas, but also newly arrived migrants, LGBTQ people, the disabled and, not least, young men.

However, we’re quite sure that we are reaching out to more young people in general. Our colleagues in Värmland had asked young people who had been in contact for their digital consultation what they would do if the online option didn’t exist. Most of those who had visited a midwife replied that they would have contacted the youth clinic in another way, but of those who talked to a counsellor, 25% replied “don’t know” and 35% “nothing” to the question. This means that 60% of these visitors could have abstained from consultations if they were not offered help digitally!

How have you marketed your digital clinic?

We have printed business cards, brochures, and posters, which we have put up in various places, including schools. We also have a Facebook page, but we’ve realised that this is not really the right forum for young people, as they socialise more on Instagram and Snapchat. It’s also important to realise that many young people in rural areas do not really know what a youth clinic is, which you should bear in mind when you want to disseminate information.

Marketing is incredibly important if you want to reach out to young people, and it makes sense to focus primarily on digital marketing when launching a digital clinic.

Lilo, what does working remotely from Gothenburg involve?

I used to work at the physical clinic in Umeå, and when I moved to Gothenburg I had the opportunity to work digitally. I think it’s going really well, I’ve already worked on-site and keep an eye on the clinic, the staff and the area. It’s a great benefit to have local knowledge, I can imagine that it is harder to get into the work and check up on policies and procedures if you leap into digital working right away.

Do those who staff the digital clinic normally work from home?

Yes, almost everyone does so every now and then. It’s really nice to be able to work flexibly. At certain times you want to work from home, and sometimes you want to be able to work even when you are on the move. Since we can also work when we are in a different location, we can also be available during the summer, calls can be received from your country home or other places in the world.

Finally, do you have any tips for others who want to set up a digital clinic?

Absolutely! Here are our top tips:

  • Don’t wait – take the plunge! Avoid getting caught up in thoughts of risks and consequences. There’s actually not so much difference between a digital and a physical consultation. The same questions are asked and the same procedures apply.

  • Make sure you use good technology! Don’t sit working on equipment that’s too old and systems that are sluggish. Restart your computers regularly and make sure you have good Wi-Fi in-house.

  • Contact other youth clinics who work with online consultations and ask them to share their insights. We belong to a network where we can juggle ideas with others who work digitally, and it’s a really good thing to have a forum, where we can learn from each other’s mistakes and experiences.

  • Invest in marketing! Also, be sure to market yourselves in the right place, where you find young people.