Patients can select their preferred means of communication (eg. some people may be at work and unable to take a call), however it is ultimately up to the GP to consult through whatever medium they think appropriate for the patient. For very simple things they use messaging (via keyboard typing, dictation software or preset messages) but where they need a conversation they use the telephone or call people in. They could also the secure video consultation option, built into the system at no extra cost in the ‘Transform’ and ‘Improve Pro’ packages.