General practice – along with the wider healthcare sector – is under pressure, managing more with less. As the number of patients increases, as their needs become more complex and as resources continue to diminish a solution is needed.
The benefits technology can deliver are something that we’ve addressed previously. Here Dr Anshumen Bhagat, chief medical officer with 15 years’ experience as a GP, running three NHS practices in North London, and founder at GPDQ, discusses bringing digital healthcare solutions to patients.
A few statements have stood out for me in NHS England’s recent publications; firstly, from the Five Year Forward Plan published in October 2014, ‘England is too diverse for a ‘one size fits all’ call model’. Secondly, Professor Sir Malcom Grant, chairman of NHS England, in his 14/15 – 16/17 NHS Business Plan, says, ‘There is no question that we have pushed our resources to the limit in committing to the plan’s deliverables. There is no scope for any further demands, without further resources.’
I am an NHS trained GP – a supporter and advocate of the NHS. I am extremely proud and privileged to be part of an organisation that was founded nearly 70 years ago, commits to providing healthcare irrespective of income, social status and race and has delivered huge outcomes to date. However, this doesn’t detract from the fact that we can’t carry on as we are – given the pressures our NHS is facing today. Is innovation the solution?
The healthcare system has changed dramatically over the past decade. While the objectives remain the same – improved affordability, better customer satisfaction and better health outcomes – the way these objectives are met has changed because of advancements in technology and an increasing pace of innovation.
Due to the transformation of the digital healthcare sector we have seen an exponential growth of mobile apps in the healthcare ecosystem. GPDQ was the UK’s first GP-on-demand-app, but now, in 2018, there is an abundance of mobile health solutions for patients. Let’s look at some of the key challenges facing the medtech industry.
Ensuring quality whilst innovating
When thinking about access to innovative technology, often, the issue in healthcare is not creating a clever digital solution but rather implementing this technology in a meaningful way that prioritises suitability for the patient and clinical outcomes above proving the technology itself.
The widespread availability of mobile health solutions presents an accessible, affordable and convenient opportunity. However, some medical professionals get so caught up in creating a seamless digital service that they lose sight of the importance of clinical quality whilst innovating.
As Professor Steve Field, CQC chief inspector of general practice, recently said, “While innovation should be encouraged, it must never come at the expense of quality. As with all health care services, patient safety must be at the heart of all decisions around what kind of care is offered and how it is delivered.”
One of the biggest challenges for the UK’s medtech sector is striking a balance between embracing innovative technology to create a service whilst effectively coping with the growing demand for that service and having the ability to simultaneously deliver excellent clinical care. There is a risk that adopting new technologies can leave us with little time to focus on quality and what’s best for the patient.
Reliability, safety and the human touch
When developing a mobile health solution it’s tempting to focus on the innovation around patient convenience and value to the exclusion of all else. However, I believe that patient care and quality should be the primary concern.
A major part of ensuring quality is offering a safe and reliable service that improves the overall outcome for the patient. Technology can play its part in this; for example, using electronical medical records, which are easily transferrable and accessible for clinicians and electronic prescribing has been shown to make prescription errors 50% less likely compared to handwritten ones.
Quality of care
Most of the reviews we receive from customers show that they benefited from the speed, ease and convenience of using the GDPQ app; however, they were particularly impressed by the service from the GPs themselves – the top-quality clinical care. This is a function of, not only working with the best GPs, but also thinking about how we can enable them to be at their best – in our case that by providing a 25-minute consultation length as standard to allow enough time to cover everything thoroughly and working with a range of innovative partners to equip our doctors with technology-enabled tools for diagnosis and treatment.
There are many telemedicine companies offering a virtual health solution for patients – and virtual consultations are a great tool for triaging patients. However, healthcare requires a range of tools and access modes and, most importantly, care and empathy. There is often no substitute for a physical examination to keep things safe, and certainly no substitution for the human touch.
A successful mobile health solution
GPDQ was born out of my desire to help build a sustainable healthcare system in the UK. For me, community-based primary care is the key to achieving this. I work on that primary care frontline in the NHS every day, and it is stretched and under a lot of pressure.
The concept that a patient wanting to see a GP has another option – one that doesn’t involve putting pressure on other areas of the NHS, such as unnecessary attendance at A&E – is something that complements the system and enhances patient choice.
The healthcare industry is experiencing a noticeable shift to a more retail-centric model that enables the consumer to own their healthcare decisions. By giving them choice, convenience and access, we are creating an army of empowered, digitally-savvy patients who can benefit from digital services to help themselves, rather than solely depending on the NHS.
However, I also firmly believe that the way for us, as innovators, to maximise patient benefit is to work in conjunction with the NHS to be free at the point of need for as many people as possible. That’s why, at GPDQ, we’ve given a lot of thought to constructing a home visiting service for the elderly which the NHS finds difficult to deliver in other ways and which maximises the benefits for patients; this is only possible with a sufficient focus on quality.
Delivering the doctor to the door is, in many ways an old-fashioned concept, but bringing it into the 21st century by using technology increases efficiency and creates significant savings when compared to the alternative. As the population ages and becomes less mobile, it’s a false economy not to respond by providing a service that keeps vulnerable patients out of the hospital system.
I believe it’s all about creating digital services and applications that help our customers, engage our customers and, most importantly, provide effective health solutions, no matter where that customer resides. Technology enables medical professionals, such as myself, to make this a reality.