The impact of e-triage systems on the GP IT market

With his local CCG offering to pay for an e-triage system our columnist, Neil Paul, explores what this could mean for the GP IT market

CREDIT: This is an edited version of an article that originally appeared on Digital Health

Two separate important, but related, emails arrived this week that I think will, potentially, change IT desktops in primary care. First was an email from the CCG stating that they would pay for one e-triage system per practice; the background to this is that the NHS wants all GP practices to be carrying out online consultations this year and, from April next year, to be carrying out video consultations.

The reality, of course, is that most of us are doing video consultations already, and that there is some confusion over what they mean by ‘e-consultations’ – as you could argue that having an email conversation is an e-consultation but most people seem to have taken this to mean the ability to do online triage.

Now, normally, the CCG offering to pay for something would be good; however, the downside is actually picking one, which is often quite hard. This is mainly because none of the products are identical, and they all have added features which some practices use and love – and some don’t

A pick-a-mix of services

At my surgery we use a whole host of solutions – including a webchat on our website to answer admin questions and a bulk SMS messaging solution – so we are going to have to make a choice, and this has been made more difficult by the second email.

The second email was from the makers of accuRx, which has been supplying our bulk SMS messaging solution. The company stated that they were about to start charging – or at least would be in the new year or new financial year.

Many have grown to love accuRx; it integrates tightly with the clinical system, and the company seem agile and quick to adapt and add new functionalities. They also, generally, seem interested in helping the GP deliver more productive workflows.

Now this wouldn’t be a problem if there wasn’t an overlap.

AccuRx is about to launch an e-triage module so, in theory, practices like, for example, my wife’s- where they use an e-triage module and accuRx – they are left with the decision; do they carry on with the system they’ve just implemented, get that for free, and then pay for accuRx out of their own pockets, or do they cancel the e-triage system they are using and go with accuRx for everything and, therefore, not pay themselves?

Setting a cat among the pigeons

This, of course, is going to set the cat amongst the pigeons, and I suspect some of the current e-triage systems will develop SMS and other technologies to try and deliver the all-in-one package and get the funding. Of course, I may be wrong, and the CCGs may only pay for small modules, but I suspect there is about to be a bloodbath.

I know one of the leading the triage systems has a partnership with a video consultant company and has a post-consultation system but, as far as I know, it does not have one-to-one SMS messaging, or bulk messaging functionality; on the other hand, some of the other systems, as far as I know, don’t do video but may well be partnering with people who do very quickly.

And what about some of the other players in the market? There are companies which have, traditionally, just done the SMS work, and there are some smaller companies which, I suspect, are struggling to gain market share. I do wonder if they all need to pivot and think about what else they can do – not to compete with these guys, but see what they are not doing.

Looking ahead

I’ve two predictions here as to what areas I think people will move towards. First is chronic disease management, as delivering some of the risk stratification of patients, and dealing with the lower end ones, could be done virtually or remotely perhaps, but we don’t have the tools yet.

My second prediction is nursing and care homes. The current clinical systems in place in care homes are patient record, not ward round, management devices, so how do you get all the appropriate multidisciplinary team members in a room at the right time for the right patient with the right plan in place, and then manage that over time?

I suspect some solutions for this may exist; I’ve certainly seen products that talk about measuring patients’ vital signs –  and send alarms when these go off – but that’s not what I’m talking about. I’m talking about bringing together a team of individuals from different organisations to manage different patients.

If anybody knows a good way of doing this, or if a brilliant product already exists, let me know – but I do wonder if it is an area right for development into.