Online consultations have made waves; designed to lighten the practice workload and improve patient access in the face of rising demand they are changing the way practices and patients communicate – in the first instance. Then why all the fuss?
Harry Longman, chief executive of askmyGP, paints a picture of online consultations in practices and busts some common myths about obstacles to implementation.
When practice managers (PM) get together there’s a single chorus on the biggest problem; ‘We can’t manage the level of patient demand. We, the GPs and all the staff are stretched beyond the limit and it’s just not sustainable.’
But what they are getting offered from on high is online consultations. Where is the link to the real problem? Isn’t this just another piece of bolt-on technology, another bother for us on top of everything else?
It’s oh so quiet… online demand
So, let’s imagine ourselves, for a minute, to be at Balaam St Surgery in East London – where I was the other day. PM Divya tells us they have only had three ‘phone calls between 8am and 9am; she wonders whether the ‘phones are down.
It’s the same story at Witley where, last week, the partners asked, ‘What’s wrong?’ There’s nothing wrong; it’s just that now most of the demand is coming online.
Effective online triage
A receptionist will take a glance and, if it’s medical, in two clicks send it to the doctor. Some other question? They’ll sort it themselves, right now. It’s a bit more interesting work than explaining to patients why they can’t see their GP of choice for another two weeks. Meanwhile the GPs are taking an average of 20 seconds to read what the patient has written, compare this with the previous notes and decide what to do.
This is the magic of digital triage – two thirds of patients will be dealt with remotely, either with a secure message – taking only a few seconds to send – or a ‘phone call. The rest will be offered a face-to-face appointment today – with their named GP if they wish, or another clinician as appropriate.
It’s so efficient, saving 30 to 40% of GP time, some of them are now calling patients to see how they are – they have so much time freed up, they have time to care.
Taking on the challenge
So, what’s the problem? Like any change, it’s a journey. Suggest online consultations to your GPs and be prepared for responses like, ‘We’ll be inundated with extra demand – you’re opening another lane on the motorway!’ This is not true. Demand doesn’t go down, as many would wish, but it doesn’t go up either.
Or, ‘Our patients will never use this.’ Amazingly, we’ve found the same appetite in some of Britain’s poorest populations as we have in the poshest – across some of the most diverse inner city and rural communities. Even some of the smallest, single practices – with patient lists of 3,000 – and the largest with over 30,000.
What makes the difference when it comes to uptake is enthusiasm from the practice staff. GPs are quite good at persuading patients but it turns out practice managers, administrators and receptionists are even more effective.
Another common qualm is the classic, ‘It’ll take forever to get them to change.’ When the system is right what happens is a step-change from launch day. We have had up to a 70% shift in week one and over 30% is normal. Patients learn one at a time, at the point they need help. When the response is swift, they’re delighted.
The real problem is most practices with traditional systems are clogged for weeks ahead and fighting off patients who want help now when there are no slots available. The solution is very simple, to abolish the old system, start again with a clean slate and BOOM! ‘My life has changed for good!’
But that takes about four weeks.