28 September 2017

Are digital tools the way to improve access to primary care?

Dr Mizan Hoque summarises the inspiring and thoughtful discussions among colleagues working in primary care at our recent event. 

UCLPartners primary care development event on 20 September ‘Are e-consultations the answer to the access challenges in general practice?’ explored many innovative ideas to address some of the major challenges that primary care is facing.

As always with this series of events, we attracted a wide range of participants including clinicians, primary care leaders, managers and digital innovators (as a colleague from ‘the world of tech’ preferred to be described). This facilitated a rich and lively discussion.

The setting of the evening’s discourse was broadly about how advancements in technology can help to enhance primary care. There was a general consensus that primary care is behind in taking advantage of technological advances that have revolutionised most other aspects of our lives. Many examples of how technology has resulted in major changes in other industries served to further highlight the potential that could be realised if the primary care community could venture into this area in a more substantive manner.

 

Dr Murray Ellender from the Hurley Group and Dr Mobasher Butt from Babylon Health both shared experiences and benefits of using different technology to help improve access in primary care. econsult – a website-based platform for triage and consultation – was one such model that had proved successful for the Hurley Group, and caught a lot of people’s interest. It offers patients a platform to consult their GP by first entering the details their symptoms on the website; following which they are able to access a range of information about their symptoms, and the various options available to them, e.g. self-help, pharmacist, GP surgery, 111 services.  It then provided the doctor who was triaging the consultation request with lots more information, thus facilitating better triage, and reducing consultation time (by having more of the history available).

Other interesting ideas included the use of small computer stations in out-of-hours waiting areas, which patients could use to enter their own triage notes and have an automated set of observations done. Examples of how pre-recorded consultations to promote patient education and standardise care was another suggested idea that was easy to envision.

Naturally these endeavours are not without challenges. For instance, holding video consultations with patients could pose challenges with connectivity and be limited by internet bandwidth speeds. Email correspondence with patients has security issues. Also, there was a question raised about how well suited our current IT infrastructure is to be able to effectively take on some of these new innovations.

E-consultations encompass a broad array of consultation platforms, each with their own merits and challenges. It is definitely a conversation that’s long overdue, and there are some very interesting advancements that are being made. It became quite apparent that many of these initiatives do indeed require larger organisations and networks with a wider range of resources to push the area forward in an effective manner. Robust evaluation of these new methods is essential to fully understand their scope and limitations, and help guide wider adoption.

Mizan Hoque is a Primary Care Quality Improvement Lead at UCLPartners.

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