Associate feature: Empowering patients and staff with digital primary care

Clinicians are rightly cautious over changing how we care for patients.

However the widespread use of ‘digital by default’ marks the start of a collective journey on which primary care professionals need to embark.

Healthcare has been relatively slow in adopting new technology. Look at other industries; I can’t remember the last time I went into a bank branch. Everything is done online.

With COVID19, a digital front door to primary care has been thrust wide open. It needs to stay open so that it can continue to benefit staff and patients alike.

It is crucial that we continue to provide existing ways of access to ensure equity of care.

We don’t want to exclude anyone. However, today I think people are more willing to accept that there are some components of care that could be done online.

Our three GP practices serve a mostly urban population that features some high levels of deprivation and a high proportion of elderly patients with associated multi-morbidities.

We put a strong emphasis on a multidisciplinary approach.

Our practice team includes GPs, Advanced Nurse Practitioners, Practice Nurses, Pharmacists, Physiotherapists, Mental Health Nurses, Healthcare Assistants and our administrative team.

We aim to ensure that patients see the right person at the right time, which might not mean seeing a GP.

We also want staff to have tools to do their jobs more efficiently and support continuity of care. We have been looking at how technology could help us.

Using technology to support patients and staff

Our use of telephone consultation has mushroomed during the pandemic. We also have access to Near Me for video consultation. We are encouraging both clinicians and patients to use this when required and appropriate.

Of course, if we need to bring a patient in face to face, we'll do that. Technology helps doctors choose the right type of care, which does not always mean a face to face appointment.

We are using online triage technology, developed by Klinik Healthcare Solutions, to give patients a choice of how to access care. Patients can go online to request an appointment or get health advice 24 hours a day, 7 days a week.

The Klinik system prioritises patients' enquiries as emergency, urgent, or routine using Artificial Intelligence-based algorithms developed by their team in Finland.

The system enables our clinicians to review the information provided by patients, and provides a suggested priority level. This allows us to ensure we have the patient see the right person at the right time. It means that patients aren’t seeing multiple healthcare professionals and potentially have their problem dealt with more quickly.

They also don’t have to wait to get through on busy phone lines.

Meanwhile, the workload is shared across the whole practice team and we achieve greater efficiencies as a practice. I think this is a win-win for both the practice and the patients.

We are exploring innovations such as remote blood pressure monitoring. This will allow our practice nurses to review patient readings taken at home, and see those who are most in need.

We are also looking at setting up an online system to review patients with chronic diseases. If somebody's got diabetes, for example, we can ask them to fill in an online form and bring them in if they need a more in-depth review.

Technology is also allowing us to get involved in some innovative research. We are planning to take part in the Lucid study, run by Imperial College, which involves using a video-enabled rectoscope, called LumenEye, to examine patients with rectal bleeding in the practice. There would be a consultant in the local hospital able to view the images in real-time or after the examination.

Such diagnostic technology could help us better collaborate with secondary care, and enable more procedures to be carried out at the practice. This would help deliver efficiencies for patients and the wider health system.

Dispelling the fears over digital by default

Digital technology is helping to support the process of care, and how people access that care. Patients welcome the new way in which they can open the digital front door, with tools such as Klinik’s online triage technology scoring high rates of patient satisfaction - 91 per cent of patients who used the Klinik platform said the experience was either good or excellent.

For some, there are fears that technology could harm the doctor-patient relationship. As with any tool, there is the potential for negative impact. Take social media. You can use it in a positive way, but you can also see many negative applications.

Given the increasing prevalence of these tools, it would very helpful to see the healthcare profession taking a proactive role in developing best practice to ensure high quality and safe implementation of technology.

We are all learning about how we should best use technology to improve care. Policy-makers, regulators and funders need to come together with healthcare providers on this journey, so we can make the right choices for all.

But today we have the keys to empowering and engaging patients in their healthcare. It is time we came together to open the digital by default door.

Dr. Azhar Ali is managing partner at the Forth Medical Group. This article was sponsored by Klinik Healthcare Solutions.