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21.12.19

Trying to book an appointment at your local GP surgery is enough to bring anyone out in a cold sweat. That is, unless you enjoy spending your mornings listening to on-hold music or getting short shrift from disgruntled reception staff who clearly overslept on the day that customer service training was given.

Or you might be one of the lucky ones in the catchment areas of well-run surgeries who have adopted the latest technologies to streamline and simplify the end-to-end patient experience. After all, caring and competent clinicians only play a role on the road to recovery. And frustratingly, for many, that road is blighted with obstacles: archaic practices, long wait times and exhausted staff members. So how could we do things differently? 

Lots of us are guilty of Googling symptoms as a first port of call, but what if the internet could offer more than generic information and unregulated forums? What if genuine, qualified GPs were available at the click of a button at any time of day, from anywhere in the world? What other ways can technology support in the mission to improve healthcare for all?

In July 2019, the UK government announced a collaboration with Amazon to provide reliable health information from the NHS website through voice-assisted technology.

By asking questions such as “Alexa, how do I treat a migraine?” and “Alexa, what are the symptoms of chickenpox?”, users will receive professional, NHS-verified health information in a matter of seconds, thus relieving pressure on local surgeries and hospitals. That’s the plan, at least…

Whilst digitising NHS services is a big step forward - especially for those who cannot access the internet through traditional means - I cannot foresee voice-assisted technology adequately providing the required assurances. Being told to “rest and sleep”, “keep warm” and “drink plenty of water” is all sound advice for treating flu, but I suspect many will still seek a second opinion - just in case!

Arguably possessing more potential for relieving that pressure are Virtual GP programmes. 

Push Doctois one such programme. Founded in 2013 and regulated by the Care Quality Commission, this Manchester-based enterprise offers online video calls with GPs for same day prescriptions, sick notes and referrals.

 

Frequently treated conditions include infections, joint pain, colds, flu, asthma, tonsillitis, gastroenteritis and irritable bowel syndrome, as well as mental health. Patients can choose from paying for a membership or a “pay as you go” service where appointments start from £30.

London-based Babylon offers a similar service, with the following mission:

Babylon believes it is possible to put an accessible and affordable health service in the hands of every person on earth.

 

How? By combining the ever-growing computing power of machines with the best medical expertise of humans to create a comprehensive, immediate and personalised health service and making it universally available.

Their Babylon GP at Hand service offers 24/7 virtual GP appointments on mobile or tablet, whilst their Interactive Symptom Checker can help to assess a condition:

Babylon's AI system has been created by experienced doctors and scientists using the latest advances in deep-learning. Much more than a searchable database, it assesses known symptoms and risk factors to provide informed, up-to-date medical information.

Many such services claim to be the “future of healthcare” and it’s difficult to argue with, at least where straightforward, common medical cases are concerned.

 

I’m sure we’ve all had moments in life where we need to hear a qualified professional tell us we – or our parents, partners, children – are going to be alright. That those nasty spots are just chickenpox and not a sign of something more sinister. In these instances, a Virtual GP is a truly brilliant concept that could feasibly save the NHS - and patients – time, money and resources. The challenge, however, is how confident GPs can be in their diagnosis by looking at pixels on a screen. What if the rash isn’t chickenpox, and the doctor missed the signs by not conducting a thorough physical examination in person? 

An infallible escalation process is required to counter such challenges (for instance, ensuring patients are fully assessed in person and treated within the hour if their condition dictates), although I expect such a process could never be fully honed, no matter how sophisticated the technology or wide-reaching the adoption. 

What may be possible, however, is to develop a 360 degree view of patients that combines multiple advanced technologies. Artificial intelligence, remote monitoring and the internet of things could all play a huge role in reshaping the healthcare sector as we know it. 

In a fascinating article by Helena Pozniak of The Telegraph, she explores how GPs of the future could know how well their patients are without laying eyes on them:

Smart pills swallowed by patients could monitor how they’re responding to their medication. Wearable biosensors – from contact lenses that track glucose levels to shoes that measure weight, balance and temperature – could alert doctors if anything is amiss and provide a digital health diary.

Advanced analytics combined with the internet of things today can help predict if a frail patient is about to fall. In the near future it may even tell us if someone has a sudden heightened risk of a heart attack.

 

According to a February 2019 Forbes Insights article, the three major zones for investment in health-related AI are:

 

  • Digitisation: Using AI or other digital tools to make operational processes less expensive

  • Engagement: Improving how patients and consumers interact with healthcare providers, systems and services

  • Diagnostics: Developing new products and services that use AI algorithms to provide diagnoses or health advice to patients

In a world where our health services are buckling under the pressure, it’s reassuring to know of the far-reaching and transformative potential of technology to reduce wait times, human errors and mortality rates. It’s only a matter of time before this potential is realised, but let’s hope it is sooner rather than later – for everyone’s sake.

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