With 1 million patients now using the NHS every 36 hours, the pressure is firmly on the nation’s healthcare system to cope with an increased, ageing population, more complex medical conditions being treated, increased waiting time for treatment and more ingenious medicine which is keeping people alive for longer. Tie that to Brexit and the drive for a 7 day service against today’s staffing pressures and you can see a perfect storm brewing.
Enter then, Health Minister Jeremy Hunt and reflect on his 5 Year Forward View for the NHS. Published in 2015, he laid out his vision for a gradual but persistent transition to patient power – in which digital technology would play a central role. This was expanded on with his appointment of digital guru Martha Lane Fox to identify four key changes to map out a digital NHS for everyone. Her stated targets included the following:
o To reach the furthest first and leave nobody behind
o To provide free WiFi for all throughout the NHS
o To build the skills of NHS staff to support people’s needs in the digital age
o To boost take up of online GP services
So it’s exciting three years on to hear good news coming from NHS Digital’s Leeds HQ. Their latest figures show patient registration take up for secure GP online services in England has risen sharply. Nearly 14 million patients are now going to their GP’s online for a variety of NHS services without the need to visit a surgery or phoning the practice. These include:
• Booking appointments
• Ordering repeat prescriptions
• Patients view their own records
The figure of 14 million patients is up 42% on February 2017 and amounts to a total of 24% of patients in England now being registered.
For the GP surgeries in local communities who have taken the plunge to embrace technology and overcome initial reservations in parts, these digital pioneers are now reaping the benefits from a variety of online GP cloud service providers. The results are significant time savings for both the staff and practice GPs, fewer ‘no shows’ and improved patient awareness as patients become more knowledgeable about long term conditions. The net benefit is derived because GPS have integrated the online public service with single source information clinical systems like EMIS and SystmOne.
There will always rightly need to be a hawkish attitude around protecting sensitive data, however if these new online systems are well governed and securely managed, the public that take up this offer can enjoy a degree of ownership of their healthcare data in intelligent partnership with their GPs and healthcare providers – and in so doing, feel good too they are contributing to improving NHS service efficiencies in the 21st Century.
With the advent of wearable technology and health trackers, along with social media and the power of Google, many patients are turning to personal investigation to check out their personal health symptons and conditions online using Google, Bing, Yahoo and others. This marks the evolution of the e-patient.
US cancer sufferer and blogger Dave de Bronkart whose moniker is ‘e-patient Dave’, originally rose to prominence in 2009 and recently spoke at the Intersystems joined-up healthcare event in the US to advocate greater openness in the worldwide healthcare community between patient and the doctor as the patient seeks to know more.
Patients are able to access their digital health records (though relatively few do – 0.4% of GP patients thus far in the UK) and by doing so are best placed to identify any errors in separately held records across service providers and regions. With access to online services, cost savings for booking appointments online, obtaining referrals, and even doctors using wifi to track patient flow through a hospital, this creates massive savings for primary care providers and hospital trusts.
The mainly holistic but equally powerful change however comes through the doctor being open to suggestion from the patient during consultations, as a result of today’s vast wealth of data available online. This offers patients access to research resources which can supplement practioner’s knowledge as well as reinforce or challenge, which should not be written off. As e-patient Dave argues, this should bring doctor and patient closer together but could be seen by some GPs as a threat. The patient should be welcomed in bringing their own healthcare research and knowledge to the table. By being open to this he argues, it increases interaction and creates a more educated dialogue, involving better informed questions and greater degree of insight whether a good or bad prognosis. This ultimately provides the opportunity for perceived delivery of a greater level of personal care through proper and open consultation.
These are concepts advocated by UK health minister Jeremy Hunt, who as the NHS seeks to go paperless by 2018, has tasked Martha Lane Fox with putting together a proposal on increasing the uptake of digital innovation in the NHS. This will no doubt include proposals to involve greater use of social media or webex consultations, other than the existing social media use of just inviting views or questions by the healthcare organisations which a number have already undertaken. With the higher motive of saving billions of pounds, there is nonetheless an argument that greater empowerment and enablement will assist trusts as they seek to save money bluntly through technology on the one hand and enable the patient to be more involved in their own care and outcomes. Just keep a weather eye on the critical issue of the handling of patient data and privacy as this direction evolves.