Looking from the outside, and I’d like to keep it that way for as long as possible, the practice of medicine seems pretty high tech these days. Technology underpins the discovery of new drugs, improved diagnostics, and new procedures, all of which, notwithstanding the skill of medical practitioners, improves patient outcomes. But access to some of the most basic medical services has not kept pace with the expectations of a 24/7 society and I’m not alone in thinking this.
Sir Bruce Keogh, the Medical Director of the NHS for England, has expressed some strong views. In an interview with The Times1 he talks about the health service having a long way to go before it catches up with the technological progress of recent decades. This referred specifically to GP consultations and he goes further in his speech on Transparency2 when he talks about taking responsibility for your own healthcare, online consultations and owning our own health records. This is radical stuff and is bound to divide opinion.
If, like me, you believe intelligent ICT empowers individuals you will welcome Sir Bruce Keogh’s statement. Similarly, you will be encouraged by the Health Secretary, Andrew Lansley’s clarion call for health professionals, app developers, and patients to come up with new ideas for health apps3. I wouldn’t go so far as to say there is a strategy but I think it’s clear that a vision is emerging. However, many will see this as nothing more than an attempt to make savings by keeping patients away from expensive practitioners; innovation always has its doubters.
So imagine a scenario where I’m not feeling too good. I tap the medical app on my smart phone and enter some details regarding my symptoms. A message tells me my symptoms resemble something that’s doing the rounds and the best thing is to increase my fluid intake and take some paracetamol for the next three days. After three days I get another message asking if the symptoms have cleared. If yes, then my electronic patient records are automatically updated thus maintaining my medical history. If no, then I’m guided through some more questioning. This could lead to an online consultation with a GP or maybe I’m advised to make an appointment for a face to face consultation. Either way, it is arranged and confirmed automatically through my app.
I suggest three conditions need to be in place for this to be successful:
With NHS Direct handling over nine million calls each year4 there is a considerable body of knowledge that can be called on to develop remote diagnostic best practice and embed this into an online diagnostic tool.
The second point will be influenced by the future direction of the NHS 111 service.
Privacy and integrity are paramount but let’s not lose sight that millions of us put our trust in such things as online banking. The principle of accessing and updating sensitive personal information remotely is established and technology can provide ways to make this happen safely and securely whether in our private or working lives – take a look at this short video to see how.
For me, this is ICT at its best; it has the potential to save money and, as a taxpayer, I feel good about that. It fundamentally changes my experience as a user and gives me more control; I feel empowered. But what do you think? Is Sir Bruce Keogh’s vision focussing on potential cost savings or the patient experience? What other conditions would you need to be in place before you use the online service? How do we avoid creating a two tier health service? Let me know your thoughts.
1 Sir Bruce Keogh interviewed by Chris Smyth (29.08.11) The Times Online (paywall)
2 Sir Bruce Keogh (2011) Transparency Event (transcript of speech)
3 Andrew Lansley (22.08.11) Department of Health Website
4 NHS Direct website (02.09.11)