As the medical director for a global IT firm and a clinician with a passion for IT and innovation, I often enjoy catching up with colleagues to gauge the mood of those on the front line of healthcare delivery. I was having coffee with Dr. Atif Ghaffar, a GP from the West Midlands, when we started to discuss the state of general practice. Only this morning had we both read the BBC article titled: UK's short GP consultations 'crazy' when suddenly he looked me in the eyes and came out with “IT is killing general practice.”
Well that's a bit awkward, seeing as my cheesecake hadn't arrived and he made me feel in an instant that I was responsible for the failings of my adopted industry. But thinking back to my clinical days, I realised I needed to investigate further if I wanted to make the correct diagnosis for his woes.
According to the BBC, the average GP consultation is 10 minutes and it is thought to be the shortest in the developed world. The profession is concerned that this may get worse, given the changes planned for the NHS and a shift to more of a community care model. And while the BBC article looked at a number of factors, it didn’t refer specifically to IT.
I was curious to hear Atif’s perspective, and seeing as my glorious New-York-baked cheesecake had arrived, I sat back to listen to my esteemed colleague’s frustration with IT.
Atif, through his work as a GP and the Governance and Education Lead for the Walsall Alliance Federation, has seen many changes over the past 15 years. The death of Primary Care Trusts (PCTs), the marriage to Quality Outcome Framework (QOF) and the birth of Clinical Commissioning Group, (CCGs). He is in regular contact with more than 30 primary care practices that cover a population of more than 120,000 people, so he is well aware of the challenges, and his feelings echo those of his colleagues. Primary care has often been overlooked when it comes to IT. The wealth of data that has been collected through QOF has made GPs and their teams feel like glorified data-entry clerks completing a check-box exercise. That's not to ignore the potential value of the data, but it has meant a reduction in the time available for face-to-face interaction with patients. The desktop becomes a distraction rather than a tool. Even saving a couple of minutes can make a huge difference, especially when you consider that the first golden 60 secondsis when you may glean the most important and helpful information. The last thing a GP wants to do is to be waiting for his screen to refresh, or searching for info from the last hospital visit. Distractions can mean that this opportunity is missed if the patient isn’t engaged.
As we talked, it become apparent to me that it isn’t actually IT that is the problem. The challenge is gaining access to the right IT. We focussed on the top three challenges and I shared my experience of how IT was capable of making the difference needed for better patient connection.
Top 3 IT challenges for GPs:
- Outdated Infrastructure slows the system, eating up valuable time during face-to-face encounters. Desktops and laptops run on old operating systems, and network speeds can be variable, resulting in unresponsive technology.
- A lack of interoperability means a lack of real-time access to data from hospital stays. That matters because the sickest patients are the ones who are regularly at the hospital, and waiting for the data to arrive by snail mail means informed decisions about care can be delayed.
- GPs lack the tools they need to proactively manage patient care and provide better outcomes, particularly for patients with chronic conditions. To move quickly to value-based care, GPs need access to health risk data and tools to help patients actively improve their health.
So what needs to happen?
- IT-as-a-Service (ITaaS) needs to replace trust-owned infrastructure. This model ensures that desktops and laptops are refreshed regularly so that they remain optimised for speed. The network is managed by experts with global experience and new technologies come online quickly.
- Interoperability needs to be tackled by adding a layer on top of current systems to integrate data across the healthcare economy. Interoperability solutions work to bring information to the right people as and when it is needed, while proving security and richness of data.
- Population health management needs to be a priority. As the breadth and depth of patient data increases through care providers and personal input from the Internet of Things (IoT) and wearables etc., we need a data management model, including analytics, which brings it all together. The true value of QOF has not been realised as it is target-based, whereas population health management will focus on stratifying risk and on value-based care. Technology, such as remote monitoring and telehealth, can make intensive services, which patients with chronic diseases need for better outcomes, efficient and affordable.
So by the time we finished our coffee and cheesecake, I'm glad to say I learned a lot about what makes many GPs anxious. Our conversation also helped me frame the opportunity we have if we use IT in the right way. We need to forge partnerships with the NHS and focus on building a sound, flexible infrastructure with system-wide interoperability. Then we can use IT as platform to facilitate future healthcare initiatives. My feeling is that population health management will be the game changer, but to truly realise the benefits we’ll need to have the right IT infrastructure at the start.
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Perhaps it was my elaboration of the capabilities of what an IT services company can provide, or maybe Atif was placated by the coffee and cake. Either way we had both learned a little more about our respective domains and I’m looking forward to our next discussion regarding the NHS.
Post Date: 2017-02-16