Building on the COVID tech revolution

Dumfries based GP and EMIS Clinical Intelligence Director, Dr Rob Walter, reflects on the impact the pandemic has had upon general practice, and how we can emerge stronger from this crisis with the support of the right technology.


When it comes to healthcare, I’m a firm believer that technology should support the user, not replace the user. Over the past year, tech solutions have been fundamental in enabling healthcare teams to continue to safely care for patients, and there’s no doubt that this global crisis has forced an acceleration in the use of technology across the healthcare economy. But if there’s one thing the pandemic has taught us, it’s the vital role that human connection and interaction plays in our wellbeing. As general practice begins to find its feet after a period of upheaval, we’re contemplating how to marry the old ways with the new, and find a balance that means technology is enabling clinicians to do what they do best; care for patients. 
 

Life on the front line

General practice has always been adaptable and responsive, but when the COVID outbreak reached the UK, we became more fluid than ever. Overnight, teams pivoted from face to face, hands on patient care, to remote consulting and triage by necessity. In the very early days, many practices experienced a lull, as patients were fearful both of leaving their home, and of using valuable GP time. As the nation settled into the new normal, demand soon picked up pace – but without the same level of visibility, there was a public perception that general practice was ‘closed for business’.  

In reality, our teams were busier than ever before – managing patient needs in parallel with new ways of working and the implementation of new technologies. The pandemic didn’t allow us the grace of a transition period – instead we all faced a steep learning curve as new solutions were introduced and adopted. Patients too were forced to adapt to new models; beyond merely adjusting to new ways of seeking support, there was an onus on taking control of their own healthcare and relieving any unnecessary pressure on practices. The downside of course, as has been widely reported, are those patients who stayed away when they shouldn’t, and who are now presenting late with serious illnesses that are harder to treat and manage.  

For clinical teams, much as for the general population, the personal isolation was difficult to face. Like many GPs, I got into this career because I love spending time with my patients. When ways of working were transformed in response to COVID, one of the biggest impacts for me personally was the limited opportunity to connect face to face with both patients and colleagues. Various periods saw colleagues shielding and self-isolating, and the opportunities for in-person interactions were few. To me, it reinforced the human side of my job – the generations of families I have known and cared for, the daily connection of a morning coffee break with colleagues, the non-verbal cues picked up from sitting opposite a patient. Technology can never replace the intuition and knowledge of social circumstances that allow a clinician to make a judgement. So where then does it find a place within the healthcare landscape? 

Technology that meets modern challenges 

As we emerge from the COVID crisis, general practice faces a combination of challenges; managing the ‘backlog’ of patient needs, supporting the mass vaccination programme, and establishing new ways of working, borne from a combination of traditional service delivery alongside new approaches and learnings taken from the past 18 months. Fundamental to our success is the implementation of technologies that help healthcare teams to cut through the noise. Rather than replacing clinical judgement, we believe technology should empower clinicians to make informed decisions by delivering the right information, at the right time, to the right person.  

By signposting patients to the most appropriate service at first contact, we can ensure that the patient is safely directed to the right place, and if necessary, we can use this opportunity to gather information. With both myself and the patient confident that when they come for a consultation, they’re seeing the right person for the job, I can in turn eliminate the time previously taken finding old notes or having the patient recount their concerns once more, and instead be present and prepared. Technology can help me deal with any admin much quicker so I have more time to spend with my patient, enabling more meaningful conversations that ultimately improve outcomes.  

When facing the unmet and delayed demand at our door, we need to use technology to ensure that we focus and prioritise those most at risk. With more remote consultations and self-care, the opportunistic diagnoses are more sporadic, but conversely it becomes easier to spot deterioration. As such, the use of tools such as analytics and risk stratification allow us to identify those most at risk - to highlight the frail, the non-attenders, the dis-engaged, the chaotic and unhealthy lifestyles, and those that are non-compliant with polypharmacy - and focus on proactive, preventative care. In doing so, appointment time will be awarded not to those who shout the loudest, but to those with the greatest need.  

Building the future of healthcare technology 

In my role within EMIS, I am always looking at how we can get the right patient to the right clinician, and then present the relevant information concisely and appropriately. Ensuring that we are balancing the clinician priorities and the patients' needs. Technology needs to support the clinician seamlessly, so that the clinician is not replaced but empowered. Being involved in the development of these products and solutions ensures that we’re creating tech that truly supports our users and brings the right information into focus. The reward is that I have time to deal with the patients’ concerns in the right context, and ultimately improve satisfaction for all.