On 15 June 2017, DigitalHealth.London, in partnership with Healthy London Partnership, NHS England and ECHAlliance, were pleased to welcome primary care stakeholders and industry working with online consultation technologies, to an event to support primary care practices across London to progress with wider implementation of online consultation technologies.

Through a combination of presentations from clinicians, tabletop ‘hacks’ and industry pitches, the afternoon sought to identify current barriers to wider deployment of online consultation technology, support and inspire attendees to identify solutions and personal next steps.

Below, readers can access presentations and a summary of key outputs from the digital healthcare event.

Presentations:

Opening Keynote (inspiration): ‘The Art of the Possible’ (TBC)
Dr Murray Ellender, The Hurley Group & Web GP

Online consultation tech: The current market overview
Phillipa Rose Hodgson, Healthy London Partnership

Why doing nothing isn’t an option: Neighbourhood insights from Camden

Dr Ammara Hughes, GP partner and trainer in Camden

Re-engineering your service: Getting ready for change

Dr. Aumran Tahir, AT Medics

Discussion highlights and next steps:

So why have you not yet considered virtual consultation technologies? What would help you make progress?

• Money is the enabler – and the sticking point!

• The incentive needs to be spelt out very clearly to stakeholders. An interesting point for industry partners: Reducing DNAs is not an incentive to primary care clinicians – many frequently rely on them to catch up with their practice schedule.

• Metrics may be difficult to determine – but they will be important.

• We need to address the fear, and apprehension at ‘taking the plunge’.

• One incentive will be patient empowerment. We can hand over as much as possible to patients before they attend GP clinics, streamlining subsequent engagements.

• Organisational readiness is a factor. Organisations need to be ready to change, which means their staff need to be on board at all levels, and willing to adapt to new processes. All staff need to recognise the importance of this!

• Patients need to be more aware of these technologies too – whichever form they take.

So, how can we start to address these barriers? 

Finance:

In the absence of clarity on funding, messaging needs to emphasise the things that are more important – eg. Improved outcomes for patients and more efficient workflows for staff.

Changing Behaviour:

• Patient behaviour needs to change, and for this to happen staff behaviour will need to change first!
• Therefore staff training is essential, especially for reception teams. Staff always need to remind patients to go online as the first point of call.
• Answerphone messages have proven helpful for some – again to remind patients to go online.

Building Evidence:

• Both staff and patients need to know the benefits of these technologies – so we need evidence that chimes with the challenges facing clinicians.
• There’s lots of evidence already out there, particularly in case studies. We just need a way to pool and share it!
• DigitalHealth.London can support with sharing these.
• A way of sharing feedback, lessons and best practice would be helpful.

Addressing the issue of fear:

• Information governance issues can always be overcome.
• Remember, some solutions are simple! Whatsapp has had a huge impact on clinical communication.
• Stakeholders need to be reassured that these technologies will not add to already stretched workloads.
• A team to travel between different GP practices, engaging and reassuring practice teams about the benefits of these technologies would be helpful.
• Perhaps a role here for the GP consortiums to take the lead.

So why is doing nothing not an option?

• Patients expect this. They do not want to wait two weeks for an appointment when they have a concern now.
• Simple pressures on the system can be avoided. In many cases patients currently book appointments ‘just in case’ often simply because they do not know how long they will have to wait for an appointment – many of these could be dealt with better through online triage or consultations.
• Immediacy is really important for patients. This doesn’t necessarily need to be immediate engagement with a clinician, just confirmation that they can engage within 24/48 hours.
• There is so much pressure on the system, we cannot afford to just carry on with business as usual.

How can we make progress now? (Next Steps)

• Hubs can help! Working at scale, in partnership with other practices, can really streamline adoption of these technologies.
• We need to build evidence from those practices that are already using this technology – start to pool case studies of success and share the benefits.

Solutions out there now (Industry Pitches)

Babylon

An online consultation and artificially intelligent triage platform that combines the best of clinical expertise, smartphone technology and machine learning to put accessible and affordable healthcare into the hands of everyone on the planet.

MedicSpot

MedicSpot installs telemedicine stations in pharmacies which allow for a full remote clinical examination in addition to a video-consultation – ensuring a more accurate diagnosis and increased patient safety.

Engage Consult

Online consultation request and clinical workflow system for General Practice

Sense.ly Ask NHS

The Ask NHS mobile app uses a ‘virtual nurse’ to gather information as any clinician would in a person-to-person interaction, the app then directs patients to the most appropriate NHS service or resource.

Ada Health

Ada is an AI powered medical assessment engine that gives users a differential, next step care information and the ability to connect to a GP from their smartphone.

Accenture’s NHS Mail 2 Platform

The national collaboration platform for the NHS, which includes Skype for Business audio & video functionality that can enable virtual consultations.

eConsult

eConsult – primary care triage designed by GPs, for GPs

Connected HealthTech Solutions

A Virtual Clinic Platform Delivering over 300,000 consultations a year.

Veloscient

Iplato

myGP the number 1 downloaded free medical app that improves patient access and outcomes

Cinos Communications Services – HealthConnect

HealthConnect delivers secure, IG-compliant video conferencing for your clinical needs, and creates exciting new opportunities for managing patient demand.