As a health system, we find ourselves in uncharted territory. The gap between need and provision has never felt greater. Much of this lies beyond our control as individuals. However, there are some steps we can take in our own practices.
The challenge is how to make the scarce resource go as far as possible, ensuring the greatest benefit to our populations. We provide substantially more appointments than ever before with a dwindling workforce. We are working longer than ever before and it’s still not enough.
The situation is anticipated to become more challenging as we move out of the pandemic, with 47% of GPs planning to cut their hours. In short, workload is unsustainable and likely to increase.
My experience of apps
Over the past five years I’ve enjoyed exploring how tech can support both patients and clinicians to have better quality conversations. I had a few early experiences of apps that galvanised my interest.
I provided primary care steer on the creation of a web-based decision-support tool for the Royal College of Paediatrics and Child Health. The project team soon recognised that to complement the web based interface, a counterpart app would streamline the user experience and increase impact for clinicians working beyond the reach of decent wifi or mobile signal.
During this period I found my head was fizzing in the evenings after long, busy days as a GP. I needed to do more than just doubling down on my usual decompressing activities of surfing and time with family to help switch off. I took to using the Headspace app to help with my sleep and have never looked back.
Stepping aside from this personal experience, I do believe that digital can help bridge the yawning chasm between need and provision. At their best, digital health tools can be used not to replace the human element of care, but rather to support and focus. Right patient, right time, right clinical situation has become a guiding principle for me.
How can tech help us?
Digital health technologies are a diverse range of offerings, but two common threads are their accessibility and scalability. In short, they allow people to access help at any time of day or night, unlike being tied to the usual working hours of general practice.
Because clinician time is inelastic, the time for each appointment needs to come from somewhere. The unit cost remains the same, regardless of scale.
Digital health technologies are different. In contrast to face-to-face consultations, whether 10 patients or 10m patients use a digital health tool, such as a mental health app, the additional time or resource required is minimal. This mechanism can also be used partly to uncouple clinician time from delivery. In short, digital health technologies actually make time elastic.
Why partly? Well these tools allow clinician time to be better focused, providing care to those people at a time when they need it most. Both those who need human involvement at that particular part of their health journey or those for whom digital tools are less easy to use.
How clinicians can use technologies
Digital health technologies can be slotted into part of a patient’s healthcare journey to help make progress, where traditionally they would have been static. For example, solutions to help improve pain and keep someone active while waiting they are waiting for a hip operation. This bridges a chronological gap.
They can also be used alongside current treatment, to augment and strengthen, bridging a quality gap. For example, keeping a mood diary between appointments with a psychological therapist or a tool to support someone quitting smoking, in between appointments with a smoking cessation counsellor.
Both of these then support the human element, multiplying our impact as individual clinicians, supporting a greater number of people, more effectively.
Many of us involved in health tech found our way into it along a winding path, often more of serendipity than our own planning.
With the sector expanding and the reach of digital extending, the path can be straightened. An understanding of what digital can offer can be shared with all clinicians, rather than confined to a handful. Given that apps are interwoven in our daily lives and ever more so in medicine, there's been a growing need for a training resource where busy clinicians can explore what are digital health technologies and what they offer.
There is help at hand in the form of a new online training academy, offering free, CPD-accredited digital health training for GPs and all NHS frontline workers. Whether you’re taking your first steps in exploring digital or you are a veritable digital wizard, there’s something for everyone.
You can access it at orcha-academy.com and on the Health Education England NHS Learning Hub. The resource offers straightforward learning, to familiarise NHS staff with where to find, and how to use, high-quality and trustworthy digital tools.
- Dr Richard Pratt is a GP in Cornwall and a clinical associate of ORCHA, the Organisation for the Review of Care and Health Apps, which reviews healthcare apps and provides libraries of accredited apps to NHS providers in 70% of regions.