Author(s): Katie Taylor
Virtual GP services began to be discussed as early as the year 2000, and health advice is now the second-most searched for topic online. But are the realities of the concept shaping up to our dreams for this new model of care?
We're often advertised the benefits of app-based health services as the answer to long waiting times and a busy lifestyle. However, some — including the regulatory Care Quality Commission — have voiced concerns over more-apparent differences to traditional options, such as a lack of continuity of care, fears about data protection and the possibility of improper monitoring in the longer term or missed drug contraindications. Many simple check-ups need person-to-person interaction, the absence of which could lead to missed symptoms and inappropriate prescriptions.
But deeper problems are now becoming evident as health-related technology sees wider recognition and adoption.
In the UK, such medical apps are increasing pressure and problems for the National Health Service (NHS), with current funding methods unfairly benefitting brick-and-mortar facilities that also offer app integration. One such example is London's Lillie Road practice, which provides traditional GP services alongside free app-based consultations via NHS-affiliated GP at Hand.
The NHS contributes a set amount of money per patient to surgeries, with the cost of treating chronically ill or elderly patients usually subsidised by the funding received for healthy individuals who seldom make visits.
However, facilities offering app-based services are attracting a high number of young, tech-savvy individuals, who typically fall within this generally healthy group. Nearly 80 percent of Lillie Road's patients, for instance, are between the ages of 20 and 39, and only 1 percent over 70 years old. The modernisation of amenities is pushing particularly older patients to other surgeries, putting disproportionate financial strain on these practices.
It may appear that these apps are at least able to free up GP time so that unwell individuals can secure face-to-face appointments more quickly. However, fast and easy access to medical professionals through mobile phones is leading relatively healthy patients to use these services more often, meaning that GPs are instead experiencing a heavier workload.
Paid-for apps such as Push Doctor are also affecting public health service staffing, with about 7,000 NHS GPs registered on its system as practitioners look to supplement their earnings.
One straightforward solution would be to ultimately deal with all triage cases and mild illnesses using artificial intelligence to analyse symptoms data and offer advice about treatment routes or at-home self-care methods. But the cost of developing and integrating this technology into existing systems, particularly for an organisation as technologically fragmented as the NHS, would be substantial. The King's Fund think tank additionally notes that the NHS is poor at adopting innovations, with annual spending on the propagation of new technologies at just £50 million of the £125 billion planned spending by the Department of Health in England in fiscal 2017/18.
Virtual consultation services could eventually allow for faster and more convenient access to healthcare advice: GP at Hand offers online appointments within two hours, and the Lillie Road clinic jumped from a little under 5,000 to just over 19,000 patients in three months — a staggering nearly fourfold jump in capacity and demand. A current average of 80 percent of appointments are closed entirely online, keeping these patients out of physical establishments.
But the incompatibility with traditional services now being recognised is likely to take years to navigate. Further diagnosis and treatment remains essential.
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