With 22 mentions the “e-consultation” is a repeating theme of Arvind Madan’s NHS England GP Forward View and in the last blog I tried to nail down what this means with “the patient seeks help from their GP online”. But what’s the point of the whole idea?
The main problem facing NHS primary care is the gap between capacity and demand, and this must be the point. In the absence of the fabled 5,000 extra GPs that means that it needs to save GP time for the same or better patient outcome.
Now the Parliamentary Committee on Primary Care has weighed in with its view. Amid the hand-wringing it too highlights the potential of digital channels, and says email should be the norm for communication with patients. But this is a mistake, eliding the crucial differences between regular email and the kind of secure, structured methods we need for true e-consultation.
Email has been widely used in Denmark between patients and GPs for some years with little evidence of benefit. Even secure messaging between patients and GPs may show no time saving (Mayo Clinic study).
GPs will not agree to any system which increases their workload, however up-to-the-minute it seems to MPs. Encouraging email ping pong, or even secure messaging ping pong, won’t do it. Whatever the model for e-consultation, it must be secure of course, but also highly structured to deal with patient demand in a way which improves the quality of clinical information, saving time.
As promised, I’ve looked at the published features of the two current offerings in this space, our askmyGP service and Arvind Madan’s own webGP/eConsult, listed in this handy comparison table.
Hope this is helpful – I’ll look next at the cost models.
PS: Pulse are running a feature on telephone triage, would like a GP to propose the benefits. Let me know if you would write 500 words – they are even offering to pay!