The past couple of years have seen GPs and consultants adopt health technology and new ways of working very quickly, while under great pressure. Zoom consults and telephone appointments were no doubt going to be something that would be integrated into the care structure, but the pandemic made them necessary, and they had to be integrated into the daily routine of the NHS in a short time frame.
In the 1950s patients had to queue for an appointment, by the 1960s and 70s, surgeries were allocating 5-minute appointments. With the advance in technology, today's 10-minute appointments (which may or may not be conducted face to face) will likely be booked online and checked in via a touch-in arrival screen, supported by a health kiosk.
So, where could digital healthcare take us in the next ten years, with more time to innovate, and adapt, less pressure to integrate these solutions under time constraints, allowing research and development teams to unleash their creativity? What will this all mean for GP consultations in the future - will we be talking to an avatar or will things be much the same?
Consultations of the future
There are a multitude of consultation models available to help GPs make the most of their time that have had varying levels of influence throughout the history of the NHS; from the Byrne Long model in the 1970s when the idea of involving the patient in the consultation was fairly new through to the Calgary-Cambridge model which is much-more patient-centred, with many more models in-between.
Whilst consultation models may provide structures that help to make the most of a 10-minute appointment, they have mainly been written for face-to-face consultations and do not take account of the use of telephone and email, or patients with mobile-phone and internet-driven lifestyles who expect technology-related benefits within their GP practice. It is not inconceivable to think that the consultation model may change drastically in the future with the advent of technology.
Will the GP practice remain the centre of care delivery or might we get our health checks whilst visiting the supermarket? Will we get to physically see a GP or will an avatar question and diagnose us?
The implementation of any new technology within the GP practice context requires consideration of ways of working and service design. This is certainly true of the health kiosk; to get the best value from the device thought needs to be put into how kiosk use might best fit within the patient flow and how it might be utilised to save clinician time. Our practices are using their kiosks in a number of ways in synergy with the standard consultation model, including:
- Collecting data from patients on the kiosk prior to a face-to-face appointment
- Allowing patients to book an appointment with the kiosk
- Using the pathway questionnaires to screen out people who do not need to be seen face-to-face
- In place of a face-to-face appointment, for example, a pill check or BP reading
- Using the kiosk for data gather at clinics
It is not inconceivable to suggest that technology such as health kiosks could enable GPs to spend more than 10 minutes per patient in the future, allowing clinicians to direct their attention to where it is most needed and enabling patients to take responsibility for elements of self-care.
What is your vision, will you share your vision with us?
A recent paper in the Frontiers in Digital Health journal has suggested that the adopters and users of technology are too often an afterthought for developers who are more concerned with the functionality of their kit than how it will be used in a real-world context.
There are an overwhelming list of tasks that have to be achieved within a 10-minute appointment, including ascertaining the reason for the patient’s attendance and a history/effects of the problem, choosing an appropriate plan of action, achieving a shared understanding of the disease and related lifestyle factors, involving the patient in the management of the condition, establishing a rapport with the patient, picking up on social cues, and, if at all possible, keeping this overwhelming list of tasks within a 10-minute window whilst drawing on limited resources and an ever-changing social context. This can be more of a struggle if a patient presents multiple problems in any level of detail.
Here at EK we want to put our practices and clinicians at the centre of our plans for the future so we would like to hear your thoughts. Wild and wonderful ideas are very welcome and will be discussed in our development meetings. If money was no object, how could the health kiosk best be developed to help you in your practice?
Let us know call 01223 812737 or email firstname.lastname@example.org