Is tech the answer to care home conundrum?
I’m not a petrol head. If you gave me a Formula 1 car, Lewis Hamilton would have nothing to worry about because I’ve not been shown how to use it.
Giving technology to a doctor who is neither interested or invested in it would be a similar waste of time.
However, as a doctor with 20 years’ experience – including 14 as a GP – I’ve come to recognise both the role and potential of technology in treating patients.
By way of background I’m the senior partner of Loomer Road Surgery, in Chesterton and Haymarket Health Centre, in Tunstall, Staffordshire.
We have four full-time and seven part-time GPs and we look after 28,000 patients. We have to use our finite resources sparingly innovatively.
A couple of years ago I realised how inefficiently we were practising with call-outs to care homes, so started to look at possible solutions. With increasing workforce issues, the need to practise differently became a priority.
We have 12 care homes in our catchment area – significantly higher than the national average – and at peak times we were getting as many as 20 call-outs a day! That's enough work for one GP alone!
I’m not criticising the care home staff. They’re so highly regulated that they’re worried about getting it wrong. As such their default position is to call out a GP or a paramedic.
Throw in the fact we have an ageing population and that people are living a lot longer with more complicated medical conditions and it’s created a perfect storm.
GP numbers are falling but patient expectations are rising. A lot of the call-outs we were getting to care homes were for routine complaints like chest infections, water infections and minor conditions coughs. I remember once getting called out for a blood test result!
It was against this backdrop that we were asked about 18 months ago if we wanted to take part in an initiative called the North Staffordshire and Stoke-on-Trent Video Consultation Pilot, which connected GPs to care homes via Skype.
Health commissioners appointed Preston-based digital agency Redmoor Health to upskill GPs and care home staff in how to use online video technology – and the results have been transformational.
Under the initiative, selected GP practices and nursing and residential homes in the region were given portable computer tablets loaded with audio visual programmes, the CCGs’ Florence telehealth system, health management apps and video consultation technology.
Care home staff were trained in how to take basic measurements like a patient’s pulse, temperature and blood pressure and give that to GPs. It’s important to say that staff can measure but not interpret. There’s an awful lot of information you can get from a trained eye but they’re not substitute doctors.
What happens now is a care home will call us and we can normally set up a Skype call within a couple of hours or sooner unless urgent action is required.
We’ve not had any complaints or any significant events from patients and many actually prefer a Skype call.
On average we’re now doing about 30 per cent of the care home call-outs we were before the initiative and we’ve built up some really good relationships with a few of the really engaged care homes staff. Conversely, care homes who have not engaged have remained problematic or gotten worse.
From a doctor’s point of view we’re able to see more patients and reduce our carbon footprint in the process by driving less.
Technology is a tool. It’s not the solution to every problem but it’s an enabler. Ultimately it’s about harnessing the benefits of modern technology to provide better healthcare.
The final point I’d make is that great technology is only as good as the staff that use it which is why the training is so important. Without the training the technology will be like that F1 car that never gets out the pits.