Patients don't want to self-diagnose, they want insights
Why, so often now, do we seem to treat digital healthtech as an alternative to clinician contact?
Why do we read six articles a week in the national press forecasting a time, apparently close at hand, when technology will allow us to dispense with clinicians entirely? And why would we want it to?
As Dr Matt Orr wrote in these pages a few weeks back, healthtech can and should save patients time – that’s one of its main jobs. But that doesn’t have to mean avoiding contact with a doctor altogether. My own digital vision involves more doctor, not less: I think healthtech can be used to bring clinical expertise closer to the patient, rather than replacing it: an enabler, not a surrogate.
I have to say, too, that I’m not convinced there’s much appetite among the public for self-diagnosis, as Dr Orr concludes. People are Googling their symptoms, sure, but I doubt most of them really want to self-diagnose.
Patients are usually quite aware that they can’t diagnose their own health conditions – hence the anxiety that Dr Orr identifies. I think they just want health insights quicker than they tend to get them right now – and, more than that, they want more of a say in managing their health in general.
GPs are incredibly hard-working people, and as a group they’re seriously competent too. But they’re not gods, and in my experience they’re actually pretty reticent about being treated like they are. GPs are often required to make major decisions, on the spot, with less to go on than they might like – and that can have lasting consequences that we wouldn’t choose.
As things stand, the GP typically defines the health pathway from the outset: they meet a patient, for perhaps only a few minutes, and then chart the clinical course with often scant information. The less welcome results of this can include fragmented health pathways, and treatments the patient hasn’t really bought into – or even be counter-indicative – all of which can impede health outcomes.
Patients are rarely engaged much when it comes to treatment. Doctor may know best on some fronts, but it’s natural to want some input over one’s own health, and we should be looking at ways to enable that. Part of the problem we face now, though, is that the patient’s notes often don’t follow them around properly.
A lot of this can be resolved by bringing the data we hold on patients closer to them, and putting them in better control of it. Simply put, a single data platform is essential to integrated care, and integrated care is essential to patient empowerment.
I’ve chosen Business Cloud for this piece, at least in part, because I think it’s the Cloud itself that’ll help us sort this out. I was nodding along to much of Linda Vernon’s recent piece, on putting patients first when it comes to tech; especially the bits about how patients need to be able to see their notes in a quick and easy format online, but that we can’t impose technology either on them, or on the clinicians in charge of their care.
I’m keen for the private sector to provide a testbed for this, so that it can be used at the national level once the evidence base is there. Then, as that evidence base does grow, it’ll open up opportunities for all to benefit – not just those who can afford it – so long as we keep that ‘big’ data transparent, anonymised and properly labelled.
At Doctor Care Anywhere, we’re doing something not dissimilar in the insurance sector to that which Dr Vernon and her colleagues are doing for the NHS in Lancashire and South Cumbria – giving patients a single platform to view their notes, track their health indicators, and book appointments, at very short notice if needs be.
In the coming months we’re taking it further, bringing primary and secondary care together in the Cloud, to create what we’ll be calling the Internet Hospital. It’s a plan for improving the speed and quality of health outcomes, and the patient experience while we’re at it.
We believe that only when you can see all the component parts of a patient’s care in one place – and design the care pathway accordingly, in partnership with the patient – can you empower them to manage their own health more effectively, and empower doctors to make good on the promise of integrated care. Digital healthtech should be about strengthening the bond between clinician and patient – and bringing the expertise of consultants, as well as GPs, closer to the patient, faster.
And this, in my view, is exactly how we should be doing it.
→ Dr. Bayju Thakar will be speaking at Can technology save the NHS? on 6th June 2019. Book now