Thu 31st Jan, 2019

Are we ready for video consultations?

The recent news that patients in England will be able to access video appointments with their GP by 2021 instead of 2023 could be welcome news for all of those of us who have to wait on average 13 days to see their GP.

The media still seem stuck in year 2003 and call this being able to ‘Skype your doctor’ which in itself raises concerns about security.

Skype uses 256 bit AES encryption normally but not on calls with mobile phones over PTSN, so how secure is this generic solution? Well, I won’t be sharing my calls over Skype. The vast majority of junior doctors in hospitals use Whatsapp for encrypted messaging with their colleagues but with the recent announcements by its parent company, Facebook to aggregate their platforms and their own statement to US Congress that they still share data with dozens of users, that looks like a non-starter too. The idea of UK health data/calls being potentially sold to US companies such as app developers, insurance companies has real ethical and moral challenges

So the NHS is going to be looking for a secure, probably British system that is built with them rather than an off the shelf package given to them. Fortunately, iPlato has been developing a patient to GP video and chat solution, in partnership with NHS England and funded by SBRI which has already been trialled in real-life practices. The remote consultation package runs over the Number 1 downloaded medical app in the UK, myGP which has nearly 1 million downloads and a 4.6/5 rating.

There is still a gap between politicians and clinical staff over the value of video consultation in itself. Talking with a group of 50 GPs in a meeting, only 10% thought they would choose to use video – not that they were technology dinosaurs. However, many GPs felt that the GPatHand service currently offering video consultation meant they were losing young, relatively healthy patients from their lists and would need to offer video to ‘compete’ with their GP colleagues. The Chair of the RCGP went further and ‘accused wealthy tech companies of creating a “digital divide” as younger and fitter patients are “siphoned off” at the expense of those in greatest need, and then using “bully boy tactics” if anyone challenges their methods’.  So the NHS needs a solution that offers more than video, is secure, is inexpensive and is built around their needs and practices

On final thought was on how affordable a solution like this should be. Looking at this with economist s the feeling was that from a NHSE budget of £111bn, the cost of deploying the video (and more) consultation solution should cost less than £1 per patient per year. So for £60m a year, we can all have video, we can all have it now and we can certainly afford it.