On this side of the pond we have “patient portals” can Sen/receive text messages, look at test results, make apts. Now “Epic” a system largely in use in greater Boston area, can connect you with all your docs even if rival hospitals are involved. You link your self to the various portals and thus you and your docs can see everything. Thus your GP knows what is done by your cardiologist from a different hospital group.
My GP surgery book a 10-minute admin "appointment" for every electronic or phone query that gets allocated to a doctor. This then blocks the patient from booking any further appointments themselves, as it counts on the system as an "appointment". It also looks like it means 10 minutes of the doctor's time is allocated to that query, same as if the patient had an actual f2f or phone appointment. so it doesn't create a time advantage, except when other staff deal with the occasional query. Since their standard-issue NHS GP website got the latest upgrade, the option to do an electronic query did reappear, having seemingly been switched off for months, I looked at the page again and again in vain hope of not having to fight for an appointment, but was repeatedly greeted with a message telling me the service was suspended until time X on day Y (and if I went back after this time, there would be the same message again, with a new date). It has been on occasionally since then, but comes up with a message saying they are at capacity for the day when "too many" patients have raised a query. The system seems to be designed to limit practice workload, not to deal with need. High demand is perceived as excess demand, I have been given to understand that some patients come with queries that aren't necessary - I guess this is where the "opening the floodgates" idea comes from. But how are patients to judge for themselves? Do many patients really want to go through the process of fighting for an appointment or submitting a query unless they think they really need help? The practice are missing out on the triage potential of patients filling in the online form, but seem to prefer it that way. I just wonder how many patients come to harm because they didn't have the time/energy to battle for an appointment or simply aren't available at 8am in the morning. There are things I have left longer or never asked about at all. When admin staff were asked if they could book an advance non-urgent appointment for someone who felt too ill to queue up at 8am, they said the patient would have to take the first available appointment - this denies the patient a choice of doctor or a choice of time. I also had problems with doctors trying to say patients had to go to the local hospital for a referral and have no choice. Before that, no information was provided about the choices available and doctors won't recommend anywhere.
The most common response to queries is "please book an appointment", getting the patient no further forward and leaving then to the 8am "appointment scramble". For patients who feel unwell or fatigued, this is an additional drain on their energy and means some queries just never get asked. I think it is effectively healthcare rationing.
The most common response to queries is "please book an appointment", getting the patient no further forward and consigning them to the 8am "appointment scramble". For patients who feel unwell or fatigued, this is an additional drain on their energy and means some queries just never get asked. I think it is effectively healthcare rationing.
I was an early adopter of AccuRx tools at my GP surgery 3 years ago and yes they have revolutionised General Practice and further.
All GP surgery staff nationwide would be lost without their tools, and yet many ICBs are looking for cheaper alternatives because the NHS always looks for the cheapest deal, not the best…
I like the messaging system, you get prompts about appointments etc. I do think we need to change our thinking in terms of who see and when and time frames, both patients and practitioners, as you say. But I also think it’s about patients being re-educated to accept these changes. Many will still go to the surgery rather than using online prescription ordering. The reality of what is happening in the health service today is very different, and scary, for patients and staff as patients can’t expect immediate attention. I can see it from both sides.
Technology can be a very useful tool both within community and hospital services and particularly around preventative services. The “Epic” System sounds like a major step forward, but actually in other areas, e.g. financial sector, it is not that new. Over here systems are still not properly linked, which given the amount of money that has been spent over the last few years is staggering. The DH&SC seems more interested in telling us the financial numbers rather than where the money is going, not on wages it seems. Only within the last few weeks do they seem to be asking those at the front end what might work, rather than concentrating on delivering services in the most effective way.
In my usual way a slightly rambling response, but we have to embrace every bit of useful technology we can but not forget human quirks, frailties and reluctance to change.
Hi Rory
On this side of the pond we have “patient portals” can Sen/receive text messages, look at test results, make apts. Now “Epic” a system largely in use in greater Boston area, can connect you with all your docs even if rival hospitals are involved. You link your self to the various portals and thus you and your docs can see everything. Thus your GP knows what is done by your cardiologist from a different hospital group.
Jerry from Wellesley
We are coming out of the Stone Age 😀
My GP surgery book a 10-minute admin "appointment" for every electronic or phone query that gets allocated to a doctor. This then blocks the patient from booking any further appointments themselves, as it counts on the system as an "appointment". It also looks like it means 10 minutes of the doctor's time is allocated to that query, same as if the patient had an actual f2f or phone appointment. so it doesn't create a time advantage, except when other staff deal with the occasional query. Since their standard-issue NHS GP website got the latest upgrade, the option to do an electronic query did reappear, having seemingly been switched off for months, I looked at the page again and again in vain hope of not having to fight for an appointment, but was repeatedly greeted with a message telling me the service was suspended until time X on day Y (and if I went back after this time, there would be the same message again, with a new date). It has been on occasionally since then, but comes up with a message saying they are at capacity for the day when "too many" patients have raised a query. The system seems to be designed to limit practice workload, not to deal with need. High demand is perceived as excess demand, I have been given to understand that some patients come with queries that aren't necessary - I guess this is where the "opening the floodgates" idea comes from. But how are patients to judge for themselves? Do many patients really want to go through the process of fighting for an appointment or submitting a query unless they think they really need help? The practice are missing out on the triage potential of patients filling in the online form, but seem to prefer it that way. I just wonder how many patients come to harm because they didn't have the time/energy to battle for an appointment or simply aren't available at 8am in the morning. There are things I have left longer or never asked about at all. When admin staff were asked if they could book an advance non-urgent appointment for someone who felt too ill to queue up at 8am, they said the patient would have to take the first available appointment - this denies the patient a choice of doctor or a choice of time. I also had problems with doctors trying to say patients had to go to the local hospital for a referral and have no choice. Before that, no information was provided about the choices available and doctors won't recommend anywhere.
The most common response to queries is "please book an appointment", getting the patient no further forward and leaving then to the 8am "appointment scramble". For patients who feel unwell or fatigued, this is an additional drain on their energy and means some queries just never get asked. I think it is effectively healthcare rationing.
The most common response to queries is "please book an appointment", getting the patient no further forward and consigning them to the 8am "appointment scramble". For patients who feel unwell or fatigued, this is an additional drain on their energy and means some queries just never get asked. I think it is effectively healthcare rationing.
I was an early adopter of AccuRx tools at my GP surgery 3 years ago and yes they have revolutionised General Practice and further.
All GP surgery staff nationwide would be lost without their tools, and yet many ICBs are looking for cheaper alternatives because the NHS always looks for the cheapest deal, not the best…
I like the messaging system, you get prompts about appointments etc. I do think we need to change our thinking in terms of who see and when and time frames, both patients and practitioners, as you say. But I also think it’s about patients being re-educated to accept these changes. Many will still go to the surgery rather than using online prescription ordering. The reality of what is happening in the health service today is very different, and scary, for patients and staff as patients can’t expect immediate attention. I can see it from both sides.
Technology can be a very useful tool both within community and hospital services and particularly around preventative services. The “Epic” System sounds like a major step forward, but actually in other areas, e.g. financial sector, it is not that new. Over here systems are still not properly linked, which given the amount of money that has been spent over the last few years is staggering. The DH&SC seems more interested in telling us the financial numbers rather than where the money is going, not on wages it seems. Only within the last few weeks do they seem to be asking those at the front end what might work, rather than concentrating on delivering services in the most effective way.
In my usual way a slightly rambling response, but we have to embrace every bit of useful technology we can but not forget human quirks, frailties and reluctance to change.