The Five-Year Forward View (NHS England, 2014) encouraged the NHS to take advantage of the opportunity new technologies have to offer patients and carers. The uptake of online services can be readily seen in day to day life, such as how we now book travel, transport, manage bank accounts and utility bills, buy groceries and even connect with family and friends. Offering an online option has the potential to make services more convenient, personal and efficient (NHS England, 2014). To make it easier for the public to access health and care information, the National Information Board (NIB) has set a series of work streams to help plan improvements to digital services. Work stream 1.1 set an objective to give the public more control by increasing the digital access to healthcare information and transactions. One example of this is online patient medical records and appointment bookings.
The patient online programme
We know that a fundamental aspect of patient centred care is assisting people to take control of their own health and wellbeing. Patient Online is an NHS England programme that is helping GP practices to promote and offer online services to do just that. According to Mr Alan Oliver, Implementation Lead for the Patient Online programme, over 95% of GP practices in England are now offering online appointments alongside traditional booking routes. This may also include access to test results and diagnoses, as well as referrals, immunisations, procedures and full medical history depending on what information the GP practice has enabled. Ms. Beverley Bryant, NHS England’s Director of Digital Technology, announced that 8 million citizens have signed up to access their GP appointments online (NHS England, 2015). These figures demonstrate the public’s appetite for engaging with digital healthcare services.
Click here to visit the NHS England website to watch a video from the Lighthouse Medical Practice in Eastbourne. They have been offering online access for 4 years now and speak of the benefits.
Click here to hear Marilyn’s personal experience of using GP online services.
Click here to hear Grahame’s personal account of using GP online services.
Click here for a Patient Online resource guide with useful case studies.
You can also join the conversation on twitter by using #patientonline.
My patient online experience
It is a real chore to get an appointment at my GP practice. If I need to be seen on the day, I have to line up in the early hours of the morning to try and secure an appointment. The line is generally 20 people deep by the time the doors open at 0800 hours and it’s a ‘first in best dressed’ approach. Alternatively, if I wish to book in advance I need to find time during the day to call, which generally results in having to wait on the telephone line in a queue.
Early this year I saw a poster in the waiting room that advertised an online application called Patient Access. I asked at reception what this was about. She explained that it was a free online service provided by EMIS Health, the supplier of the practice’s electronic clinical record system. The receptionist gave me information about how to request a user name and password and she then talked me through how to set it up on via the website or by downloading the app (Andriod and iOS available).
Once I downloaded the app and set up my access, I was excited to start exploring my medical record. I had always been curious whether my history and past test results had been transferred from my old practice when I moved a few years ago. Using the app, I could see my historic x-rays and blood results that were requested at my old practice. This was the assurance I had longed for.
A month later, I noticed I was feeling a bit flat, not my usual bouncy self. I thought I’d better see the GP and request a set of bloods. It wasn’t urgent, so I booked via the app and got an appointment within two weeks. I selected a day and time that suited me and the doctor I wished to see.
After the consultation, I was able to see the Practice Nurse and got a set of bloods done. Within 24 hours I could view the results via the app and spotted that a component was abnormal. I called the practice the following day and had a telephone consultation with the GP. We discussed altering one of my medications. The GP updated my prescription and then using the app I requested the prescription to be delivered to the pharmacy of my choice. It was a smooth and efficient process and I felt like I was in the driver’s seat the whole time. A welcomed change to the previous experiences I’ve had.
Another feature I like about Patient Access is the ability to share my health data collected via my iphone. This means that my GP can view more information about my health and wellness behaviours. I can choose from the following information to share with Patient Access: height, weight, BMI, blood glucose, BP, distance walked per day, forced expired volume, forced vital capacity, heart rate, oxygen saturation, peak expiratory flow, respiratory rate and steps taken per day. This information I can enter manually, or use other medical devices that are compatible with an iphone.
Click here to read more about setting up your Apple Health and Patient Access.
What can we do to help promote Patient Online?
The clinical record system suppliers, TPP SystmOne and EMIS that are used in many primary care settings offer online services. We can play a role in helping to promote this option and ensure that our clients are aware they have a choice to engage with their GP practice in this way.
Read more about TPP SystmOnline here.
Read more about EMIS Patient Access here.
The reality of the digital divide
According to a survey published early this year, 88% of people in the UK have one or move internet connected devices (Statista, 2016). Although this is an impressive figure, we know that many of our patients are not yet digitally connected. Internet plans, computers, laptops, tablets and smart phones do not come cheap! Cost is a contributing factor to the access and use of online services for many members of the public. When setting up Patient Access or SystmOnline, people can nominate a family member, carer or friend to also have access to their account. This may assist many who have a loved one that owns an internet connected device to help book appointments, or view their record.
At present, a further inequality to the access and use of digital platforms in society is due to low digital skills. According to NHS England, there are approximately 12.3 million people in the UK who do not have basic digital skills and around half of this group of people have never been online before. NHS England together with the Tinder Foundation have been trying to address this issue by running a Widening Digital Participation programme with older adults, people who are homeless and/or vulnerable. The programme supported and trained 221, 941 people to use digital health resources and tools over a three year period. You can read more here.
The report published in July 2016 concluded that the behaviour changes of being confident and skilled to use digital services resulted in 21% fewer calls or visits to a GP and 6% fewer trips to A&E, which saved the NHS £6 million in a 12 month period.
You can read the full report here.
To help engage our clients to be a part of the digital movement, clinicians can play a role in sharing information about the local services offering educational courses. Click here for an example of the wealth of information available on the People First website (Westminster, Kensington & Chelsea and Hammersmith & Fulham) about different online course options from local libraries, community groups and adult education centres.
It is a crucial time for healthcare services to embrace technology to offer modern, convenient and responsive services to patients, their families and carers. The Patient Online programme is a positive step forward to helping people take control of their health records and feel more empowered with their health and wellbeing.
Have you registered to access your GP held record online?
Do you have any feedback from your clients who are using Patient Access or SystmOnline?
Do have any examples of digital skills courses available in the community?