Dr Andy Whittamore
GP in Portsmouth and Clinical Lead at the British Lung Foundation and Asthma UK
I’ve heard many people say that we are lucky COVID-19 didn’t happen 10 years ago. And they are right; technology has been a cornerstone for how many of us have coped throughout this crisis.
While my own GP practice in Portsmouth had already been quick to embrace the online healthcare revolution, the outbreak of COVID-19 has forced us to move forward with our digital agenda at rapid pace.
Virtual consultations have helped healthcare services to adapt
We’ve had to rethink how to best serve our patients, many of whom we might not be able to see because they are shielding, or in order to protect our staff.
Being able to support people with respiratory conditions is of particular importance, given that they need rapid assessment of their symptoms.
Digital consultations – telephone, video and email – have been key to connecting with respiratory patients and managing their conditions, without the need to come into the GP surgery.
Prioritising patients who are most at risk
We prioritise the need for routine checks using data on patients’ prescriptions for reliever inhalers and oral steroids and engaging with the most at-risk patients and symptomatic patients.
These are markers suggesting poor disease control in asthma and COPD. We arrange for a phone call with that patient to assess their condition and can convert that to video consultation if required.
A recent study by the British Lung Foundation (BLF) found that that 77.9% of people with lung conditions would be happy to have their care managed remotely.
Attitudes are changing to remote management of lung conditions
Before the crisis, no video consultations were carried out at my surgery because of lack of demand, but now around 90%1 of our appointments are done remotely, including 10% by video.
A recent study by the British Lung Foundation (BLF) found that that 77.9% of people with lung conditions would be happy to have their care managed remotely2, proving that attitudes are changing.
Being able to attend an appointment without going to your GP surgery saves taking half a day off work, which is important for many patients who need to decide whether to prioritise their health (when they are relatively stable) over employment or school.
Remote consultation is also a bridge to patients who find it difficult to get to their GP surgery.
Addressing the hesitancy around digital technology in healthcare
Some of our team were initially sceptical about how they would be able to deliver the best possible healthcare to patients without having them in the room, but have since found it to be a useful tool and can even check inhaler techniques.
A few days ago, one of the nurses ran out of her room and exclaimed that she had just done a video consultation with an elderly patient and it had been “brilliant”. The patient had not only been able to demonstrate inhaler usage clearly but had surprised herself by being able to use our video calling platform with ease.
The experience has taught me never to make assumptions about different age groups’ abilities to use technology.
I’ve found that many older patients with chronic lung disease already have the technology to hand and there are some younger patients who ‘don’t do’ digital.
Face-to-face consultations are still there for those who need them
Of course, some things cannot be done routinely by remote consultation, for example, a breathing test known as spirometry. But there are other digital tools that can improve respiratory patients’ general care.
Use of regular online questionnaires allow healthcare professionals to track patients’ symptoms, while resources like the newly launched BLF tech hub point people to apps that can help them manage their condition themselves.
Asthma UK, where I am also a clinical lead, has just published a report called Digital Asthma: Re-Imagining Primary Care3, which highlights how the NHS can better use data to transform asthma management.
While we’ve had the technology for years, it’s taken a crisis to bring down some of the barriers and bring its use into the mainstream.
Moving forward,
we must continue to embrace the changes, not to replace, but to enhance our
systems of care for better outcomes and better experience.
[1] Data from Portsmouth practice – 80% of appointments completed over telephone and 10% video consultation – this is new technology which is being uses ad-hoc rather than in specific video consultation slots
[2] In a survey conducted in May, Asthma UK and the British Lung Foundation asked people about how their regular (both hospital and GP) care had been affected by coronavirus. For those who reported having done a virtual consultation (video or phone), 77.9% (4996 of 6410 responses) said they would be to have regular care done remotely in the future.
[3] Digital asthma: re-imagining primary care asthma.org.uk/support-us/campaigns/publications/digital-asthma/
