When the devastating Covid-19 epidemic started to sweep the UK, there was a huge, dramatic and sudden change in life in this country. This 'new normal' also affected the functioning of primary care in the same fashion. One obvious change was the way we as GPs and our staff communicated and interacted with each other as well as with our patients.
Face-to-face consultations dramatically and rapidly decreased in numbers. These direct interactions were replaced by more triage and remote consultations with patients as well as video meetings with colleagues. This change had to be introduced within a short period of time, often just within a few days and technology was called in to bridge that gap. In my opinion, despite the sudden rush to change, technology coped admirably with the dramatic adjustment in circumstances.
A good example of a contributor to help improve remote GP consultations with patients was the use of the excellent software, AccuRx which works in conjunction with a number of major GP clinical software systems. It installs easily and I personally found it superb as it allows texting long and appropriate messages to patients (including templates) and stores the message on the clinical record.
AccuRx also facilitates surprisingly good quality video phone calls with patients requiring minimum technical fuss. Pictures of clinical issues can also be transmitted through this system from patient to healthcare provider then kept in the clinical record.
I am sure that usage of this product will continue to rise, and the software (as well as other similar products) will continue to evolve and improve. The AccuRx video module can be run from your computer with a webcam or via your own smartphone. The patient does not see your mobile number or private details and assuming the patient or their representative can handle the video request (some don’t), it is a very elegant and useful addition to what can be offered via remote consultation. For another perspective on GP remote consultations, read this informative blog by the British Medical Association.
What video facilities are available for doctors?
Within practices and other primary care organisations meetings have been replaced by virtual gatherings over video conferencing facilities, which are effectively apps on mobile devices or desktop computers. There are plenty of these apps available and I will cover just a few of the commonly used ones.
My personal favourite is Zoom and it is also available as an app for common mobile platforms. The free service offers no limit on the number of meetings and from three to up to 100 people joining in for up to 40 minutes (but if it stops, just restart again though two people can last longer for 40 minutes on the free version) and for many people that is sufficient. However, for a relatively modest fee (monthly or annual) you can extend the meeting for up to 24 hours for 100 participants.
In April, The Economist said that the number of daily users of Zoom had exploded from 10 million in December to more than 200 million. I find the service easy to use though powerful with plenty of user-friendly tools such as screen sharing and the video quality is generally very good. However it also depends on how good the Wi-Fi or mobile data connection is at each user’s end.
Of course, Zoom is not the only player in town and Skype owned by Microsoft has been around for 17 years and comes with plenty of really good features. Many people have used it before the onset of Covid-19 and as a result there are large numbers of users out there. Like Zoom, it can cope with group chats and Skype can cater for up to 50 people, which should suffice for most practice meetings.
WhatsApp is widely used for messaging, audio and video calls and many people already have it installed on their smartphone. However for group chats, you are limited to a maximum of eight people joining the combined video meeting. This was recently increased from four and I am sure this is a response to what is now a very competitive market. Facetime can cope with up to 32 people on a group chat but all users must be using a suitable Apple product as it is tied to using only Apple devices.
Video and picture communication with patients is here to stay and now it will be more acceptable to have medical and staff meetings using video group chats. As well as encouraging social distancing, there is an important convenience factor here. This facility will continue to grow and blossom in primary care and I am sure new services and features will continue to transform how GPs communicate with themselves and colleagues as well as their patients. This will happen well after we have conquered Covid-19.
Dr Harry Brown is a GP, Leeds and medical editor, GM Journal