Can digital tools relieve pressure on the NHS?
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E&T spoke to digital health start-up Doctorlink about its primary healthcare platform, designed to ease the stress of GP practices in demand while increasing the efficiency within clinical systems.
The pressure on the NHS is increasing every day and will continue to increase with cuts in social care, compounded by the fact that more people are living longer.
In fact, due to such high demand, last year saw accident and emergency (A&E) waiting times hit their worst-ever level on record, with 83.6 per cent of A&E patients admitted or transferred within four hours in October 2019 – below the 95 per cent target and the worst performance since the target was introduced back in 2004.
Meanwhile, in general practices (GPs), appointment numbers are rising every year, causing an unrelenting strain on the foundations of the NHS.
In the midst of pressure on budgets and services within the sector, the NHS has been looking for new ways to save money whilst continuing to provide high-quality services for patients. Indeed, many are now turning to technology for help, with digital tools becoming a lifeblood for doctors and GPs struggling to meet patient quotas. This is where Doctorlink comes in – a digital primary healthcare platform which directs patients to the most appropriate service for their health needs.
Doctorlink provides patients with 24/7 access to symptom assessments, appointment bookings and video consultations. According to experts, the platform is set apart by its clinically approved and fully indemnified algorithms, which cover 95 per cent of known conditions. These algorithms use Bayesian logic and are built upon national treatment guidelines, with independent clinical governance.
“With the Doctorlink app, it has narrowed this waiting time down to minutes or days,” said Rupert Spiegelberg, CEO of Doctorlink. “This is because what you can do with the app is effectively find out what is wrong with you: get a diagnosis through our software, which is its own registered, class one medical device, a clinically approved solution.”
According to Doctorlink, Portland Medical in South London, a practice that cares for 12,200 patients and which has implemented the platform into its operation, has a 30 per cent uptake of the app, which in turn has reduced the overall GP workload by approximately 579 hours per year.
Dr Ravi Tomar, a general practitioner at the centre, told E&T about the ways in which the platform has been embedded into its practice. “When we were introduced to Doctorlink, we redesigned our entire system around the platform,” he explained, “which actually makes it much more efficient; much more user-friendly; better for patient outcomes and actually has had a huge impact on our staff as well.
“We need to embrace and move towards the future of how to look after our patients and also how patients would want to be looked after.”
Spiegelberg continued: “The technology takes out a huge amount of time and effort from the patient side and also a huge amount of time from the doctors. From the patients’ side, you’re getting 24-hour access to the app. You’re also getting told where to go straight away. All these things combined provide better patient outcomes.”
Indeed, through its clinical decision algorithms, the digital online service – in the form of an app – allows patients to check their symptoms, gain reassurance and advice on what to do next, book appointments and order repeat prescriptions.
“The algorithms that we use for assessing diagnosing has taken up to 18 years to develop,” Spiegelberg explained. “We have a huge amount of data – around 16 million sessions to date over that period.”
Spiegelberg added, as Doctorlink grows and more people use the system, artificial intelligence (AI) is being used to analyse the results of these diagnoses and then feed them back into the system, analysing the huge amount of data they collect on a daily basis.
There is also a constant process of reviewing the algorithms, updating and improving them, and adding new types of conditions. “We have a large team of doctors and nurses that are constantly reviewing data to help improve on the algorithms to make them better,” he added.
From a doctor's perspective, Tomar said: “We’re using AI to expand our capacity to see a lot more conditions coming in through the front door. Then [there are] the conditions that do need the attention of a GP - the complex cases, such as multiple morbidities, mental health and learning difficulties that actually need rapport.
“Because we now have more time to do that [rapport with complex patients], they are now able to get that physical contact and that sort of ‘healing touch’ of a GP, whereas beforehand, they would struggle a lot more to get that.
“It’s about online and digital services taking off the piece of the initial front door approach and filtering it down a little bit so that the patients who really need a GP’s time can get it when they need it. It’s really all about collaborative working and improving healthcare outcomes, as well as the GP’s working life.”
Not only does the platform cater to the patient’s needs, but it also benefits the clinic itself, prioritising the patients in most need of a face-to-face consultation. Doctorlink disclosed that all its users have access to this function, but 40 per cent of patients actually access this clinical advice outside standard opening hours. This, therefore, alleviates the strain on the time and resources of clinicians.
The company was founded in 2017 by Eight Roads, a global investment company backed by Fidelity with a 50-year history of leading and growing international tech companies. The platform also provides fully customisable and scalable software-as-a-service (SaaS) products for the world’s largest healthcare organisations and has provided 60 million health assessments to date.
Recently, Doctorlink has grown its national reach to 10 million patients following an agreement to provide its symptom assessment platform to a further 1.1 million people at 140 new GP surgeries in south-east England.
This new milestone, according to Doctorlink, will deliver immediate medical advice to patients across a group of NHS Clinical Commissioning Groups (CCGs) across Kent and Medway. Also, the launch of the platform will bring potential savings of 15,000 annual clinical hours for doctors per practice each year, while diverting up to 22 per cent of cases to more appropriate forms of care. The initiative also means the technology provided by Doctorlink is now available to help people through 1,350 GP surgeries in 42 CCGs in England.
Furthermore, the company has said practices already using the services are achieving uptake by up to a third of patients and seeing a drop in telephone triage of up to 30 per cent. It also found that there was a 35 per cent reduction in the need for same-day appointments. “People who use the platform in Portland [Medical Centre] have talked about the amount of reduced inbound calls to reception,” Spiegelberg said.
The company are hoping to expand the distribution of the platform, to other countries, in the near future. “We see a massive opportunity to leverage the incredible success in what is arguably one of the best health services in the world,” Spiegelberg stated. “We would like to export that and deploy that in other health systems in many other countries around the world.”
Patients can access the platform through the Doctorlink app, available on Apple and Google Play. Recently placed onto the GP IT Futures Framework, Doctorlink is helping practices meet the 'NHS Long Term Plan' to give every patient the right to digital-primary care by 2023-24.
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