By Accountable Care Journal-
Former Health Secretary, Jeremy Hunt, announced in September 2017 a new era of ‘patient powered health’ - a commitment from the government that they would invest in technology within the NHS to enable patients to take control of their own health. Several initiatives were declared, including digital record access for patients, such as access to their GP record.
A year on from that announcement, Evergreen Health looked at the progress of the NHS’s plans, and also ask patients and practices their views on patient empowerment.
NHS Fund of £200 million – too focused on tech?
At the 2018 NHS Innovation Expo, new Health Secretary, Matt Hancock, announced a £200 million fund to help boost tech transformation in the NHS. One of the most significant technology developments so far is the launch of an NHS app by December 2018, enabling patients to use online services. Brian Fisher, Strategic Director at Evergreen Life and GP in South London, commented “there are several existing providers, including Evergreen Life, who already offer many of the online services which the NHS is planning to develop themselves. Therefore, I’m unsure as to why the NHS prioritised this work. Working in partnership with other technology providers and promoting the services to patients would have been a much more efficient approach for both patients and healthcare professionals. As a GP, I am concerned this new app will create more confusion rather than solve key problems. The focus still seems to be on the technology rather than its use and engagement with both patients and healthcare professionals. We stand ready to help the NHS take the next big steps towards empowering people and developing personalised care. ”
Online access to medical records
Evergreen Life surveyed 97 people to find out more about how people felt when it came to being empowered to control their own health information and medical records.
When we asked about medical records, 79 per cent of respondents believed that the NHS had an electronic record of their medical data. The reality is, while GP practices and hospitals use electronic systems, there isn’t one complete record of your medical data within the NHS, and it isn’t joined up across different healthcare organisations.
With over 80 per cent of respondents also indicating that it was important to them that their medical information should be kept in one place, and over 90 per cent of respondents indicating they’d prefer to view their medical records online, be that via an app or a website, people are expecting that this already exists in the digital age we live in.
Knock, knock, or app notification
Booking a doctor’s appointment online should be as simple as booking a taxi in an app or booking a flight online. Basic patient services such as appointment booking and ordering prescriptions have traditionally been in the control of the GP and surgery staff. But with patients becoming more in charge of their health, being able to use these services online can help empower patients and, at the same time, improve efficiencies in the practice.
In our survey, two-thirds of people thought their GP had all their medical information in one place. While GP practices have electronic systems for things like patient records and appointment booking, there are only limited and sometimes no links with hospital records. Once you have your medical records in your hand, you can share them across the NHS system, making it safer and easier for everyone.
We support the Health Secretary’s commitment to making all data in the NHS electronic (many hospitals still write notes on paper). We support the drive to integrating records across sectors – GPs and hospitals, for instance. But the process is painfully slow and funding inadequate.
Empowering or exhausting? Gaining access to GP medical records
When it comes to gaining access to GP medical records, there is a level of complexity and frustration for patients who would benefit hugely from online services. The process isn’t always smooth, which can leave people feeling less than empowered and likely to give up trying to get this access.
One Evergreen Life user, Paul Zickel, shares his experience in gaining access to his GP medical record: “I decided to use Evergreen Life as it was one of the options on the online registration letter I received from my practice – and it was by far the most user friendly and easy to use and offered more features than the app I previously used. However, I was unable to link my Evergreen Life account to my GP record and the practice manager was unable to help me. I asked Evergreen Life’s support team for help, and they provided me with information to help me get access to my medical record.
I went to my GP practice armed with all the support information I was given by Evergreen Life, and it took well over an hour for me to sit down and work together with the practice to enable me to get access to the online services that I needed. This must be happening all over the country, and it still seems to be such a huge challenge for general practice and for patients. ”
Paul was a director of a disability charity for over 20 years and has seen first-hand how record access can improve outcomes for people. “I believe people having access to their health record can be hugely beneficial to both patients and GP practice – it’s the engagement and culture that needs to change around ownership, access to and engagement with your own health information. Unfortunately, digital record access is seen as an administrative, technical task rather than a patient task at practice level, and from what I have personally experienced at my own GP practice, online services are lacking the support and promotion that it so desperately needs. The possibilities, potential opportunities and benefits are amazing. ”
Evergreen Life works with patients and their GPs to overcome these barriers. CEO and founder of Evergreen Life, Stephen Critchlow, comments: "Despite the efforts needed to get online, over 380,000 of our 0.5 million users have done it. If the NHS invested in making this process easier, this could be a simple way to increase online NHS users." Today, Evergreen Life users make over 1 million NHS transactions with their GP surgery each month (including booking appointments online, ordering repeat prescriptions and viewing their medical record online) - saving the NHS millions.
What do GPs think about online services?
Evergreen Life also surveyed health professionals, including GPs, Practice Managers, nurses and IT staff, to find out more about their experiences when it comes to patients accessing their GP online services. Over 88 per cent of the health professionals surveyed either agree or strongly agree that they actively promote GP online services to their patients, but less than 40 per cent agree that their patients are actually aware of this record access.
When asked what would help them manage GP online services, health professionals highlighted that they need help with educating patients and making them more aware of how to gain access, including more promotional materials being made available. Over half of those surveyed revealed that GP online services increase their workload and 28 per cent say that it makes their life slightly more complicated. Despite the increased workload, over 40 per cent of health professionals strongly agree that making appointments and prescriptions available to book or order online relieves the pressures on practices. As one respondent comments, the increased workload comes from patients’ “limited understanding of medical terminology,” resulting in patients misunderstanding and “leading to unnecessary negligence complaints. ”
According to over two-thirds of health professionals surveyed, the biggest issue for getting patients online is ‘lack of technology skills and understanding by patients,’ followed by the ‘complicated registration process,’ also reflecting Paul Zickel’s challenging experience with gaining online record access. One respondent commented that they want “well-trained staff to inform, steer and guide patients,” particularly those who aren’t as tech savvy. These staff will need to "undertake the task of familiarising patients in underdeveloped, deprived areas and in particular to help elderly or educationally deprived patients." A practice manager added that “good education is vital to make any service last longer and run efficiently. ”
Power to the people?
It’s clear that the technology development within the NHS needs to be supported by a huge push in education to help empower both patients and health professionals. As GPs face the target of getting at least 30 per cent of their patients online by April 2019, there is a need to help practices to work with their patients and provide them with the information that they need to take more control of their own health. Dr Fisher commented “working with both patients and healthcare professionals is vital to making sure these technology solutions are useful for all – which is why at Evergreen Life we work on what benefits the patient first and foremost. It will be interesting to see if NHS initiatives will help to boost patient engagement and empowerment on a more national scale. ”
Stephen Critchlow said “we're proud to be working with our NHS to enable “patient-powered health. ” With more collaborative working, we can deliver this with the NHS. We want “people-powered health” meaning every person using Evergreen Life can prevent disease before they become patients, as well as getting the best service from the NHS if they do. We're the only app linked to all three GP systems in the country and it also allows people to create a health and wellbeing record themselves. This is totally aligned to the recent policy from Matt Hancock. A digital future really is an exciting one for all. ”
Health professionals - Evergreen Life can help educate your...