Reflections on 2020
The past year has been a tumultuous one globally, with the pandemic impacting on every facet of life and in turn testing healthcare and delivery beyond any limit previously contemplated.
Working routines and systems within UK primary care had to change overnight and a new “total triage” model for general practice rapidly emerged, with new technology and sophisticated cloud-based telephony systems enabling GPs to work in different environments.
The mantra of “digital first” primary care developed as a reality for hundreds of GP practices, who could work from home, in hubs, call patients back, not be limited by line capacity, integrate with video and also measure the response.
At the height of the first lockdown more was achieved in eight weeks to digitally transform general practice than in the past decade. The face of general practice overall changed for ever.
Not all primary care provision was in suitable technological shape though to try to cope with the demands of delivering care remotely, and it was clear that many practices had insufficient bandwidth.
After an initial focus, particularly by central primary care policy makers, on the benefits of video, there emerged a more considered view that it was important, but not a panacea. Telephony was re-emphasised as having an important role so that GPs can offer a mix of face-to-face, telephone, video or online consultation, as required by the Primary Care Network contract guidance, and continue to evolve the face of modern, digital-first primary care.
Predictions for 2021
Looking ahead as we enter a new year, a key focus in supporting delivery of primary care will be providing GPs with the tools needed to contact their patients as efficiently and quickly as possible. This means developing an “omnichannel” approach so that communication with patients is possible through a blend of voice, text, online and video, depending on the patients’ needs.
With general practice undergoing significant change in the last ten months, new structural and technological issues have emerged that will also need to be addressed. For instance, further call management technology is a priority to help resolve the level of failed contact attempts by GPs, resulting in calls going to voicemail or being unanswered, or video calls failing during setup.
Practice telephone costs compared with video costs, for example, will become a focus, along with the wide variation between practices depending on individual contracts and the level of support from their clinical commissioning group. With outbound calls from practices likely to remain comparatively high, telco providers should be reviewed to remove or minimise call costs.
Technology will continue to influence general practice and bring efficiencies in the way it is delivered day-to-day, both irrespective of the pandemic, for instance integrating the recording of a triage session with the practice’s clinical system, and also as a direct result of it.
Primary Care Networks (PCNs) are currently coming across a major challenge with the management and setting up of vaccination hubs. As this continues to roll out significantly through 2021, there will be opportunities through unified technology to share resources and reduce the overall costs incurred by hubs. Technology will also play a crucial role in facilitating contactless arrivals – an essential risk management feature within vaccination hubs, but also within GPs and hospitals.
Communication with patients has been an area where silos have built up and data sharing or interoperability have been a challenge. Now cloud and contact centre technology, integrated with secure data technologies, gives PCNs the chance to operate at a necessary larger scale, yet still maintaining the local presence that makes primary care patient centric.
Ultimately, throughout the pandemic and hopefully beyond that in 2021, it is the patient, their care and preservation of the doctor-patient relationship that will be the prime concern as technology continues to develop within primary care.