A digital healthcare experience doesn’t mean “online appointment booking”

Alex Wellman reports in Pulse (a British GP news magazine) on how online appointment booking is “not needed by patients”:

the policy was giving patients something they did not need. Pushing something that does not have widespread support is daft. People are not saying “we want it” with these figures. I think most surgeries are already accessible the way things are. I can honestly say that no patient has ever mentioned to me that they want to book an appointment online. To be honest, there are usually other things on their mind

Dr Brian Balmer, CEO, Essex Local Medical Committees

We have had online for a while but the vast majority are not using it. If one becomes too much involved in that, is that not prejudicial to the 16-year-olds and those familiar with computers? With people who are over 60 or 70, do we really think they are going to be able to access online booking?

Dr George Rae, GP, Beaumont Park Medical Group

Why do healthcare providers have such limited imaginations?

It’s depressing that in 2012 we have experienced healthcare leaders talking about a digital experience that’s limited to making a booking for an in office consultation with them.

Imagine if we still had airlines or banks thinking the same way? We’d have Ryanair.com letting you book an appointment with a sales rep in your local travel agent and FirstDirect.com would be an online spreadsheet document.

You can ask all the surveys you want but in 2012 there is real evidence of the fact that patients don’t want to book appointments or look at their health information. They want the opportunity to engage with their carers. If you’re uncertain about this compare the categorical failure of the NHS’s HealthSpace with the immediate success of KP’s mHealth initiative (which holds the record for the fastest ever adoption of a digital health experience).

The only major difference from the patient perspective is that the KP service has focused on mobile first AND provides patients with the opportunity to connect with their carers. Although the user experience got the blame the simple fact is that the NHS’s HealthSpace remained as pointless as Ryanair.com would be if it offered no ability to book/pay for a seat or FirstDirect would be if customers had no ability to move money, pay bills, etc.

To be effective online Doctors and Patients need tools

When asked what they really want to do online the first thing most patients and Doctors say is “I want to email my Doctor/Patients” but in practice what’s needed are more advanced tools and the advantages of email have been proven to be counter intuitive because patients don’t have training about what symptoms are important and not important and the availability of good Doctors is limited.

Please watch Dr John Bachman, Professor of Primary Care, Mayo Clinic explaining the need for a paradigm shift for remote consultations to work:

Of course the benefits have already been published in a Mayo Clinic Proceedings paper that hihglighted the increased effectiveness, patient safety and utilization of resources that can be achieved by providing patients with an interactive patient history taking tool (this is the same technology we use to create value at 3G Doctor):

Seniors already go online and most of those who can’t have someone who can

In 2012 it’s depressing to read clinicians reporting concerns of leaving senior patients behind in the move to digital.

In 2010 Kaiser reported that half of their online patients were aged 65+, in the UK half of all pensioners already use Facebook and since 2010 we’ve been reading about how retired 70 year olds have turned their hands to making successful iPhone Apps (Check out “now Web 2.0 gets to Rhyme“).

Right now Carers Week is doing great job highlighting the contribution of millions of unpaid carers. We should be looking to better serve these invaluable individuals not forcing them to waste their precious time shuffling through voice-activated phone tree systems and playing telephone tag with our expensive voicemail systems.

We’ll be over run with 16 year old worried wells

This is definitely one of the downsides of making inefficient digital services available to patients who don’t have to pay out of their own pocket (as in the UK with the NHS).

The explanation for this concern amongst some Doctors is that they feel many young patients will think that it’s now so convenient it’s worth their time booking an appointment to talk with their GP about something they might not normally have bothered with. Doctors feel this is challenging because they see such short cuts having a knock on effect of driving up the waiting times and disadvantaging those who can’t use or don’t know about this online process.

Fortunately this is also one of the biggest upsides that a GP can get from providing patients with access to a clinically validated secure interactive patient history taking tool. Here are 4 reasons for this:

1) Getting young people documenting their important health concerns is something that we need to encourage as it’s our easiest way of creating teaching moments and effectively looking for and preventing the development of disease.

2) Evidence shows patients answer questions online more honestly than during an in person consultation. The importance of this is abundantly clear to any GP who has tried to help an adolescent confront sensitive issues such as mental health, depression, sexual health, abuse, etc.

3) The tool enables a Doctor to safely review a patients reported concerns and quickly refer them. Of course this may be humbling for some Doctors but it might be that there would be something that the patient could do that would be more effective than making an appointment to meet with their GP eg. watching a specific educational video, uploading a picture to their dermatologist colleague, going to a pharmacy to get something available over the counter, meeting with the diabetes nurse, keeping a diary of what they’re eating and coming to see the nutritionist in a fortnight, a session with the practice nurse/podiatrist/etc, etc

4) Better use of time. Of course for busy Doctors there’s not enough time in the day but when you get those patients who are able to document their health concerns using your website to do this it frees up your time and energy to spend it with those patients who can’t.

About David Doherty

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10 Responses to A digital healthcare experience doesn’t mean “online appointment booking”

  1. Pingback: ICMCC News Page » A digital healthcare experience doesn’t mean “online appointment booking”

  2. Pingback: A digital healthcare experience doesn’t mean “online appointment booking” | Digital Health Journal

    • Gaspar says:

      I see patients. Hookers have cmtuosers and clients. OK, it is just a joke! Since I see some TennCare patients, the analogy does not hold up under scrutiny. I see patients because I ascribe to the medical model of care and expertise. Not that I am an expert in what my patients should do, but I am an expert in how they might accomplish their goals, how I might help, and things concerning human change. There is a bit of the sacred in the term patient, it evokes trusted care. Client is an economic term. Since I see my patients as brave people struggling with difficult changes, I do them the honor of calling them patients. And I honor my approach to them as well.I do some work as a photographer. They are clients. I do a job. As a psychologist, as a therapist, I have some sacred responsibility and the term patient honors that.And it is not a power trip issue either. The people that work for me call me Dr. Monroe. The patients I work for call me Trey.Trey

  3. Pingback: A digital healthcare experience doesn’t mean “online appointment booking” | Patient Information | Scoop.it

  4. Reblogged this on Ideas To Share and commented:
    This I a good roundup of the capacity and capability of #telehealth to help communities access their health information in different ways. The simple telephone could be considered a telehealth invention. No clinic would be without one. Telehealth is not about preventing patients from seeing Doctors. We don’t plan on replicating the experience of “unexpected item in the bagging area”. Telehealth is about finding solutions to the question “how can I access great care 24 hours a day, without putting a Doctor on every street”

  5. As a patient I appreciate being able to book appointments online because:

    1. I work, if I need to see a doctor for a non urgent appointment I cannot telephone at exactly 08:00 as I AM AT WORK.
    2. I do not want to spend 15 mins waiting to be put through to find there are no slots left and I have to do the same thing the very next day. This make me very angry and does nothing to help me feel better.

    We need more than one solution for booking appointments to include those who are retired and those who are working – the NHS should be all inclusive.

    As a dietitian I really appreciate the facility of emailing my patients, this does need some explaination that as long as the patient agrees that email may not confidential forum and they are happy for me to email them back, they have consented. We might also discuss if there is anything that they would not want me to include in an email. I can then look at them first thing in the morning when I am not on the wards or in clinic. This facilitates the patient receiving a quicker answer. It may be necessary to inform the patient that their concerns will be discussed in clinic, if the emails are becoming very frequent. We should use all tools available to us to help with patient care. I have had ALL AGES of patient report using the internet, emails etc, are we being ageist to assume people do not have access when they are elderly?

  6. Great points Jules,

    “I appreciate being able to book appointments online because I work, if I need to see a doctor for a non urgent appointment I cannot telephone at exactly 08:00 as I AM AT WORK”

    Love it.

  7. Pingback: “The doctor’s smartphone will see you now” « mHealth Insight: the blog of 3G Doctor

  8. Aguinaldo says:

    AVI is right, name changes accsmplioh nothing. My son has been a “client” of many providers for years. Doesn’t matter. It really didn’t take long to infuse the word “client” with the same disdain that accompanies “patient” or “cripple” or “retard.” The word “client” now conjures up the same pathetic, hopeless, white-trash image as any other word that has ever been used to mean “person who is dependent on our largess for survival.”

  9. Paola says:

    I hated it when the community metnal health organization I work for insisted that our patients were now “clients”. Even worse, they changed “community metnal health” to “community support and treatment services”. Thus expurgating all aspects of metnal health and patienthood so people feel “empowered”. I suspect it only encourages more of a sense of entitlement rather than empowerment.

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