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London Doctors Stage Protest Over Rollout Of App

Posted on April 18, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

We all know that doctors don’t take kindly to being forced to use health IT tools. Apparently, that’s particularly the case in London, where a group of general practitioners recently held a protest to highlight their problems with a telemedicine app rolled out by the National Health Service.

The doctors behind the protest are unhappy with the way the NHS structured its rollout of the smartphone app GP at Hand, which they say has created extra work and confusion among the patients.

The service, which is run by UK-based technology company Babylon Health, launched in November of last year. Using the app, patients can either have a telemedicine visit or schedule an in-person appointment with a GP’s office. Telemedicine services are available 24/7, and patients can be seen in minutes in some cases.

GP at Hand seems to be popular with British consumers. Since its launch, over 26,000 patients have registered for the service, according to the NHS.

However, to participate in the service, patients are automatically de-registered from their existing GP office when they register for GP at Hand. Many patients don’t seem to have known this. According to the doctors at the protest, they’ve been getting calls from angry former patients demanding that they be re-registered with their existing doctor’s office.

The doctors also suggest that the service gets to cherry-pick healthier, more profitable patients, which weighs down their practice. “They don’t want patients with complex mental health problems, drug problems, dementia, a learning disability or other challenging conditions,” said protest organizer Dr. Jackie Applebee. “We think that’s because these patients are expensive.” (Presumably, Babylon is paid out of a separate NHS fund than the GPs.)

Is there lessons here for US-based healthcare providers? Perhaps so.

Of course, the National Health Service model is substantially different from the way care is delivered in this country, so the administrative challenges involved in rolling out a similar service could be much different. But this news does offer some lessons to consider nonetheless.

For one thing, it reminds us that even in a system much different than ours, financing and organizing telemedicine services can be fraught with conflict. Reimbursement would be an even bigger issue than it seems to have been in the UK.

Also, it’s also of note that the NHS and Babylon Health faced a storm of patient complaints about the way the service was set up. It’s entirely possible that any US-based efforts would generate their own string of unintended consequences, the magnitude which would be multiplied by the fact that there’s no national entity coordinating such a rollout.

Of course, individual health systems are figuring out how to offer telemedicine and blend it with access to in-person care. But it’s telling that insurers with a national presence such as CIGNA or Humana aren’t plunging into telemedicine with both feet. At least none of them have seen substantial success in their efforts. Bottom line, offering telehealth is much harder than it looks.

UK EHR Landscape

Posted on July 1, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I hadn’t posted much about the UK, and so I thought I’d post (with permission) this email I got from a regular commenter DKBerry about the UK EMR world. I find it fascinating that one EHR vendor owns 50% of the private EHR market in the UK. Polar opposite of our world, no? Now to his email:

Have you ever presented any information on the United Kingdom’s efforts?  Everyone thinks that the entirety of the UK healthcare system is run by NHS.  NHS operates the secondary care facilities … but the primary care practitioners are private … and are contracted by NHS.  Unlike the U.S. where there are 300+ EHR vendors in the U.K. there are only a handful.  Literally.  Egton Medical Information Systems (EMIS) has over 50% of the private GP market in the U.K.

Thought you might appreciate this … Don

From this article

“EMIS and INPS software users in the UK represent around 75% of GP practices and together hold approximately 46 million electronic patient health records.

The formation of Healthcare Gateway Limited allows real-time interoperability with GP systems and other healthcare professionals within the NHS. This has the potential to significantly increase efficiency in the NHS in addition to improving patient care.”

From the EMIS Wikipedia entry:

“EMIS chose not to be one of the major current GP computer providers initially included in the proposed National Programme for IT(NPfIT) due to issues surrounding the lack of system choice for GPs.[1]

The disenfranchisement of General Practitioners and the resultant political change which affected the NPFIT led to the creation of the GPSOC (General Practitioners System of Choice) programme which allowed individual GPs to choose their own system for storing electronic patient notes. As a result EMIS are now involved in the GPSOC programme.

As of 2009, of the 5000 practices using EMIS, 40% are now able to transfer notes electronically with the GP2GP electronic record transfer software to other GP practices using either EMIS or INPS Vision.[3] In 2009 EMIS is also to release its next generation system, EMIS Web, which (with other interoperability initiatives pioneered by EMIS) is intended – subject to patient consent – to allow patient data to move freely and safely not just between GPs but also elsewhere within the NHS (Accident & Emergency, Out of Hours, Hospitals, Community Nursing, etc.).”