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Keeping the human connection in general practice
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Keeping the human connection in general practice 

When it comes to healthcare, I’m a firm believer that technology should support the user, not replace the user.

There can be no doubt about the vital role technology has played in enabling healthcare teams to continue to safely care for patients in the last year. But if there’s one thing the pandemic has taught us, it’s our need for human connection.

As general practice begins to find its feet after so much upheaval, how do we marry the old ways with the new, and find a balance that means technology is enabling clinicians to do what they do best: caring for patients?

The overnight digital switch

General practice has always been quick to adapt, but when Covid hit Scotland, we moved faster than ever. Overnight, by necessity, teams pivoted from face to face, hands-on patient care to remote consulting and triage, acting on joint advice from the Scottish Government, British Medical Association and Royal College of GPs Scotland (RCGP).

In the very early days, many practices experienced a lull, as patients were fearful of leaving their home or ‘bothering the doctor’. Demand soon picked up pace – but without the same level of visibility, there was a public perception that general practice was closed for business.

In reality, our teams – diminished with some staff shielding and others self-isolating – were busier than ever. We were managing patients in parallel with new ways of working and the implementation of new technologies. Of course, the pandemic didn’t allow us the grace of a transition period.

Patients too were forced to adapt to new models; beyond merely adjusting to new ways of seeking support, there was an onus on taking control of their own healthcare to relieve unnecessary pressure on practices. The downside, of course, was those patients who stayed away when they shouldn’t, and who are now presenting late with serious illnesses that are harder to treat and manage.

Clinicians felt isolated, too

For clinical teams, much as for the general population, the personal isolation was difficult to come to terms with. A recent survey by BMA Scotland revealed Covid-19 had pushed GPs in Scotland to breaking point, with 73 per cent saying their work was having a negative impact on their physical and mental wellbeing.

Like many GPs, I got into this career because I love spending time with my patients. When Covid transformed our way of working, one of the biggest impacts for me personally was the limited opportunity to connect face to face with both patients and colleagues.

It reinforced the human side of my job – the generations of families I have known and cared for, the daily connection of a morning coffee break with colleagues, the non-verbal cues picked up from sitting opposite a patient.

Technology can never replace the intuition and knowledge of social circumstances that allow a clinician to make a judgement. So where then does it find a place in the new healthcare landscape?

Moving out of the pandemic

As we emerge from the Covid crisis, general practice faces many challenges: managing the ‘backlog’ of patient needs, supporting the mass vaccination programme, and establishing new ways of working.

Fundamental to our success is the implementation of technologies that help healthcare teams to work as efficiently as possible – delivering the right information, at the right time, to the right person.

By signposting patients electronically to the most appropriate service at first contact, we can ensure that the patient gets safe care as quickly as possible. We can also use this opportunity to gather information.

With both parties confident they’re seeing the right clinician, who has up-to-date shared medical records, I can eliminate the time previously spent scanning old notes or having the patient repeat their history, and instead give the patient my informed, undivided attention. In this way, technology can enable us to give safer, better care and ultimately improve outcomes.

Finding those most at risk

Technology can also help us address the unmet and delayed demand at our door.

With more remote consultations and self-care, opportunistic diagnoses are more sporadic, but conversely it becomes easier to spot deterioration when more time has elapsed between face-to-face meetings.

Analytics and risk stratification tools are vital to help us to identify those most at risk – to highlight the frail, the non-attenders, the dis-engaged, the chaotic and unhealthy lifestyles, and those that are non-compliant with medication – and focus on proactive, preventative care. It means that appointments are available not to those who shout the loudest, but to those with the greatest need.

Despite all the pandemic challenges for general practice, technology can help us to focus precious resources where they are most needed and give patients the human connections that they need more than ever.

Dr Walter is a GP at the Gillbrae Medical Practice in Dumfries, and clinical intelligence director at EMIS, which provides clinical systems to more than half of GP practices in Scotland

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