Technology is rapidly changing the world we live in. If you go back 20 years, the thought of carrying in your pocket a means of mobile telecommunications on its own was considered a leap forward, however now we are at the point where increasing numbers of the population are able to access the internet via a mobile device, whilst handling a phone call, and playing media with just a swipe of a screen or a click of a button.
But how has this rapidly changing tech-orientated world affected the principles of General Practice? This can be detailed in ways for use by the practice, ways of use by the clinician, and ways of use for the patients, a brief summary of such ideals are explored below.
Technology and the practice:
Technology itself has brought on the advent of computerised records, and with the myriad of operating systems used across the country the applications of each can be diverse. In each exists methods of improved communication tools, allowing contact between staff, clinicians and support workers in practice to be adapted via tasks, notes, notifications or instant messaging. This doesn’t include the way that email has modernised communications methods for inter-department communication, or even updates from team meetings, as well as tele-conferencing.
Technology and the clinician:
In the coming years recording of experiences and learning will become a requirement with the advent of the revalidation portfolio. Online CPD, lectures, e-learning, podcasts allow individual based access to resources, via computer or mobile access. However, increasing methods of collaborative tools allow this e-learning to be extended into group learning, such as video conferencing for distance learning in isolated areas, online group meetings and project management.
Additionally the web gives us mobile access to information at the drop of a hat, replacing the need for carrying books in our working day. This includes clinician based sites like GPnotebook, or Tripanswer for medical queries, or access to MIMS and the BNF. Smart phones can also carry applications or stored resources i.e. Oxford Handbook of Clinical Medicine, Epocrates, WebMD, or peak flow calculators.
Finally social networking has allowed communication to be taken to a new level, with support groups developed across the country, for clinicians old and new it allows peer based support, both in real time and on a day to day basis. This is most used at present by the upcoming First5 initiative aimed at supporting newly qualified GPs, and locum chambers groups.
Technology and the patients:
Let’s not forget the patients themselves are embracing technology with respect to their healthcare. Already work is being done on email consultations and text messaging as information giving methods to communicate in ways desired by our patients. It also allows alternate access to harder to reach populations i.e. isolated patients or the working well.
With information giving, patients can also be directed to online resources i.e. PILS, physiotherapy advice, or medication requests, all with an aim of timely deliverance and green ideals of paper saving and carbon footprint reduction.
Further resources are available in terms of patient satisfaction. Online questionnaires can be used to evaluate patients’ opinions via email or website based interfaces regarding a variety of areas such as patient satisfaction, resource development and screening. This can be taken further i.e. the influx of tablet based computing can allow real time feedback to become more user friendly and even expand into screening i.e., using a tablet based application to assess patients for osteoporosis whilst they wait for an appointment, identifying those as high risk for subsequent in-depth review.
Increasingly social networking again is being used to help patients, i.e. Facebook groups for practices to engage with the younger population, or even text messaging notification services for DNA and available appointments. The scope is limitless.
Useful?
Theories are evident, however in practice is this useful? Well as an example, here is a snapshot of my current practice.
In consultations predominant use and creation of templates based off the recording system i.e. Systm One or EMIS to allow easier use of codes or links to appropriate resources whether kept on the practice intranet or internet. Also the daily use of www.egplearning.co.uk – an e-learning portal allowing quick and efficient access to a variety of online resources as well as consultation aids.
Whilst mobile I use the web technology of my smartphone to allow access to the above, in addition to a feed reader which pulls out journal and magazine articles specific to my learning needs, which I can then record and comment on, for addition to my developing e-portfolio. This also includes access to podcasts from learning resources, and a variety of e-learning options i.e. eGP. To support this learning, cross platform web apps i.e. notepads like Evernote, e-book readers or online storage like Dropbox can enhance our learning abilities by organising the way we work and interact and collaborate (to be discussed in a later post).
Working as a locum , having live resources for practices to know my availability has proven to be a useful tool, adapted by an online calendar showing my availability to regular practices. This in combination with an online storage service enables me to forward paperwork, invoices or other details at any given time, meaning an efficient service.
With being newly qualified I am an active member of First5 using the local group online and in person for peer support, from advice on practices, ways of organising locum work, to case discussions. This can even be done as a support in practice with other locum doctors via a variety of online sources.
And in practice the development of online questionnaires has been adapted by a current Yorkshire based practice with plans to integrate the WHO FRAX tool to screen further for osteoporosis.
Future?
The world is changing, technology is advancing. The advent of the iPad and it bringing tablet computing to the masses, and the concept of ‘post-pc’ use means as clinicians or learners, means we have more tools available to us and our patients. Amazing work with disaster notifications, via the YouTube enabled citizen reporter, real-time twitter reporting, and various mobile networks enhanced by portable computing has had significant effect in the recent Japan earthquake. QR (quick response) code technology brings limitless possibilities, from medication reviews, shared management plans, and information dissemination, ignoring the teaching opportunities it can afford.
In summary technology can enhance the service we as clinicians aim to provide to the populations we care for, at the same time allow alternate methods of communication, organisation and innovation. Whilst it might not be for everyone, the world we live in is changing, and as always change can be good.