Deflate expectations

There was interesting anecdote in one of the public submissions to the NSW parliamentary inquiry into the operation and management of Sydney's Northern Beaches Hospital, a selection of which can be found here and which include a mixture of criticism of the hospital, praise for the hospital, a bit of 'insular peninsula' whinging, and the odd suspect wearing a tinfoil hat.

One patient, who had nothing but praise for the medical and nursing staff even while recounting how one of them had allegedly punctured her artery, mentioned in passing that she had expected, now that the My Health Record was available to her, that her medical record would therefore be available to her clinicians.

No such luck for this lady, who was asked to try to recall her medical history and remember the date on which her fifth coronary stent had been inserted, which she struggled to do. “My assumption that with the “My Health” program that my medical history was available,” she wrote. “The facts should be available & will also be correct.”

We were wondering whether this will prove to be a common assumption. Just as people who opted out of having a record may have been concerned that their full history would be uploaded, there surely are plenty of people who will be disappointed that it isn't. If you've come across this in the wild, please let us know.

Speaking of anecdotes, there was a nice one in a story from the UK's Digital Health News about an idea put forward in a hackathon held last week. The developers of the University Hospitals of Southampton NHS Trust's My Medical Record platform were thinking of how to use Amazon's Alexa virtual assistant to allow patients to access their information a little easier, including by asking Alexa.

When a doctor demonstrated the tool and asked Alexa to book him a GP appointment, Alexa said there were none available and that he should instead try Babylon Health. The latter is a consistently controversial topic in the UK as it is one of those rare beasts, a real example of the much overused term “disruptive innovation”, in that it provides free access to an NHS GP on the patient's smartphone, 24/7, every day of the year, through its GP at Hand app.

The service is controversial because not only is it funded by the NHS, but it requires that patients in its catchments in London and Birmingham enrol with it and leave their existing practice. GPs have fears for continuity of care, as well as the potential that as it expands, it will attract younger GPs who want to work part time and put a strain on an already struggling primary care workforce. A recent evaluation of the platform is outlined here.

Coincidentally, Babylon's chief medical officer is presenting at the Royal New Zealand College of General Practitioners' annual conference in Dunedin this weekend, which has raised the ire of one GP at least.

Back on Alexa, and it was only a few weeks ago that the NHS announced it was partnering with Amazon to use the device to help patients find health information, with elderly people and blind people prime targets for a voice assistant. Not surprisingly, the privacy folk had a few conniptions over this, with leading data privacy groups medConfidential and Big Brother Watch arcing up over the potential the deal had to breach patient privacy.

While it look initially like the privacy lobby was fear-mongering, Alexa does record things you say to her and Amazon hires people to listen in. The NHS had to quickly move to assure people that this did not include their personal medical information.

That brings us to our poll question for the week: would you trust Alexa with your personal health enquiries?

Sign up to our weekend edition or Pulse+IT Chat to vote, or leave your thoughts below.

Last week we asked: Is a system that allows access to historic images worth publicly funding? Overwhelmingly yes, our readers said: 88 per cent were for, 12 per cent were against.

Comments  

# ACT Health staffer 2019-07-27 09:37
The fanfare around GP at Hand is flawed
There is actually increased consumption of healthcare via increased GP consultation (particular by younger people) even though the promoters tried to explain it away by pointed out the reduction in comparatively more expensive hospital ED presentations offset the increased (but cheaper) volume of GP services. Furthemore some 1/4 to 1/3 of those who sign up for this actually left the service within 6 months as they are dissatisfied how the GP at Hand consultation is run. Which meant whatever statistics their studies rely on for justification are based on people who stayed (and presumably satisfied with the services)

GP at Hand may be convenient to both patients and doctors but then it is at the cost of continuity of care, limited clinical examination opportunity via telemedicine pathways and frankly requires more resources than conventional GP practice; there is no evidence of "cheaper by the dozen" volume reduction of cost if rolled out to the entire UK

https://www.bmj.com/content/365/bmj.l2333

Not all things new and shiny are better

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