When the virus is over
After the virus, are we ever going back? We've been chatting to a number of experts in the field of telehealth this week and the consensus seems to be that now that the dam has broken, it is highly unlikely that we will revert to business as usual after the pandemic is over. Healthcare professionals will see that it is not always necessary for patients to present themselves in person, and we live in hope that funders like Medicare will no longer fear that the system will be rorted and instead embrace the savings and quality of care that can be achieved.
We are closely watching how things are panning out for the healthcare system in locked-down New Zealand, where some general practices simply will not see a patient unless they have been triaged by phone first. Hospitals are doing that for outpatients too, telling patients not to present unless specifically asked to. One DHB has even launched a fundraiser to buy remote monitoring devices for chronically ill patients to try to keep them at home. As Australia's CSIRO showed four years ago, widespread remote monitoring could save billions every year if fully embraced. Now would seem the time to seriously consider it. Things have changed utterly and we don't think they'll ever go back.
In the next fortnight, expect to see a great deal more activity in the telehealth field, particularly for electronic prescribing. While Australia's eScript network still needs prescribing software vendors to finish their work so that tokens can be sent to patients, digital scripts are the obvious alternative, and we hear that the Department of Health is being incredibly flexible in its requirements in this area. The department has been asking GPs to post the paper script to the pharmacist, but just today we hear that this is no longer necessary as long as the GP stores the script for two years.
Doctors can fax or email a script to a pharmacy or the patient but they can also take a photo of the script and barcode so pharmacists can pull down the details from the prescription exchange services. A number of existing and new apps are equipped to close the loop on this process, including allowing patients to order by app, pay and to get their medications delivered to their homes. App developers have been waiting extremely patiently for regulations to change to allow them to show their stuff but it took a global pandemic to give it the kickstart that it needed. We can't see this ever being reversed either.
Telehealth has taken off in a mammoth way – everyone has a telehealth solution now, as our tech resources page is showing – although we hear around the traps that GPs are mainly using the telephone for remote consultations at the moment. Of the video options, it will be interesting to see at the end of the crisis exactly what proved to be the most popular options: telehealth solutions designed for clinical use, or the consumer options like Skype, Zoom and WhatsApp.
Zoom has become enormously popular in a short amount of time and has a good reputation for stability and ease of use, but its security and privacy settings are pretty awful so it does not appear to be a very good option for telehealth. A number of vulnerabilities have been discovered just this week and even the FBI has been called in, issuing a warning about “Zoom-bombing”. This is nothing new – doubts about Skype's suitability for telehealth have been debated for years and many jokes have been told about the potential to listen in on a consultation about Mrs Smith's haemorrhoids – but with the volume of video consults booming, Zoom might be best avoided until it can get its act together.
It has been fascinating to see how other countries are using technology to assist with the pandemic, and this widely reported story about the new NHS Nightingale Hospital in the UK is one of the best. Less than two weeks ago, the NHS got together with the armed forces to design and build a temporary hospital for virus victims. In the space of a week, they have built a military-style hospital at the ExCeL exhibition centre in London that has the capacity to care for 4000 people in two wards of 2000 beds each. Considering the largest hospital in the country, Glasgow's Queen Elizabeth University Hospital, has almost 1700 beds, the scale of the NHS Nightingale Hospital is hard to imagine.
Even harder to imagine is the speed with which clinical IT has been rolled out. The hospital is being managed by Barts Health NHS Trust, which runs St Bartholomew's Hospital, Royal London and Mile End, and uses a Cerner EMR. The Barts IT team seems to have pulled off the unimaginable task of installing a network, WiFi, workstations, radiology and pathology systems and the EMR, integrated with the other hospitals and local GPs, all in less than a week. While their efforts have been sterling, we hope the full capacity of the hospital never has to be used.
We are continuing to update our COVID-19 tech resources page on a daily basis and we'd like to remind you that if you're looking for a technology solution, Pulse+IT has a well-stocked directory for you to peruse.
That brings us to our poll question for the week: Do you think healthcare will revert to pre-pandemic workflows when it is all over?
Last week, we asked: Has the pandemic changed the way you use technology? Yes, said 83 per cent of respondents, but no one explained how. Feel free to let us know in the comments below.