- Family doctors in the U.K. have seen their day-to-day work routines radically altered by the coronavirus pandemic.
- Many are turning to online consultation services like AccuRx and eConsult to see patients who are stuck at home.
- AccuRx built a video chat tool in one weekend last month — it's now being used in 35,000 consultations a day.
- It's a radically different primary care model that physicians say won't go away once the COVID-19 outbreak ends.
Dr. Mandip Thiara was surprised at how swiftly U.K. health start-up AccuRx was able to set him and his colleagues up with its new remote video consultation software.
The Watford, England-based family doctor said such technology had been talked about in his field for at least four years. Last month, AccuRx built the video chat tool in the space of a single weekend to help general practitioners, or GPs, stay in touch with patients during the coronavirus pandemic.
"It's just funny how, when we're in a crisis situation, over the course of 24 hours they can press a button and turn this thing on for us," Thiara told CNBC. He lamented the slow-moving progress of technological change within the U.K.'s National Health Service.
"With the NHS, everything is slow," he said. "There are all sorts of hoops to jump through in terms of funding." The NHS wasn't available for comment on this story when contacted by CNBC.
Telemedicine software has already been around in Europe for years, with the likes of Britain's Babylon, Germany's Ada and Sweden's Kry providing digital health services across the continent. Such companies have in recent weeks launched new coronavirus-focused features to reduce the burden on physicians.
AccuRx, mainly known for its flagship text-messaging service that connects GPs with patients, itself started life about four years ago. Since it launched video calling, the firm's new feature has been used in almost 400,000 consultations — an average of over 35,000 a day.
But innovation in health care has often been met with resistance from within the industry, not least due to fears over the implication for patients' privacy. One of the biggest obstacles is that the health system is driven by "risk, not opportunity," according to AccuRx CEO Jacob Haddad.
And the biggest risk in a global pandemic? That the health system "is going to collapse" due to the surge in demand, Haddad told CNBC.
"In peacetime, you can have a new innovation, and most people focus on, 'What are all the ways that things could go wrong?,' rather than, 'How can we make this thing more efficient?'"
What are video consultations like?
GPs across the U.K. have seen their day-to-day work routines radically altered by the health crisis. They're having to do much of their consultations online or via telephone as patients are stuck at home due to the country's lockdown measures.
Some have set up "hot hubs," Thiara said, which are for coronavirus patients who "absolutely need to be seen" — particularly the elderly. But the vast majority are encouraged to undergo triage over the phone or online and consult their doctors remotely.
But there are myriads of people still requiring treatment for non-coronavirus illnesses. Recovering cancer patient Neil Hart returned to the U.K. from a planned vacation to the Philippines last month. He had been diagnosed with bowel cancer in 2019, but fortunately managed to have it removed in surgery.
Hart, a marketing manager for U.K. health recruiter ID Medical, still had to receive ongoing care due to a post-op wound that had become infected. He continued maintaining the wound while on holiday, but wanted to be seen by a professional upon his arrival back in Britain.
With the U.K. on lockdown, Hart had to seek medical advice remotely. So he called his local GP surgery, which set up a phone appointment with his nurse. She then sent him a link to an AccuRx video consultation via text message.
"The video quality was probably better than Zoom, it was seamless," he said. "I was able to straight away show her a close up of the wound. She reassured me that I was doing the right things and working in the right direction."
Will telehealth continue in the future?
Dr. Clare Gerada, who formerly chaired the U.K.'s Royal College of General Practitioners, has seen a significant change to the way she works. Gerada, who works across two practices in London, said she now "very occasionally" sees her patients face-to-face.
"About 99% or more of our care of patients has moved digitally or remotely onto the telephone, which is very strange," she told CNBC. "It has transformed."
Gerada is also a co-founder of eConsult, an online health system set up by her NHS partnership, the Hurley Group, to help patients consult their GPs. The platform can access a patient's health records, allowing doctors to determine what form of care they should recommend.
"The use of eConsult is now exploding across the country," Gerada told CNBC. Two years ago, it was handling around 300 consultations a month on average. It's now doing about 12,000 per day — or 360,000 per month.
For many clinicians in the country, it's a radically different primary care model that's unlikely to go away once the COVID-19 pandemic ends. "We can never see ourselves going back to how it was prior to this," said Thiara.
Tech like AccuRx has "dragged us into the 21st century," Dr. Mark Porter, a GP partner based in the Cotswolds in England, told CNBC. "It was always likely to happen, but not at this pace. Necessity is the mother of invention."
As for hospitals, they're seeing tech adoption, "but not on the same scale" as GPs, Porter said. Hospital staff see "incumbent" digital consultation tools procured by the NHS as "too slow to be implemented" and unable to cope with increased demand, according to AccuRx's Haddad.
Gerada agrees. She has been trying to persuade hospital outpatient departments to use her company's eConsult software. "Maybe that will happen," she said. But for now, she says, those departments mainly rely on phone calls and Zoom's video conferencing platform.