There is little doubt that COVID-19 will forever change primary care as we know it; and without the benefit of a crystal ball we can only guess how general practice will look in the post-pandemic world
There is little doubt that COVID-19 will forever change primary care as we know it; and without the benefit of a crystal ball we can only guess how general practice will look in the post-pandemic world.
What we have seen during the past few weeks, is a dramatic disruption to the primary care model, with GPs and practice owners scrambling to understand how to adjust to a new model of care and new technologies that will enable the delivery of such a model that they have resisted for so long. For many of us in digital health, we have vehemently believed that cloud technology and telehealth would deliver a new level of convenience and choice for both patients and practitioners. So if there is a silver lining amongst all the chaos caused by this virus, it is that this hypothesis is looking to be proven correct, and now hands are being forced to adopt a care model (and technologies) that patients have been demanding for some time.
Yet with rapid disruption comes considerable risk, and understanding how to navigate those risks to ensure you come out of this storm with your business intact, albeit transformed, will be key to some of the decisions you are having to now rashly make.
Health tech companies are playing a key role in how general practice will deliver care to patients, but many of those too, were complacent and are now unprepared for the storm that COVID-19 has brought. We can see much last-minute action as they, too, hurriedly attempt to upgrade their own technology offerings to support telehealth and billing requirements that are being rolled out with the recent policy changes. And with so many providers, so suddenly (and possibly realistically unpreparedly), offering innovations to pre-screen, check symptoms, and register your new virtual patients, how do you know who to trust with your patients’ data?
Even more interesting is how this disruption has lowered barriers to entry to the primary care market, meaning new entrants can offer publicly funded health care that can be quickly set-up onc loud software with a much lower cost delivery model. Coupled with a great digital marketing platform, and the service can appear to offer high quality health care which can entice patients to move to different providers at the drop of a hat. Gone are the days of consumer (i.e. patient) loyalty, when something new and shiny flashes before one’s eyes.We have only this week seen the National Home Doctor Service previously a federally funded service to provide an after hours GP locum service now offering a 24 hour telehealth services with prescriptions and referrals.
Patients will soon be spoilt with choice and lured by temptation with rumoured offerings such as improved access to medication prescriptions due to Medadvisor moving into the telehealth space, or whispers of a certain private health insurer doing deals with a telehealth platform to offer nil- or minimal-cost consults to anyone holding a valid Medicare card.
And before we take a moment to breathe and process all of this, the unwelcomed arrival of COVID-19 has also acted as the catalyst for PMS providers to jump onboard and add to their platforms too. All of a sudden, offering additional technology upgrades or bolt-ons such as symptom checkers, as well as collecting very detailed historical personal data on our patients, which they could potentially pass along to third party websites.
In the rush to respond to the COVID-19crisis, have GPs simply deemed patient privacy to be less important, and inadvertently fed a new technology the fuel it desperately needs to shake, or possibly overtake, the primary care model as it has existed until now?
Many primary care practices remain firmly entrenched in a bricks and mortar model, with a Practice Management System largely unchanged for 20 years that is still attached to a server located on the premises. So how does this feasibly compete with new telehealth providers using cloud technology, allowing their clinical staff the flexibility to work from anywhere?
These are the type of questions our GPs need to be asking themselves now.
My supposition is that primary care will never entirely revert to the way we once knew it. As much global research indicates, the cost of delivering healthcare via telehealth is vastly reduced. This, combined with offering patients convenience and choice, telehealth is certainly to be the formidable competitor that general practice has never before encountered.  We will very likely see a blended financial model of telehealth being offered, with bulk-billing options for those from lower socioeconomic groups, and co-payments reintroduced for those patients with the means to afford it. Patients will openly embrace the convenience that the primary care sector finally offers, and will most likely choose to continue to use telehealth options over the less convenient face-to-face.
With upcoming changes to electronic prescribing and the arrival of the Active Script List, patients will soon be able to request prescriptions with or without a telehealth consultation. This change was planned prior to COVID-19, no doubt with the view to improving patient convenience and reducing unnecessary visits to the GP for people on long-term medications.
With all this disruption, the future looks bleak for general practice. So, what advice would I offer to ride out this storm and transform your practice?
- Start thinking about using a cloud-based practice management system to reduce the overheads and allow your clinical and administrative staff to work remotely.
o  Medirecords has been adopted by some of the newer telehealth platforms providing urgent care, psychology and corporate care.
- Create a communication strategy to manage your patients.
o  Remember patients are also adjusting to this disruption and may be unsure of how to access care, so communicate will be key.
- Explore using devices and remote monitoring to manage your patients with Chronic Disease.
o  The iHealth devices are currently being piloted in the Murray PHN, and allow patients to monitor their health using bluetooth devices with a remote monitoring capability.
- Treat your patients more like customers, understand their health care needs, create a Customer Relationship Model to ensure you are managing their health needs appropriately, and engage your nurses in remote Chronic Disease Management programs.
o  There are many great examples of where this has been done globally
- Think about a membership or loyalty model to make sure your patients keep coming back to you, and don’t get tempted by the many new, and “shiny”, technology entrants in the market.
- Continually seek feedback from patients so you know how and what to improve.
- Analyse your patient data to design better models of care and to target patients who could be better managed.
- Think carefully about who you choose as your technology partners. A good rule to remember is if the technology is free, then your patients’ data is most likely the cost you are paying for the Always read a technology provider’sPrivacy Policy so you know exactly what is happening with your patients’ most sensitive information.
