One of the biggest impacts of technology on healthcare has been the ability to turn your home into a basic GP surgery. Smartwatches can measure your heart rate, blood pressure and how many calories you’ve burnt; digital assistants can remind you to exercise; gadgets will help you monitor your asthma and cope with back pain; you can videochat with your doctor via your laptop. You can even buy smart shorts that log electrical activity in your muscles.
The gradual shift from calling a GP surgery to make an appointment and travelling there, to monitoring and managing conditions as part of your regular day – often online – is being welcomed at both ends of the phone line.
As one of the most popular medical websites in the UK, Patient.Info is at the forefront of this revolution. More than 100 million people logged on to the site in 2018 to read articles about healthcare, check symptoms and learn to live a healthier life.
Jason Keane, Chief Executive, says Patient.Info’s success and popularity is a result of the clear, accurate and reliable clinical information people find on the site, which has all been written by healthcare professionals.
“The objective is to empower people to make informed choices,” he says. “That’s about understanding the patient’s needs and offering them great content so they can manage their own care. It’s getting patients to the services they need. Patient.Info plays a critical role in not only being able to give people the ability to make informed choices, because the content is written and peer reviewed by GPs, but it makes the entire experience very safe and secure in one tool.”
A high level of safety and security is important when people are sharing personal information online, so Keane and Clinical Director Sarah Jarvis MBE took no chances and moved Patient.Info onto Azure, Microsoft’s cloud platform. They also use Power BI to quickly and easily understand all the information held in their Data Lake.
Moving to Azure also allows the website to cope with sudden surges in demand – during winter when flu is more prevalent, for example – as Azure will automatically free up more server space when needed.
“Our users need to have complete confidence in what we’re doing,” Keane adds. “We work with Microsoft because we know all of the data is in a very safe and secure environment. It’s the best technology out there to really make sure that all of that information is not only safe and secure but meets UK and EU law.”
Patient.Info grew out of an online health information director set up by Dr Tim Kenny and his wife, Dr Beverley Kenny, in 1996. Tim led a group of medical authors to produce a resource for medical staff and their patients.
It has evolved into an award-winning service led by Jarvis – a GP, former GP trainer and resident doctor for the Jeremy Vine show on BBC Radio 2 – that also produces a newsletter sent to 750,000 subscribers and around 3,200 leaflets for patients and doctors on health conditions and 850 on medicines, in addition to hundreds of editorial features, all medically peer reviewed and approved.
Its 23-year growth has been mirrored by a rise in demand for GPs and the services they provide in communities. In 2017, the British Medical Association warned that the NHS was at breaking point. There are around 34,000 GPs in the UK, but a report by the King’s Fund, Nuffield Trust and Health Foundation in March this year stated that the shortfall in the number of GPs is “so serious that it cannot be filled at all”.
The Government is drawing up a Green Paper on social care in the UK, with former Deputy PM Damian Green recommending new taxes on older people and a private insurance model to top up a universal level of state care.
Jarvis has been a GP since 1990, and has seen first-hand the demand levels rise.
“We know that we have a huge crisis in the number of GPs and healthcare provision across the UK, we know that the Department of Health is moving very long way towards trying to empower people to be in charge of their own conditions and to self-care,” she says. “We know that up to one-in-three people walking up to A&E does not need to be there, and about the same proportion in general practice. We need to engage patients; we know that up to half of medications are not taken as they should be, and that’s even more of an issue for patients who are taking what we call preventive medication.”
“So much of the work we do these days is proactive, it’s about keeping people healthy and stopping them from getting ill in the first place,” Jarvis says. “That means that it’s not remotely surprising given that we’re doing so much more for our patients, and that they’re getting older and that they have more long-term conditions, that GP workload has increased by about 50% in the past 10 to 12 years alone. We have to empower patients to self-manage if general practice is going to survive and be there when people need it.”
According to research published in 2017 in BMJ Open, the open access medical research journal, GP appointments in the UK last an average of 9.22 minutes. People in 28 countries, including the US (21.07 minutes), Switzerland (17 minutes), Belgium (15 minutes) and Sweden (22.5 minutes), spend longer with their doctor.
The challenge for GPs is to offer people the best possible care when they are seeing them for less than 10 minutes. Patient.Info is helping family doctors by giving them fast access to information they can trust, while they are in a room with a patient.
“Around 60% of the GPs in the country have access to the information on Patient.Info directly within their consulting systems, which they can trust completely because it was written by their peers and it’s been peer reviewed,” Jarvis adds. “They can read it on their screen while the patient is in the consultation. I’ve used Patient.Info for 20 years and it is such an invaluable part of my working life. A patient came in recently complaining of chest pain, shortness of breath and dizziness, and was convinced they were dying. I could immediately bring up the page on panic attacks, go through it with them and say, look at these symptoms, you’re having panic attacks.”
As people live longer, they develop more complex medical conditions that need to be managed. Whether it’s a website full of easy-to-read information or a leaflet, simplicity is key when a large proportion of the people who use NHS services are elderly. Azure is ensuring that no matter how technologically adept or otherwise someone is, they can still access the care they need.