We all know that doctors don’t take kindly to being forced to use health IT tools. Apparently, that’s particularly the case in London, where a group of general practitioners recently held a protest to highlight their problems with a telemedicine app rolled out by the National Health Service.
The doctors behind the protest are unhappy with the way the NHS structured its rollout of the smartphone app GP at Hand, which they say has created extra work and confusion among the patients.
The service, which is run by UK-based technology company Babylon Health, launched in November of last year. Using the app, patients can either have a telemedicine visit or schedule an in-person appointment with a GP’s office. Telemedicine services are available 24/7, and patients can be seen in minutes in some cases.
GP at Hand seems to be popular with British consumers. Since its launch, over 26,000 patients have registered for the service, according to the NHS.
However, to participate in the service, patients are automatically de-registered from their existing GP office when they register for GP at Hand. Many patients don’t seem to have known this. According to the doctors at the protest, they’ve been getting calls from angry former patients demanding that they be re-registered with their existing doctor’s office.
The doctors also suggest that the service gets to cherry-pick healthier, more profitable patients, which weighs down their practice. “They don’t want patients with complex mental health problems, drug problems, dementia, a learning disability or other challenging conditions,” said protest organizer Dr. Jackie Applebee. “We think that’s because these patients are expensive.” (Presumably, Babylon is paid out of a separate NHS fund than the GPs.)
Is there lessons here for US-based healthcare providers? Perhaps so.
Of course, the National Health Service model is substantially different from the way care is delivered in this country, so the administrative challenges involved in rolling out a similar service could be much different. But this news does offer some lessons to consider nonetheless.
For one thing, it reminds us that even in a system much different than ours, financing and organizing telemedicine services can be fraught with conflict. Reimbursement would be an even bigger issue than it seems to have been in the UK.
Also, it’s also of note that the NHS and Babylon Health faced a storm of patient complaints about the way the service was set up. It’s entirely possible that any US-based efforts would generate their own string of unintended consequences, the magnitude which would be multiplied by the fact that there’s no national entity coordinating such a rollout.
Of course, individual health systems are figuring out how to offer telemedicine and blend it with access to in-person care. But it’s telling that insurers with a national presence such as CIGNA or Humana aren’t plunging into telemedicine with both feet. At least none of them have seen substantial success in their efforts. Bottom line, offering telehealth is much harder than it looks.