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A faulty production line

GP apps and online services 'no magic bullet', warns health think-tank

The benefits to GPs from the NHS drive to adopt new technologies are ‘uncertain’ according to a new report from the Nuffield Trust health think-tank, who warn it is no ‘magic bullet’ for staff.

It highlights key pitfalls of NHS England’s digital drive, including the workload implications of educating patients to use technology and the risk of policy makers ‘assuming this will deliver big savings immediately’.

But The Digital Patient: transforming primary care? report does say that these digital tools and apps can be ‘transformative’ for patients, particularly in helping them manage long-term conditions.

It states that ‘the impact of this new digital capability is far from certain; we are lacking evidence in a wide range of areas’ and sets out to explore the current evidence for policymakers to adopt.

The risks of failing to consider this include NHS professionals shunning technology that they think will increase workload or misinform patients, or – as already revealed by Pulse – the growing impact of private GP app providers disrupting primary care.

The report looks at seven key domains where the NHS is expanding the use of technology:

  • Monitoring and wearable technology
  • Online triage
  • Online sources of health information, targeted interventions and peer
  • Support
  • Online appointment booking and other transactional services
  • Remote consultations
  • Online access to records
  • Apps

Many of these fields are already widely adopted and delivering benefits, but to a varying degree, it says.

The report states that maximising these rewards will require training professionals to work differently.

For example, on how to recommend and use data from NHS licensed apps and wearable devices, or to demonstrate how patients can get the most out of online records, for long-term condition management, and online booking.

But the report states: ‘All of this requires resources and it is a mistake to think that the use of patient facing technology to support healthier lifestyles and self-care will be an easy or free option.’

‘It will require funding and support at all levels of the system, at least in the short term. We make a number of recommendations about where this might be most helpful.’

A statement from the Nuffield Trust adds that ‘some of the 165,000 health apps on the market have not been properly assessed yet, and of those that have, some have been shown to be inaccurate or ineffective.’

Though NHS drives to ‘kite mark’ approved apps for GPs to prescribe will help this, ‘the lack of evidence around the effectiveness of apps extends to other technologies too, like online triage systems.’

It also warns that many consumer health apps and wearable devices have a short lifespan before patients lose interest.

Leader author Sophie Castle-Clarke, fellow in health policy at the Nuffield Trust, said: ’Technologies that patients can use offer some of the brightest hopes on the NHS horizon… But this technology could be a double-edged sword, and there’s still a lot we don’t know.

‘Without regulation and a careful look at the evidence – not all of which is compelling – these digital tools could compromise the quality of care and disrupt the way care is provided’.

Readers' comments (8)

  • its strange how these experiments such as web based GP consults will fall apart once they are analysed with a more scientific eye.

    Much of the technology drive is a PR exercise designed to reward friends of politicians with juicy contracts.

    One of our depts did put up a project for a web type consult forum but most decided wasn't worth the risks because they were so useless and wouldn't get through any quality assurance process.

    they were wrong as we are seeing millions spent on useless projects

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  • Ooh how we were all dreaming of the day when we could remotely monitor the blood pressure, weight, pulse and sleep times of the 'healthy and wealthy' patient cohort. Absolutely marvellous developments are afoot .... where is my Fitbit?

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  • Apps, monitors and patient held protocols for disease management do not reduce consultations

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  • The biggest thing will be diagnostic apps. We know from nhs111 that the current algorithm programs are useless, but at some stage and using "big data" we will be able to "speak" to a virtual doctor and get helpful advice.
    The big question is whether this will be in 2 years or 20 years...I for one welcome our computer overlords.

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  • No aps and online services are not the magic bullet. They are one of many tools available. If youre trying to change the course of a river you dont take bricks out of the dam because they haven't stopped the river. You move them around, link them with other bricks and add more! The public prove time and time again when technology makes their lives easier they will use thats why we have online shopping, online banking, facebook and other communication platforms. Personally I use patient Online and I think its brilliant.

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  • If this is going to happen then a fundamental re-think of medical education is needed. We are all taught to take a history then examine the patient. This usually leads to the correct outcome and has stood the test of time. IF we are wanting to cut out the exam then medical education needs to change. I suspect it may be of use in certain scenarios but of course will lead to many unforeseen problems. Also medico-legal issues need to be sorted out.

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  • It will fail. Just like computer for schools with unwilling students, especially when you cannot concentrate while in pain.

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  • Has anyone checked the price rise in MDU subscription. Probably not worth the clinical risk.

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