Topic: Empowering the patient-doctor relationship with digital technology

2020 was a year in which most of us found ourselves thinking about many aspects of life that we took for granted, regularly re-evaluating and risk scoring common everyday activities to decide what was really ‘worth doing’. We used to ‘go’ to work every day, ‘go’ to the shops or the pub or a sporting event and we used to ‘go’ to the doctor. We used the word ‘go’ to mean physically leaving our home.

From March 2020, the word ‘go’ began to take on a different meaning: instead of physically ‘going’, spending a significant amount of time outside of our homes, we increasingly ‘go online” to do our work, shopping, socialising, and to get medical help. Books have been written about ‘the death of distance’ (1997), ‘martini marketing’ (2014), and ‘the patient will see you now’ (2014) describing how technology will change our lives – but perhaps 2020 was the year when these changes became mandatory rather than optional.

Before March 2020, doctors usually would see patients in person, but sometimes conduct telephone consultations. They stressed the importance of all the valuable clues they get from how the patient moves, looks, sounds and smells, in addition to what they say. Yet now, how few (not how many) people actually sit in a doctor’s waiting room – how many people have to plan time off work, even if the consultation lasts less than 10 minutes? Now it is normal to wait outside if a physical consultation is necessary, maybe even queue in the cold. More often than before, consultations involve a digital interaction between doctor and patient.

Healthcare goes digital

How many, or few, of our experienced healthcare professionals, were trained to give a digital consultation? Patients weren’t trained to prepare for them either. In 2020, protocols were written for video consultations and healthcare professionals discovered a lot more about which patients had which levels of digital competency and confidence in using digital tools. Doctors discovered how many of their patients had smartphones and laptops but also how many of these patients knew (or not) how to download and install simple apps and use video call tools. Healthcare professionals and administrators discovered how much easier it could be when patients were already comfortable with communicating by email and SMS or familiar with commonly used social networks to share information asynchronously. Patients sometimes had to be trained and supported on the technology, but a great many welcomed the convenience of digital.

In 2014, the NHS produced its ‘Five-Year Forward View’ (the Care Act 2014). Its vision for 2020 discussed how services would be delivered, but only mentioned the word ‘digital’ four times and ‘technology’ 12 times. Much has changed in five years. Norman Lamb MP, Care and Support Minister in the UK coalition government, saw the Care Act as ‘the most significant reform of care and support in more than 60 years’. The slogan ‘think local, act personal’ was seen as representing a significant change in legislation, of importance to service users and carers in England and Wales because ‘for the first time it puts them in control of their care and support. It also makes clear what kind of care they should expect’. 2020 has probably put concepts such as ‘think local, act personal’ in the spotlight like never before. Scientists did a brilliant job in 2020 to deliver vaccines and new treatments for COVID-19, but the importance of individual behavioural choices has also been highlighted. Indeed, without the co-operation of individuals – in terms of social distancing, wearing masks, hand and surface hygiene – COVID-19 might have inflicted much more damage. We must not underestimate the contribution of risk-aware, responsible patients.

Topic Discussed: Empowering the patient-doctor relationship with digital technology

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