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Heralding a new era in Irish general practice?

In a joint interview with the Medical Independent (MI), NAGP Council member Dr Michael McConville and NAGP CEO Mr Chris Goodey express huge enthusiasm and confidence about their new telemedicine project, GP-Online.

They contend that, if successful, it will have a major impact on the general practice landscape in Ireland and will be hugely beneficial for both GPs and patients.

However, a number of online GP services and fledgling GP video consultation apps already exist in Ireland, so what is so special about their offering?

Both contend that their telemedicine app-based project is unique, in that it will allow patients to book an appointment with their own GP, will ensure continuity of care, and will not be limited to a small range of conditions, like other web-based GP services.

“Unlike any other competitors, this is not going to be limited. Any condition can be presented. It will be integrated into the normal working day of the doctor… if the doctor thinks the patient should be examined or needs bloods taken, they will be asked to come into the practice,” Dr McConville, who is Director of the project, explained to MI. As a GP in Cavan with over 20 years’ experience, he maintained that up to half of daily GP consultations could be carried out through telemedicine.

How it works

Patients will be able to book a video consultation appointment with their GP for a scheduled time through the GP-Online app’s booking system.

For patients who need a prescription, it will be mailed to them or arrangements will be made to send it to their choice of pharmacy, Dr McConville said, adding that ePrescriptions will be used as soon as the framework is in place to support them.

“Less than one-in-five of my consultations end in a prescription, so prescriptions are a vital part of medicine but they are not the only part. Communication, face-to-face communication, and the continuity of care with someone you are familiar with, from the comfort of your own home, are what matters,” Dr McConville maintained.

Continuing, he said that GPs would be able to set their own consultation fee and working hours for GP-Online telemedicine appointments. He confirmed that the service “will be compatible with all platforms”, across smartphones, tablets and PCs, and will work on “good 3G so broadband is not essential”.

It is planned that GPs who use the service will pay a monthly fee and also a “transactional fee” per patient. The set-up costs of the service are being funded by the NAGP and a number of individual GP investors. The NAGP Council “voted unanimously” to develop GP-Online, Mr Goodey reported.

Convenience

Dr McConville said the service will be very convenient for patients, who will not have to leave their own home, especially when unwell and immobile.

He also contended that given the current direction of general practice, with GPs wanting more flexible or part-time working arrangements, GP-Online will allow GPs to better tailor their working hours and location.

Mr Goodey pointed out that telemedicine is long established and other similar GP services in the US and Australia have been successful. He stressed that GP-Online will augment existing GP services, not replace them.

Both Dr McConville and Mr Goodey acknowledged that the project will be a “learning curve” for patients and doctors, and that they anticipate and are prepared for some teething issues.

Dr McConville stressed that security and safety will be rigorously tested in the trial phase of the service. “It will be version one that we will be launching and we will keep adding to it and refining it,’ he said, confirming that the service will seek to integrate electronic health records and individual health identifiers, which are currently in the pilot roll-out stage by the HSE.

While no formal talks have yet been held with the HSE about using GP-Online for public patients, Mr Goodey said the Executive is aware of the project. Dr McConville expressed confidence that the Executive would be interested in using the service for GMS consultations, and that GPs would be quick to sign-up to using it.

Mr Goodey and Dr McConville were open to the service being expanded to consultants and other healthcare workers or licenced internationally in the future. For now, they are concentrating on launching the project, with a current target of quarter two this year, and making it a success in Ireland.

“What people don’t seem to get is that over the next five years, nearly 1,000 GPs are due to retire in Ireland. Access to GPs is going to become very difficult. The whole model of how general practice works will have to change. If we use technology and empower ourselves, patients and other healthcare workers we can help this, though not eliminate it. We hope the HSE will see the sense of this.

“When GP co-ops were first introduced, there was huge scepticism and resistance to them at the time and now people couldn’t imagine life without them… yes, there will be teething issues but as long as we get the technology to work, we are sure patients and doctors will find this of benefit to them. We are very confident it will work and we know there is an international market out there already for it,” Dr McConville concluded.

The GP-Online project will be unveiled at the Primary Care Partnership Conference and NAGP AGM in Maynooth later this month.

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