We keep hearing that the solution to the workload crisis is going to involve telehealth and the greater use of “apps”. In future Mr and Mrs Smith aren’t going to have to see a GP because IT is going to provide them with the information that they need. GPs, freed from the shackles of seeing the worried well are going to have the time and resources to deal with our ageing population. Many IT providers are stepping into the breach to provide the solutions that are needed. So that’s ok then…
Well yes and no.
You have to look at what our patients are seeking to get out of a consultation. To assume that it’s just information is misguided in many cases. Sure, some people do, but what the majority of people are looking for is reassurance.
Our patients can and do already use the NHS choices website. It’s full of useful information about the causes of conditions. It even tells patients what to do when they have a condition, and when they need to visit their GP.
However, despite being a comprehensive source of information, what it is not, is reassuring. When a patient has a cough, they’re not interested in all the causes of a cough. They want to know what’s causing their particular cough and what they need to do about it.
The mistake is assuming that just by giving the patients personalised information you’re going to meet that need. You may do for some. However, for many of our patients, it’s just not going to give them the reassurance that they need. Our challenge, as app designers, is to produce apps that give patients this reassurance. We can build apps that give them the information they need relatively easily. Nevertheless we need to be working out how to do more than that.
To me, this is going to involve a multidisciplinary approach from tech teams. Our apps are going to need to give our users the information they need at the time that they need it. Yet our users are also going to need to trust the app. Medicine, and General Practice in particular, is a relationship business.
This means that as health systems architects we need to be looking at the wider picture. It’s not just about what the app does, it’s about how it does it, and how people come to the app in the first place.
At Yourpressure we’re building an app to allow our patients to measure and manage their blood pressure, so it’s something that we’ve spent a lot of time thinking about. We don’t have any definitive answers yet, but we have had some thoughts...
We think that video and audio content is going to be vital. There seems to be something powerful about seeing and hearing another human being speaking to you that gives information more credibility than words on the page. Think of how successful some TV doctors have become as trusted sources of information. We should be aiming to get our users feeling the same way about our apps.
In terms of the route that gets users to the app, that needs to be carefully considered as well. If the app is seen as an obstacle to obtaining treatment, then it will never be trusted. Conversely, if it makes our users lives easier, it’s more likely to be successful. At the moment, some developers and pathway designers seem to have lost sight of that fact.
Finally, we think that the user experience is going to be vital. Part of the art of being a GP is giving patients just enough information. Too much information and the message is lost. Too little and our patients leave unsatisfied and anxious. As app designers we have to resist the urge to give people every last little bit of information. Instead, we should concentrate on designing “lean” apps that give people just enough to fulfill their needs.
We think that the way to find the answer to all these questions is through prototyping, user testing, and rapid iteration. Competent use of analytics will help us to find the way forward. Meanwhile, what problems do you think that telehealth apps will face? As ever, please let us know in the comments.
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