Finally……some light at the end of the tunnel or a false dawn?

Implications for primary healthcare in a post pandemic world

As vaccines loom on the horizon, finally there is some hope that the end is in sight or at least the beginning of the end is finally in view. However, vaccines are just the start. It is the execution of the vaccination programme that really matters.

The vaccination delivery programme will represent perhaps, the greatest health challenge since the foundation of the Irish state.

It is both a challenge and a tremendous opportunity for Irish general practice to demonstrate the essential role it plays in the health and lives of Irish society.

At the moment, it remains largely uncertain exactly what approach Government will take to vaccinate the population.  What is certain however, is that it’s obviously essential this is done correctly.  Not only is there an immense medical and logistical challenge, but equally what many commentators do not seem to have grasped so far, is that the success of a Covid-19 vaccination programme depends as much on information technology as immunology.

Without  accurate, easy to use, repeatable, real- time processes and computer technology, to record and store the details of  what, when , to whom  and which vaccine was delivered, public health will simply have no idea what level of population  immune response has been established ,with obvious consequences then in terms of opening up society and the economy.

It is somewhat disconcerting that the Government only in recent weeks seems to have established its corona virus task force to develop a vaccination plan and roll out.   Given that it has been obvious for some time, that the only sustainable end game to this crisis, has been a public vaccination programme, one would have thought planning should be much further advanced by now. To be fair, different vaccines have each got different delivery mechanisms and supply chain implications which makes this very complicated. Some are double dose, some are single shot, some require ultra – cold chain, and others do not, so the devil is in the detail and this is a Rubik’s cube of a problem.

In terms of vaccination delivery, different countries will take different approaches driven by a variety of interwoven criteria from population cohort, disease severity, efficacy to economics, speed, logistics and so on. In the USA, immediately after the Pfizer/ Biotech vaccine was announced, it was the share prices of retail pharmacies that were up the most as the market read through was that , with something akin to over 90% of the US population living within 5km of pharmacy, they would be the major financial beneficiaries.

In Ireland, at the time of writing it is not entirely clear what the plan is. What is certain is that GPs should be central to any plan.

Doctors enjoy a position of unrivalled trust in Irish society.  Let us not underestimate how important trust is in gaining public acceptance for vaccination. As all Covid-19 vaccines have been developed at unprecedented speed, naturally there is a degree of public scepticism as to patient safety.  Without public acceptance the population uptake needed to establish sufficient immune response is simply not going to happen and this indeed will be a false dawn.

However, in practical terms, trust on its own of course is not enough.  Doctors need to be able to efficiently manage and report a vaccination programme and all that entails, while still providing care as usual to the needs of all their other patients.  As it is, GPs have had to manage unprecedented change in working practices in 2020. Many practices now operate a closed-door policy for safety reasons with many patient consultations now delivered either over the phone or via video. Inevitably this has resulted in a strain on admin resources with a significant increase in the volume of inbound calls, the logistics of scheduling patient appointments and collection of payments from non – GMS patients.

These challenges seem set to multiply in 2021.  The only efficient and effective way to manage public vaccination at scale at GP practices is using platform technologies that will provide a set of IT tools to easily and automatically manage communications and engagement with patients.

Platform technologies enable patients to do some of the work as they can schedule and book appointments directly but at times controlled by the practice , order repeat prescriptions, perform Covid-19 triage or download test results and also automate repetitive workflows and processes .    Repeat appointments, tests and prescriptions can all be automated so little or no additional admin work is required.  At risk of a deliberate bad pun, it is exactly what the doctor ordered.

Over the past year, MyClinic365 has worked with a number of practices to successfully reduce inbound calls by over 30% as patients now interact with the platform for appointments, test results and repeat prescriptions.   There has led to reduced “telephone tag”, endless voicemail messages from frustrated patients and less stress for the front desk, practice managers and practitioners.

Another major benefit of a patient engagement platform is the amount of useful information that can be captured along the way. Right now, you probably intuitively think you know which patients attend most often, the most likely to DNA etc but with a platform all  this data can now be captured  automatically and you can actually get the facts .   It is incredibly useful to move beyond conjecture to analysis of data as the numbers won’t lie.

If GP’s are to be part of the public health response for vaccination, it is essential that every practice operates at optimum efficiency.

When you consider the practical logistics involved in handling the vaccine, communicating with patients, scheduling appointments, sending reminders, recording patient data, uploading patient data to PCRS, avoiding waiting room overcrowding, maintaining practice throughput for non-Covid-19 related care, 21st century technology is needed to deal with a 21st century pandemic.  Otherwise, practices risk overloading their practice and possibly spreading the disease to staff and other patients as well as financially losing out.

All of us take for granted the convenience of online banking for access to our bank or online booking for flights. In fact, we would likely find it very frustrating or odd if our airline told us we had to ring their call centre to book a flight.  Why should scheduling a doctor’s appointment or getting a repeat prescription be any different?

MyClinic365 has been developed by a GP for GP’s so that practices can work smarter not harder.  It is available, without the commitment of a long- term contract, on a simple monthly subscription.

As they say, seeing is believing, so we strongly recommend a brief online demo.

For further details, please contact the MyClinic365 team at hello@myclinic365.com