Increasing Efficiency in Primary Care

Increasing Efficiency in Primary Care
Female patient listening to doctor in medical office.

A 2015 LHM Casey McGrath report states that there is a total of 2,954 full-time equivalent GPs in Ireland, which gives a rate of 64 GPs per 100,000 of population. The number of Irish GPs is well below the rate for Organisation for Economic Cooperation and Development (OECD) countries which have good primary care facilities, such as the UK, Australia and Canada. The number of medical cards and GP-visit cards has increased substantially over the past decade. From a base of approximately 28% in 2004, over 40% of the Irish population now has a medical or GP card.

The number of consultations per year is disputed among statisticians but, combining figures from the Central Statistics Office (CSO), the Economic Social and Research Institute (ESRI) and a 2013 Irish Medical Journal (IMJ) study, the average attendance rate for General Medical Services (GMS) patients is 7.71 per year, while for private patients it is 3.07.

A recent independent study indicates that 50% of Irish GPs spend an average of 12 minutes per patient and 35% have seen patient time reduced in the past 12 months.

31% of GPs intend to retire or leave the profession in the next five years so there will be a major shortfall in GPs and the numbers will not be enough to maintain current standards. As mentioned earlier, these current standards are well behind other OECD countries.

Patients are living longer, often with complex and multiple health conditions This is leading to an increase in the number of GP consultations and, therefore, an additional strain on GP practices. Approximately 700 GPs are over the age of 60 with an average retirement age of 67. We have the government Slainte Care policy which is aiming for free medical care <=18 by 2021. We need 1310 new GPs, but our training schemes have provided a total number of trainee places of under 200 per annum. We have the closure of rural practices.  Just 37.5% of GP trainees are planning a career in Ireland and only 46% of GP trainees plan to work as a full-time GP 5 years on. By 2021 annual GP consultations are likely to have increased by 10.3 million and by 11.5 million by 2026.

Needs of the Primary Care providers

The consensus regarding the needs of the Primary Care providers is that they would benefit from assistance to make their business more time efficient. The overall speed of service is slowed down due to paperwork and the burden of administration. Booking appointments and the interaction with patients while doing so creates duplication of work.  When doctors receive patients’ blood test results they must be contacted, and this can mean multiple phone calls that the GP or administration staff must make. Time is a big factor in general practices and it would be in their best interest to cut down the amount of time spent on the phone.

Technology allows us to connect patients with healthcare workers more rapidly and efficiently than ever before. Healthcare is an inflationary model and it is exacerbated by the fact that everyone wants to hire more people. We should be looking at innovative technologies that will allow us to do things more efficiently.

We do not have enough healthcare workers so it makes sense that we need to automate standardized repeatable processes.

We need to use automation to replace low value intensive tasks. It does not mean eliminating employees but elevating them to higher functioning roles that make use of the clinical expertise they have been trained for. Automation in healthcare is a must have.