Thursday 13 August 2020

Only on the phone

Is it just me, or have others noticed a growing trend to develop new apps only for the phone in your hand, and not for the laptop on your desk, table, or lap? Here's a case in point.

My local medical practice - Mid Sussex Healthcare - is encouraging patients to download and install the new Airmid app developed by TPP. I'd already been using TPP's older SystmOnline app (also promoted by the practice, but not so strongly) for some time. 

SystmOnline was OK for reordering repeat medication, but otherwise rather limited. 

Airmid is however much more comprehensive, and lets me do all kinds of things. I can - of course - arrange appointments and order fresh medication. (Although in the post-coronavirus world, an 'appointment' generally means a phone conversation with one's doctor at a booked time). I can also view all kinds of medical facts about myself. So far as I can see, I have access to much of the entire online record available to the practice, going back many years. 

I'm chiefly interested in stuff like which vaccinations I've had, and the results of regular blood tests - annual and six-monthly - which I then copy onto my own spreadsheets, to build up a long-term picture. Interestingly, I can use the Airmid app to add personal information myself, such as self-measured weight, alcohol consumption, blood-pressure measurements and pulse measurements.    

The thing is, TPP have developed this useful (essential?) app for Apple phones and Android phones, but not for laptops and desktop PCs. There's no corresponding big-screen version. I think this is only a reflection of the fact that smartphone use has become close to universal. Most people now carry one, keep it on and connected, and consult it often. So it makes excellent sense to develop apps only for the phone - and only secondarily (or not at all) for any other kind of device. So one now has to own a smartphone to access medical services. 

There are consequences. One is that those who dislike tech, and doing things electronically, are going to be left out and become badly disadvantaged. That's actually quite a large and diverse group. It doesn't include me, but I frequently meet people who belong to this group, sometimes stubbornly, sometimes because modern tech just seems to them overwhelming and alien. And there are those who might wish to have a go, but simply can't afford the high cost of these devices. There are also those who have arthriticky fingers incapable of accurately hitting tiny buttons on small screens, and/or dodgy eyesight incompatible with those small screens.

The low-tech or no-tech folk in my own village must be very worried just now. The old, direct approaches to medical assistance have gone, removed when lockdown measures were put in place. It's no longer possible to pop into the surgery and ask a few questions. That's banned, because of the virus. Instead access is through a phone. The low-tech method being the old-fashioned landline phone - a less-than-perfect device if one's hearing is impaired, and it requires the patience of a saint to hold on and gradually work through the calling queue, and only then speak to a receptionist. 

'Seasoned techies' like me can submit a written request for a conversation with a doctor, either via the app, or by using a link to another online service from the practice website. Either way, familiarity with electronic devices and how to use them is needed. With the written request, you have to answer a structured online questionnaire. Mind you, it helps you focus sharply on what you really want to discuss, and it brings out what you already understand about your condition, and about any existing medication for it. The doctor can quickly peruse this, see how matters stand, and then decide whether a quick chat on the phone will do, or whether a face-to-face conversation and physical examination is required. 

For me, completing a typed questionnaire is much easier than trying to explain things to a receptionist, and I don't mind this way of doing things. But many will. They will miss the good old days, when a stroll to the surgery to see the doctor - for a pleasant chat, if nothing else - was part of their leisurely social round. But the new way must free up valuable time, and enable many more patients to be 'seen', all of which is a good thing. 

No doubt the practice doctors bless the pandemic for bringing in a streamlined new system for seeing patients without a lengthy and contentious consultation process. It takes pressure off them, and (for now) solves the problem of retiring doctors and ever-more patients needing attention. And it was all done quickly and painlessly. We won't be going back to the old way. 

For better or worse, every patient who possibly can will have to use a smartphone, and that app. 

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