Dr Peter Moore: Video consultations are just the beginning

A video consultation with your GP is accepted

A video consultation with your GP is accepted - Credit: Getty Images/iStockphoto

Under pressure for fast mathematical calculations to decode German messages during World War Two, post office engineer Tommy Flowers developed colossus, the world's first computer.

Luckily, living through this coronavirus pandemic is not the same as living through World War Two but will the pressure lead to some exciting technical developments throughout our NHS?

One aspect of General Practice which worried me was telephone triage.

When patients rang up I would assess the situation over the phone.

Without being able to see the patient, I could ask questions and even listen to the tone of voice but a true assessment was difficult.

Several times I was caught out. Either I would arrange to see a child immediately or even ring 999 only to find that the child was happily playing or the parent would make it sound like a minor problem only to find a moribund child.

A five-minute phone call would often end up with a face-to-face consultation to play safe.

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Talking to family and friends using Zoom, FaceTime or one of the many other systems has become normal. But will it work in General Practice?

Recently, I had a mock consultation with a colleague from his mobile to my iPhone to demonstrate the new GP video system.

As the 'patient', I was at the top of the screen with my colleague below.

It was very clear and, I understand, confidential. It just needs a good signal or WiFi

Now, instead of a phone call the doctor can see the patient which makes the assessment far more accurate; is the patient or child alert, are they breathless and how ill do they look?

Rashes can be examined and even photographed.

Often this ends up with advice and suggested treatment without the patient having to come in.

This worked well during the lockdown when everyone knew they should not to leave home.

Sick notes are easier. Rather than having to see a patient when the GP knows they should be off work, they can request a note online and the GP can send the sick note via a text.

In the past if a patient known to be terminally ill died we could not issue a death certificate or sign a cremation form if the doctor had not seen the patient for two weeks.

Even if the patient was receiving excellent care from the nursing team or residential home and the death was expected, if the doctor had not seen the patient for two weeks the case had to be referred to the coroner.

This caused delay and unnecessary upset for the family. Now a video consultation is accepted.

And video consultations are just the beginning.

Many people wear a personal 'Fitbit' giving regular information about exercise, respiration, pulse and many other aspects of their health. In the future they may be able to check oxygen levels.

There is now a machine which looks like a mobile phone case but opens up to reveal two pads. By putting two fingers from each hand on the pads, the machine can produce an ECG, electrical recording of the heart, which can be sent to the doctor.

Recorded video consultations are now being used to assess new GPs for the membership of the Royal College of GPs, an exam all potential GPs have to pass.

But will all this technology take away the personal aspect of the GP?

Rather than spending time examining the patient, taking temperatures, counting the respiratory rate and pulse the doctor will have all the information and be able to spend more time talking it through.

For elderly patients who find the technology frightening, it will free up doctor's time for the personal care they need.

World War Two led to the first steps in the revolution of computing.

The coronavirus could lead to a revolution in GP care.

Are they any downsides? Remote gynaecology might be a problem.