Call Us: +44 (0) 7825 431294

Why we need ‘Medicine in the Cloud’

I’ve written before about the trend of clinicians starting to show real leadership in digital health and I highlighted one of those clinicians, Professor Shahid Ali, and the fantastic work he was doing with care planning in his Bradford practice. This week I was fortunate to hear from another clinician leader, Dr Mohammed Jiva, and I wanted to replay some of that whilst suggesting how this points to increased access to affordable healthcare through a concept of ‘Medicine in the Cloud’.

The ‘Middleton demonstrator’

Mohammed Jiva is a General Practitioner in Middleton, a busy district north of Manchester in England. For the last 6 months he’s been leading a demonstrator programme across 9 GP practices in that area, designed to reduce unplanned hospital admissions whilst increasing patient access to primary care services – without additional resources. He has achieved this by a clever re-configuration of resources:

–       He created a diary system called DISHI which allows any of the primary care providers (including pharmacists and community nurses) to book patients into any available clinic in the area. So for example a mental health patient may not be able to get an out-of-hours appointment at his own centre, but through the diary he/she can be referred to another clinic operating an evening or weekend surgery. The local hospital also has access to the system and can refer patients back to a more appropriate service.

–       The DISHI system also tracks hospital admissions and discharges in real-time, so the handover from primary to secondary care is much faster than the old letter-based approach.

–       Unusually for the UK (and this may surprise some of you) the local hospital has online access to the patients’ primary care records, so they can be treated more effectively if they are admitted.

–       He has also introduced the use of WebEx to make better use of scarce resources. Firstly pharmacists can set up an instant conference with a GP if the pharmacist needs a second opinion on a walk-in patient – this has been used for skin complaints as an example. Secondly, all 9 GP practices are offering WebEx consultations to allow patients a remote consultation if it is more convenient, a service they call “GP On-Line”

The combined effect of this is to move towards a 7×24 primary care system, making best use of all resources and avoiding unplanned hospital admissions, but within the same resource envelope – no new staff have had to be hired in this programme.

Why is this important for the future of healthcare?

While I was listening to Dr Jiva talk, I began to think about the possibilities. If you combined this user-friendly approach to access, with the long-term care planning approach pioneered by Professor Ali, you start to see a really powerful future for primary care, where patients are supported in achieving much better health outcomes whilst enabling much more convenient access to those services, more like a multi-channel approach that we see in other industries.

I also began to see this as the same trajectory we see in cloud computing – instead of fixed resources that stay in one place and are often under or over-utilised, we are sharing those resources across all user demand, and making the whole process much more cost-effective. I’m calling this ‘Medicine in the Cloud’, not because the clinicians and patients are using cloud-based IT services (though in many cases they will be) but because we’re going through the same step-change of virtualising resources and enabling 7×24, access anywhere, services.

I also noted that in both Dr Jiva and Professor Ali we have two visionary, entrepreneurial clinicians who aren’t afraid to push the boundaries. We need more like them to step forward.

What do you think of this concept of ‘Medicine in the Cloud’ – scary or exciting? Please comment below or feel free to contact me.

1 Comment
Leave a Reply