Delivering Patient-Centered Care Through New Technology

(Posted on Friday, September 20, 2019)

Babylon’s GP at Hand is a health app launched in England almost two years ago with the mission “to put an accessible and affordable health service in the hands of every person on Earth.” GP at Hand is open to anyone who lives or works within 40 min of its clinics, and in the past two years, 50,000 people have registered with just one of the clinics in west London. Its diagnostic tool, the ability to have video conferences with doctors, and the two-hour response time verses 8 or more days for a visit to your GP are all reasons why this app being adopted by so many so quickly. 

As reported in the Lancet in August 2019, the app has changed the way its users consume healthcare, and this transformational driver of the health system in the UK comes with both strengths and weaknesses. The issue of accessibility is one raised in the Lancet report: 

Helen Stokes-Lampard, chair of the Royal College of General Practitioners, worries that the digital revolution could leave chunks of the population behind. “New technology needs to be fair and accessible to everyone, not just people who have the latest 4G-enabled smartphones”, she said. “The digital divide is a profound concern; those who are able to access exciting new technology are fitter, healthier, and more affluent.” She points out that around 8 million Britons do not even have access to email. “If we move to a digital-first NHS without having a digital-first population or a digital infrastructure, then we are doing a disservice to our rural population, our frail population, and our deprived population”, she said.

So while this new technology introduces an innovative approach to patient-centered care in the UK health system, it remains to be seen whether Babylon’s GP at Hand will be a solution for all. What is remarkable, in contrast to the patient base in England, is the app’s accessibility in Rwanda. Again, from the Lancet:

The Babylon app has 3 million users worldwide. 2 million of them are in Rwanda. In the small African nation, Babylon is known as Babyl. It has been in the country since 2016 and is partnered with the Bill & Melinda Gates Foundation and the national government. Users register with their mobile phones, for a one-off fee of around US$0·20. Babyl provides nurse and General Practitioner appointments, prescriptions, and referrals to laboratory tests and specialists. It is all done over the telephone. Patients dial *811# and ask for an appointment. A time is arranged, and a triage nurse telephones. Staff can refer the patient to a GP, who will call later, or a health facility. Prescriptions can be issued digitally and a code sent to the patient’s mobile phone; the patient attends the pharmacy and collect the medicines. The national insurance provider pays.

Babyl provides over 13 000 consultations to Rwandans every week. The country of 12 million people only has around 1200 doctors. “We are seeing the benefits digital technology can bring to Rwanda”, said Mobasher Butt. The country is well placed to take advantage of telemedicine. It is one of the fastest growing economies in Africa, it has extensive mobile broadband coverage and a government with a long-standing commitment to health. Whether digital health can be rolled out to more chaotic parts of the region, such as neighbouring Democratic Republic of Congo, remains to be seen.

Integrated, patient-centered care means that every element of our health system is working toward improving the quality of care offered to patients. It means care is delivered when and where the patient needs it, including at home, virtually. GP at Hand offers this convenience. As with any new technology, GP at Hand comes with challenges as well. For more on the strengths and weaknesses of this technology, read the full report in the Lancet.