Primary Care and Health Tech News Blast ep 3

January 19, 2019

Hello eGPlearners,  in this news update- covering the big stories for primary care over the past week….

lets tech-enhance your primary care

If the first time we are meeting Im Dr Gandalf of eGPlearning where I look at supporting you with technology-enhanced primary care and learning so don't forget to subscribe and ring the bell to be the first to get notified of all these updates.

https://egplearning.co.uk/

Let us start

GP partnership review

This piece of the future of General practice was released on Monday 14.1.19 as led by Nigel Watson with seven recommendations at the heart of the review.

Recommendation 1: There are significant opportunities that should be taken forward to reduce the personal risk and unlimited liability currently associated with GP partnerships.

Recommendation 2: The number of General Practitioners who work in practices, and in roles that support the delivery of direct patient care, should be increased and funded.

Recommendation 3: The capacity and range of healthcare professionals available to support patients in the community should be increased, through services embedded in partnership with general practice.

Recommendation 4: Medical training should be refocused to increase the time spent in general practice, to develop a better understanding of the strengths and opportunities of primary care partnerships and how they fit into the wider health system.

Recommendation 5: Primary Care Networks should be established and operate in a way that makes constituent practices more sustainable and enables partners to address workload and safe working capacity, while continuing to support continuity of high quality, personalised, holistic care.

Recommendation 6: General practice must have a strong, consistent and fully representative voice at system level.

Recommendation 7: There are opportunities that should be taken to enable practices to use resources more efficiently by ensuring access to both essential IT equipment and innovative digital services.

From a digital perspective recommendation 7 is key. Updating systems and allowing innovation must happen, Digitising records would be a major support to practices and help to tackle another uncosted area on subject access requests. Taking this burden away from partners would be very useful. Also working better with statutory organisations for reports for DWP and DVLA would be helpful and reduce considerable administrative burdens on practices. In this past week I have done three reports for the same patient all relating to the DWP- one unified system would reduce unnecessary workload.

Updating our IT infrastructure and policies more in line with consumer tech is also a must. Tackling the ‘computer says no’ mentality due to a reliance on legacy IT would allow primary care to truly innovate, and I eagerly await the day I do not have to use internet explorer 8 in practice.

Many will know I have been critical of the interim review which was published last year. The final review is, however, a good document that identifies the challenges facing partnership and also commends the positive impact the partnership model has in primary care.

Several of the recommendations are high quality and call on other pieces of work to deliver an improvement for partnership in practice- particularly the call for a sort out of indemnity and the premises review.

I do still feel strongly that a key piece lacking is a direct request to increase the global sum funding for practices, as this would significantly and rapidly improve the partnership the workload impact for partners and attract more staff making it more viable and sustainable. I do still see this as a major omission of the review which is in the terms of reference. It should have been requested and using the long term plan as the vehicle to suggest increased funding does not directly help as this still requires increased work for new money, rather than offer a stabilising impact.

However, I do feel continuing to state the review is not fit for purpose is not true. The case studies are useful. I do maintain that much of the data collection could have been done rapidly online and not needed a UK wide roadshow to deliver on the review, but accept that the data and narrative is helpful. A key question moving forward is how much of this review will be implemented moving forward.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/770916/gp-partnership-review-final-report.pdf

As an addition for those in Nottinghamshire, see this excellent summary by the Nottinghamshire LMC chief exec - Michael Wright with useful supportive links.

https://www.dropbox.com/s/bc641eq5gilm0da/Checkpoint%202019.docx?dl=0

The difference in GP access across England is shocking

Speaking of Nottingham according to a breaking story today Rushcliffe (where I live) is the most well-covered GP area in the country. A stark contrast to where I work- St Anns which is in the second worse category for coverage- areas only 2 miles apart.

While many, especially will claim this is shocking news, to those who work in primary care it will be obvious. People work where there is a better work-life balance or income. The challenges of working in rural and inner-city areas in comparison to suburbia can be ignored and tackling health inequalities is paramount.

https://www.bbc.co.uk/news/health-46912055

The patient who objected to 'Asian doctor' silenced by the receptionist

After a patient objected to seeing a Doctor because she was Asian this excellent reply by the reception team highlights the challenges many people still face.

See this tweet: https://twitter.com/DrPunamKrishan/status/1085161089699069952

One area to consider is the institutionalised prejudice about choosing the gender of the clinician you may see. While there are many cultural and preference reasons for a woman to want to see a woman and similarly for a man to see a man, it can be argued this is still prejudiced that in some areas is supported by some CCGs and area teams insisting practices offer daily appointments with both male and female clinicians regardless of the organisation size.

Is this appropriate? As seen in this story when chosen by race it is abhorrent but choosing gender is more acceptable? What a confusing way to define prejudice.

https://www.bbc.co.uk/news/uk-scotland-glasgow-west-46894843?fbclid=IwAR2BU0qFAtCgkYuvGDfKuFjapiHSlNzz0cBVnijBjepsySg6VBozV7BewFQ

Pharmacists warn of a 'surge' in shortage of common medicines

This has been a hot story over the week and likely to develop further. Anyone working in primary care will know about the challenges of obtaining certain medications, whether a doctor, nurse pharmacist and indeed patient. Last week I commented on the challenges about Rivaroxaban. Now this story has broken to the wider media.

The article shows some of the challenges such as:

increased global demand

the increasing cost of raw materials

new regulatory changes causing the closure of factories

fluctuations in exchange rates making it more attractive to supply Europe than the UK

generic companies unwilling to keep creating unprofitable items.

Part of the challenge is also created by the brand switching and use of branded generics by medicine management teams to bring down the costs for CCGs. While this has led to an ‘on the books’ reduction in cost, the opportunity cost to primary care is not factored in for the workload of GPs and pharmacists in dealing with switches and the potential health damage and costs caused by patients who have not had their medications on time. If this was to be factored in I would estimate it would obliterate the savings made, hence the cost to the system rather than individual pots may need addressing. This is potentially where PCNs may help, however, on a national stage there is little I feel the new changes will do.

There is also commentary by many pharmacists about the gaming of suppliers and warehouse companies who deliberately withhold stock to drive up prices, then release them with a short use-by date to increase profits. Much of this is caused by the poor way pharmacists are renumerated for the cost of items particularly with the drug tariff rates which are often out of date when published due to the rapid changes.

For this reason, I again state my challenge to our Secretary of State for Health and Social care @matthancock to work with organisations like the RCGP, BMA, GPC and RSPh to be bold and create clear guidelines for all how to manage these issues rather than pointless statements asking people not to stockpile, - given few seem to be listening and we are likely to be hit with challenges as Brexit progresses.

https://www.bbc.co.uk/news/amp/health-46843631?__twitter_impression=true

Don't forget to check out this week’s TipThursday on the best haematology app - Buku Haematology. I like this app and see why on the video below.

YouTube: https://www.youtube.com/watch?v=X-HWDNKaM4Y

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

Facebook - https://www.facebook.com/Egplearning/ Twitter - https://twitter.com/egplearning

Twitter - https://twitter.com/drgandalf52 Website - https://egplearning.co.uk/

Support: https://patreon.com/egplearning

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The best haematology app? Buku Haematology

January 17, 2019

What is the best haematology app?

Watch this review of Buku Haematology - a useful clinical reference resource that details how to manage haematological investigation results, work up for common haematological conditions and emergencies.

With a clean interface and clear explanations and reference to BMJ, CKS and national guidance it really is a valuable resource for anyone in primary care.

The highs and lows section covers individual test results and the implications of them to help clinicians understand how to manage the results in the context of each patient.

The coagulation section gives useful guides on problems with coagulation including FAQs on DOACs like Rivaroxaban.

The workup section explains common presentations and considerations for haematological conditions and how to manage from a primary care perspective and what point to refer.

The obstetric section has useful criteria for managing anaemia in pregnancy. The emergency section helps guide how to manage complex haematological emergencies.

Created by Dr Alex Langridge and Prof Steven O'Brian it really is a useful app that is updated in content on a regular basis.

Check out this app in detail use the link below to download it: https://bukuhaem.appyourself.net/?web...

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

Facebook - https://www.facebook.com/Egplearning/

Twitter - https://twitter.com/egplearning

Website - https://egplearning.co.uk/

Support: https://patreon.com/egplearning

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NHS Long term plan - Primary Care and Health Tech News Blast ep 2

January 13, 2019

Hello eGPlearners,  in this news update- covering the big stories for primary care over the past week….

lets tech-enhance your primary care

If the first time we are meeting Im Dr Gandalf of eGPlearning where I look at supporting you with technology-enhanced primary care and learning so don't forget to subscribe and ring the bell to be the first to get notified of all these updates.

https://egplearning.co.uk/

Let us start

Long term plan

Called the 10year plan or 10YLTP released on 7.1.19. This video is a review of the executive summary, as the full document is 136 pages long as will take some time to digest.

What are the headline points?

https://www.longtermplan.nhs.uk/online-version/overview-and-summary/

Split into seven chapters.

Chapter 1

Spend an increased amount of funds on bringing successfully implemented changes to healthcare of care to other areas.

Right to digital GP consultations. (doesn't say video).

Focus on networks of practices (likely to be called either neighborhoods or PCNs) to deliver care in communities for primary, community and social care to prevent hospital admissions.

Focus on social prescribing, personal health budgets and the voluntary sector.

Guarantee of a greater rate of funding for the first time ever under a Tory government for primary care using the previously announced £4.5b for community care by 2023/4.

Shift away from hospital-based care for both outpatients (maybe video consultations for outpatient to reduce infrastructure costs like estates/parking etc).

Video Consultations in primary care:

https://www.youtube.com/watch?v=Jw0ehthmFN0

Focus on urgent treatment centres instead of emergency departments and same day discharge from acute wards.

Chapter 2

Prevention.

Focus on prevention ie stop smoking, obesity programme, supporting reducing alcohol - much of this seems public health territory no longer funded by local councils - sharing the costs or shuffling the money?

Focus on deprived groups with outcomes like smoking rates in pregnancy, learning disabled /autistic patients and homeless patients to name a few based on locally supported programmes.

Chapter 3.

This identifies priorities for care quality and improvements, particularly on mental health. Focus on cancer survival, maternity-related deaths, increasing planned (elective surgery) and ring-fenced funds for mental health (2.3bn a year by 2023/4)

Chapter 4

Looking at Workforce, reintroducing training budgets for health education England (taken away in recent reforms) and a workforce implementation plan for later this year. Increased funding for nursing training and routes into training including recruitment from overseas. Also new roles with a focus on professional development especially in primary care based on networks.

Chapter 5

Details the focus on technology including digital access for all, interoperability of data and use of new technology like AI. This chapter will be covered in more detail in our in-depth look later in the month.

Chapter 6

Looks at changes to the financial structure of the NHS to maintain funding increases to prevent challenges in the future including various efficiencies ie saving £700m in administrative costs.

Chapter 7

The final chapter explained the implementation of the plan including legislative changes to enable rapid implementation. It recommends changes to: create publicly-accountable integrated care locally; to streamline the national administrative structures of the NHS, and remove the overly rigid competition and procurement regime applied to the NHS. This includes the shift to integrated care system models by 2021.

5y GP training

Straight from med school - pilot not really 5y as same time in training just different spread

http://www.pulsetoday.co.uk/news/gp-topics/education/five-year-gp-based-training-could-start-in-2021-says-nhs-england-adviser/20038049.article

Man shots GP with a crossbow

Lone worker risks - Zero Tolerance or not?

We provide a health care service but are not servants.

https://www.bbc.com/news/uk-england-beds-bucks-herts-46759669

Rivaroxaban shortage

Furosemide, naproxen, most eye drops,

Impact on workload is unaccounted and risk to patient care being held by GPs and pharmacists.

Look at formal joint guidance from NHS England/RCGP/BMA/Royal Pharmaceutical Society for how clinicians can safeguard patients should further short or long term shortage supplies hit.

Don't forget to check out this week’s TipThursday on a must own GP app- Nottinghamshire LMC app, useful guidance, tools, and resources for any GP regardless of the stage of career or location.

YouTube: https://www.youtube.com/watch?v=ANFl2GzlLYM

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

Facebook - https://www.facebook.com/Egplearning/ Twitter - https://twitter.com/egplearning

Twitter - https://twitter.com/drgandalf52 Website - https://egplearning.co.uk/

Support: https://patreon.com/egplearning

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Must own GP app- Nottinghamshire LMC

January 10, 2019

Must own GP app- Nottinghamshire LMC app

Hi #eGPlearners , with millions of apps out there how do you know which ones you should use. Try one of my top 5 apps as a must own GP app- the Nottinghamshire LMC app. 

Watch the video here and do not forget to subscribe to be the first to see future episodes. 

#TipThursday

The Nottinghamshire LMC app in my view is a must own GP app. 

It contains multiple resources useful for any GP at any stage of their career.  Linking to BMA resources means that although Nottinghamshire centric, the app is relevant to GPs in any geographic location. This includes a guidance section which is kept up to date, resources for partners, trainees, practice managers, and sessional GPs. 

The app contains useful news links and contact details including local LMC events (Nottinghamshire focused). 

The SHOP library allows you to share experience and innovation while the services section links to valuable resources offered by the LMC. 

Finally, the Wellbeing section is diverse with multiple resources, tools, and links to financial, mental health, well-being, support and self-development help. 

I find this a truly useful app with multiple resources. One development could be to enhance reporting like the BEAM to LMC app offered by the Londonwide LMC. 

Take a look and download the app from the link here

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

Facebook – https://www.facebook.com/Egplearning/
Twitter – https://twitter.com/egplearning
Website – https://egplearning.co.uk/

Support: https://patreon.com/egplearning

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Primary Care and Health Tech Newsblast ep 1

January 5, 2019

Hello eGPlearners,  in this news update- covering the big stories for primary care over the past week including a really valuable resource to analysing appointment usage at the end.

 

lets tech-enhance your primary care

If the first time we are meeting Im Dr Gandalf of eGPlearning where I look at supporting you with technology-enhanced primary care and learning so don't forget to subscribe and ring the bell to be the first to get notified of all these updates.

 

https://egplearning.co.uk/

 

Let us start

 

GP IT shake-up by Matt Hancock - GP IT Futures framework
move data to cloud so by 2024 all patients can access GP services digitally, with
practices able to offer online or video consultations.
S1 and EMIS market leaders EMIS X already announced how will others respond?

Switching providers

Outdated IT - IE 8

 

http://www.pulsetoday.co.uk/news/gp-topics/it/gp-it-systems-set-for-major-overhaul-as-dhsc-launches-procurement-process/20038019.article

Boots UK acquires Wiggly-Amps
- change in delivery and better tech interface
- take on Pharmacy2u

 

https://www.thehtn.co.uk/2019/01/04/boots-uk-acquires-wiggly-amps/

Test your breath to check cancer
Pilot at Owlstone Medical practice to use Breath Biopsy to check for unstable molecules as
part of 2y trial lung cancer a likely focus but possibly others.

 

https://www.thehtn.co.uk/2019/01/03/tech-trial-hopes-to-detect-multiple-cancers/

GDPR - government rule out exempting GPs from SARs
MP Margot James feels would weaken the rights of patients
However the increase in the number of requests is fuelled by Lawyers who make a profit from fewer costs
Siginifcant workload increase- not mirrored by other organisations like gas/ banks etc
no guidance on excessive req no one wants to be the test case for ICO

 

http://www.pulsetoday.co.uk/home/finance-and-practice-life-news/government-rules-out-exempting-gps-from-gdpr-subject-access-requests/20037913.article


DNA

Big story of the week possible £200m saved  1 in 20

Cost of £30 an apt  PSSRU- not paid by the individual but a cost to the system

Variety reasons, sometimes can't be helped

The overall cost to the system as a buffer sometimes it just nice- chaos and a break

 

http://www.pulsetoday.co.uk/home/finance-and-practice-life-news/patients-miss-one-in-20-gp-appointments-at-a-cost-of-200m-warns-nhs-england/20038021.article

 

NHS Digital GP practice data hub - area, time to apt, which healthcare professional, apt type ie f2f/tele
https://app.powerbi.com/view?r=eyJrIjoiYzU2OTA2ODktZTIyNy00ODhmLTk1ZGEtOGVlZmRlZDNjYzY3IiwidCI6IjUwZjYwNzFmLWJiZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9

 

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

Facebook - https://www.facebook.com/Egplearning/
Twitter - https://twitter.com/egplearning
Website - https://egplearning.co.uk/

Support: https://patreon.com/egplearning

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Are you hoping for a Dry January?

January 3, 2019

Are you hoping for a Dry January?

 

Hi #eGPlearners - are you hoping for a Dry January? Check out this Dry January app review on how the app works and whether it is useful for individuals or patients. 

Click on the image below to see the full video or read below. 

 

dry_january_thumbnail.png

It is reasonable to assume that alcohol drinking increases over December with Christmas parties, festive celebrations over the holiday period and New Years which also culminate in lesser-known occasions like Black eye Friday. 

But with a new year comes change and a slew of new years resolutions. Many may participate in Dry January - where you do not drink alcohol for the whole month. To support people,  the Alcohol Change UK charity has created the Dry January app, but is it any good?

The app is easy and free to download. It asks for your current drinking habits and lets you add this quickly and easily. Presenting you with an approximate unit intake, cost and calorie intake per week is also a good set of metrics to use. 

The app does ask if you want to contribute and savings you make as a pledge. I think this is reasonable as the Alcohol Charity UK have created this app for free and offer you the choice. Better yet- even if you pledge it is only a percentage of the savings you have made so technically you are not paying for it. 

Logging your habits is easy and customisable. The main dashboard provides clear information and some resources to support you. 

However, I think the app could be improved. while Dry January can be a useful idea, for those significantly high drinkers stopping suddenly can be dangerous and clearer warnings on this would be more ideal particularly when logging your intake. Also signposting to regional support services would be a more useful way to use the app. 

Overall, I like the app and think it works better than many of the tools in the patient health records I use. If it leads to a permanent change in drinking habits this can be really helpful, although it is important to remember that boom or bust methods to cut vices can sometimes lead to rebound use which can be just as damaging to a person's health. Subjectively many clinical colleagues mention higher admission rates for alcohol misuse in the first two weeks of February and Dry January may be the cause. 

 

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning. 

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Twitter - https://twitter.com/egplearning
Website - https://egplearning.co.uk/

#TipThursday - https://egplearning.co.uk/tag/tipthursday/

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3 GPs in an eGPlearning Podblast

December 28, 2018

3 GPs in an eGPlearning Podblast

 

Welcome by Andy, Gandhi and…….Shubz

 

How did Shubz get into podcasting from his mygpevents journey to listening to inspirational speakers. This led to his podcast 2GPs in a pod and speaking with Zoe Williams, Rupy Aujla and others

‘You do not have to leave medicine to do all this other cool stuff’

Gandhi talks about having flux in your working week as recommended by notable people like Warren Buffet and Pat Flynn

 

We discuss how to utilise time as a locum for portfolio working and balance in your roles.

Andy talks about the ease of saying yes, but the importance of saying no occasionally

 

We then discuss the Next Gen GP programme created by Nishma Manek with amazing talks by Nikki Kanani (our Supreme leader- including how difficult it has been for both podcasts to pin her down for an interview given NHS England oversight).

 

Gandhi talks about the importance of teams around you and how they can support you ie his partners and working on the podblast with Andy as a team.

Shubz echoed this with a shout out to his MyGPevents partners Mehul and Max.

 

We did a recap of Andy and Gandhi’s year, starting with Gandhi which including being elected and attending his first RCGP Council meeting as a National Rep, and the importance of having your say- including his controversial comments on the partnership review by Nigel Watson.

 

We all talked about how the omission of a baseline increase in the global sum seemed confusing and the impact of indemnity funding and planned changes to pension regulations that may significantly impact the future of GP partnerships.

 

Gandhi finished off with talking about his continued efforts with the eGPlearning platform including TipThursday on YouTube, and his 84km Pilgrimage in Iraq in October.

 

Andy talks about his work with the NCGPA including signposting health- a project applicable to any locality to help with practice-based signposting, his video journey for patient information videos for the area:

Which has gone mainstream by being shown in the Broadway Cinema in Nottingham in the new year.

He also talked about the power as a partner being able to innovate in your own practice. HIs focus has been on creating a user-friendly website seen here: Parkside medical practice

 

Note Andy did all the illustrations, which is also on offer to your our listeners as part of the collaborator reward for supporting the eGPlearning Podblast on  Patreon account. At this limited reward, Andy will draw you into our new banner as a caricature.

 

We then move on to talk about health technology moving forward including the regulation of health tech by NHS England and NICE, RCGP, and the hype cycle on artificial intelligence (AI) and challenges off innovating in the NHS.

 

Andy then mentions his vision of the use of wet technology as discussed in our genomics podcast (with 23andMe) earlier in the year. Andy makes his 2019 prediction of the AI backlash in healthcare with examples like the Wysa app.

Gandhi predicts the rise of personalised medicine focusing on individual patient care vs condition-based care as patient focus shifts from wanting to know if they are unwell to wanting to know if they are healthy. He states in his view the NHS is designed to look after you when you are unwell, not to make you healthy.

Evidence of this direction is with our Secretary of state for health Matt Hancock and his focus.

 

We talk about how technology can help tackle health inequalities but also exacerbate them, particularly around access. We commented that much of the technology is based on improving access but not productivity.

 

We then discussed the impact technology can have on health with Gandhi using an example from the programme Criminal Minds about knowing your own family history and the impact that may have on your own health outlook. Does it create a healthier life or does it create health anxiety?

 

This led on to a discussion about overdiagnosis and overtreatment- key challenges in health care moving forward. This included a discussion on Martin Marshall Vice-chair of the RCGP and his article on rethinking medicine.

 

We moved on to talking about the use of data like Facebook and metrics to hyper-target health information a little Black Mirror-like,

 

We then ask the question,- how would you spend £100million on health tech

 

Gandhi mentioned his idea for a unified video consultation platform for primary and secondary care. Could the NHS app provide this?

 

Shubz talked about using technology to facilitate communication to provide bandwidth so we can be more effective in caring for patients.

 

Andy talked about creating a system to help physician productivity - Sherwood tech incubators. Gandhi then changed his idea to create an NHS approved a version of Asana - a project management tool.

 

We finished by creating a Christmas tradition of doing a roundup episode between the two podcasts each year.

 

Contacts Andy: @drawfoster and www.avoidingpuddles.co.uk

Contact Gandhi: @drgandalf52, @egplearning, www.egplearning.co.uk or subscribe to the eGPlearning Youtube channel.

Contact Shubz: @2GPs_in_a_Pod or myGPevents.

 

A shout out to our sponsors - The HTN (Health Technology Newspaper)

And join us for the digital week where we cover our top 5 apps, how to use technology to enhance your CPD and social media use as a clinician - all which contributes to your appraisal and revalidation in the comfort of your own PJs.

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Do you need some Headspace?

December 20, 2018

Hi #eGPlearners do you need some Headspace?

Working in healthcare whether as a GP, part of the primary care team or in hospitals can be emotionally stressful. There are many ways to manage stress and lately mindfulness is seen as an effective tool to support stress management. But access can be tricky – so let us look to technology to help in the form of Headspace.

  • Edit
 
 

Headspace was founded in 2010 by Rich Pierson and Andy Puddicombe (who wrote the Headspace guide to Mindfulness and Medication).  The Headspace platform offers unique content varying from guided meditations to animations and videos via the Headspace website and mobile app, teaching users the techniques of mindfulness.

The app is free to download and use with extra features behind a subscription paywall. These extra functions include modules to help deal with stress,  difficulties in focusing, sleep issues, chronic pain,  fear of flying and more. It also has dedicated sections to help with younger people such as settling the active child at night. 

The variable module length is useful with a minimum of 3 minutes meaning anyone can use at some point in the day. 

I love the animations which do draw me in, and the interface which is easy to use. The guided meditations work well and its simplicity is a key reason I do recommend this app to patients as well. With often limited timely access to mental health support, I have found this a useful tool for several patients as an adjunct to their treatment.  Just simply switch on the app, select your module and time length, audio or headphones on and go. 

The app also continues to work if you have to multi-task with your device. I accept this may defeat the object of guided mindfulness- but a useful feature to know about. 

Additionally, the app is resource packed including the obstacle section in the settings which are short free modules which offer advice on overcoming obstacles when trying to use the app such as worry, posture, stiffness, pain etc. 

With the rise of AI assistants like Google Home, Siri, and Alexa you can also set Headspace to run from these systems like using the Headspace Skill for your Amazon Echo

As mentioned the extra modules come at a cost. Last year Headspace was offered as part of the BMA membership at a reduced rate (as mentioned in a previous eGPlearning Podblast episode).

Currently, the app is on offer for £44 for a year compared to £9.99 a month or £72 a year if paid annually. 

Another option is to sign up at a reduced rate via Anxiety UK as part of their membership. 

I do like the interface and it is simple to use, however, I would like to change the voice if possible to customise it more, also I can see how social sharing of goals can be a valuable asset, much how many running apps use this method as a motivator. However, I can also appreciate this is not a feature all users would want given how physical health and mental health are viewed. 

Feel free to given Headspace a try either for yourself or for patients. 

Do not forget to subscribe to our various channels and feel free to comment below or on the various channels. 

#TipThursday

(ps. I receive no benefit from eGPlearners signing up to Headspace, however, some affiliate links to other resources on this page). 

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How to use Twitter as a clinician- hints and tips

December 13, 2018

Hi #eGPlearners

Welcome to the weekly showcase of Technology-enhanced primary & learning resources from eGPlearning.

In this final part of the series on using Twitter as a clinician, I share my own personal hints and tips on using Twitter and how you can use it to collect and manage your continuous professional development (CPD). 

This episode contains hints on who to follow, how to engage in a twitter debate, which primary care and clinical hasthtags are worth following, and how to create your won CPD Twitter system. 

Subscribe on YouTube for the latest video or follow and share the eGPlearning Facebook page for more. 

As always, comment, share and keep eGPlearning. 

#TipThursday

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Anatomy of a Tweet

December 6, 2018

Anatomy of a Tweet

Hi #eGPlearners – Do you know the anatomy of a tweet?

In this episode of TipThursday we continue the series looking at how to use Twitter as a clinician by looking deeper at what I call the anatomy of a tweet.

 

This episode is a showcase of the Twitter interface including how to use the newsfeed, search, trending and moments, sections, notifications, personal messages, exploring your own and other’s profiles, retweeting, quoting and liking a tweet; and how to create a tweet including images, videos, gifs and more.

This video uses my own personal profile and references various others including @matthancock and @NikkiKF.

If you want to subscribe to the DrGandalf UK Primary care twitter list see here: https://twitter.com/drgandalf52/lists/drgandalf-uk-primary-care/members

Next week we explore more specifically how Twitter may help you as a clinician, how you can use it for continuous professional development and a few of my personal tips.

Watch the full video below, or subscribe on our audio platforms:

iTunes: bit.ly/eGPlearningiTunes

Podbean: bit.ly/eGPlearningPodbean

Spotify: bit.ly/eGPlearningSpotify

Subscribe, comment, share and keep eGPlearning.

#TipThursday

00:0000:00

Are video consultations the future of primary care?

November 30, 2018

eGPLearning Podblast Video Consultations Nov 2018

 

Welcome & Thanks to our sponsor

  • HTN - Health Tech Newspaper, an innovative daily news and opinion website for the health tech network. www.thehtn.co.uk
  • Recently had their HTN awards and sign up for the HTN week (£32 for the whole week) but we are on the afternoon of Thursday Jan 24th afternoon - sign up here: https://www.thehtn.co.uk/2018/11/18/pre-order-htn-digital-week-magazine/
  • Sign up here to our Patreon account: https://www.patreon.com/eGPlearning

 

Welcome to those watching us on youtube...

We are trying something new we are recording a behind the scenes video as special content for our youtube followers.

 

Thanks for your feedback and retweets...

@Jaycemelody

@SonaliKinra

@thehealth1tech

@NCGPANotts

@NottsLMC

@somedocs doctors on social media group - retweeted us- thanks

@annalise2406 - great feedback re the app and iplato

@orcha - app review organisation connected with NHS App Library - kindly retweeted us

@NikkiKF - acting Director of Primary care for NHS England

 

What have we been doing?

 

Today main Topic is Video Consultations…

 

Remember listeners - we are not experts, these are just our opinions

 

Is there demand?

  • Venture capital and investors are putting money behind it so there is believe in the technology and concept from investors.
  • @UNHS_Cripps Have experimented with
  • @MattHancock (Health Secretary) is a GP at Hand patient and advocate of technology and is behind the concept.

 

But what problem are we solving?

  • Low capacity or convenience?
  • Probably more for patient convenience than increase capacity - but maybe if replaces home visits?...

 

What happens in a typical video consultation?

Gandhi describes his experience of working with Babylon Health @babylonhealth

 

Discussion of video consultation business models…

Babylon / GP at Hand, LIVI, QDoctor, Push doctor, NOW Healthcare, GPDQ, Zoomdoc (listen to our interview with founder Kenny Livingstone )

 

 

What problems do we see with video consultations?

  • Reduced continuity?
  • Overprescribing of antibiotics? (but discussed later)
  • Do video consultations drive an increase in demand? Does making it easier to speak to the GP make people more likely to feel the need to contact their GP?
  • Destabilising traditional General Practice Partnership business model?
  • Destabilising the Primary Care workforce - pulling GPs that might otherwise work at practices into the “private” sector.

 

Potential positives of video consultations?

  • Does patient spend in the private sector taking pressure off NHS?
  • Some patients may self-select away from NHS services to private video providers, leaving NHS to meet needs.
  • More options and convenience for patients.
  • Options for using as part of innovative systems - perhaps true power comes when part of a system including eTriage, remote monitoring, video consult and face to face?

 

How can surgeries prepare for video consultations?

Work together with federations, neighbours. Benefits likely to come from handling patients at scale.

 

Our verdicts… Good or bad?

 

Thanks for listening - certificate of engagement.

 

Comments and feedback…

 

You can now support us on Patreon!

https://www.patreon.com/eGPlearning

  • $1 just to support us if we doing a good job
  • $ 10 new banner drawn by Andy and you can be part of it
00:0000:00

How to sign up to twitter as a doctor

November 29, 2018

Hi #eGPlearners

I am a big fan of social media and often I get asked how can I use social media effectively as a clinician. In this series, we will look at how to use Twitter as a clinician. 

Twitter is a micro-blog site that lets you post (tweet) comments or re-port (retweet) comments of others to share information. Originally tweets were limited to 140 characters but this has now increased to 280 – however, you still have to be concise. 

Twitter allows the rapid sharing of information and can be an effective way of supporting learning and information discovery as well as networking. 

This TipThursday focuses on the basics of creating an account the first step to using Twitter. This includes creating your own profile and initial guidance on where to find medical tweeters (or twits if you want ;p) to follow (check out this twitter list for hints).  For information on creating safe passwords read the blog post here

 

Next week we will look at the anatomy of a tweet including common terms and how you can post, learn more about profiles and start on your journey to become a part of the Twitterati. The final week will cover more tips on using Twitter including specifically as a clinician and important considerations. 

Please comments and share any challenges you have, or if this TipThursday has made you take the leap into Twitter let me know. I am happy to help on @drgandalf52 or @egplearning

As always: 

Subscribe, comment, share and keep eGPlearning. 

#TipThursday

00:0000:00

NHS Digital resources to help you be safe using health technology

November 22, 2018

Hi #eGPlearners

Welcome to the weekly showcase of Technology-enhanced primary & learning resources from eGPlearning.

This episode looks at NHS Digital resources and governance posted on the eGPlearning Facebook page (facebook.com/Egplearning/) or available here

This is pertinent guidance that talks about four key areas such as instant messaging apps, video conferencing, bring your own device (BYOD) and mobile device use in hospital. 

Listen to the video below or read our brief notes under for more details. 

Messaging apps:

This document outlines key aspects such as encryption, passcode use, notification issues, and remote wiping- key aspects with most of the following guidance. 

The guidance does not specify which apps to use despite mentioning a few and ignores apps specifically used for secure healthcare instant messaging like Siilo, Forward and Cupris to name a few. This was covered in our previous episodes of the eGPlearning Podblast about GDPR and our interview with Dr Aisha Malik

Video Conferencing:

This guidance offers information about the use of video conferencing as a service provider, clinician and aspects for patients to be aware. It also offers a template consent form citing that use should not be compulsory. These are interesting aspects which are covered in more detail in the upcoming eGPlearning Podblast episode out at the end of this month. Click the links below to make sure you subscribe for this episode which talks in depth about video conferencing in primary care. 

BYOD

Increasingly BYOD is being considered for healthcare delivery given the lower cost to organisations and increasing in remote and part time working. This document does outline key issues to consider as both a provider and user. Particularly focusing on safety and responsibility such as two-factor authentication, sandboxing of software and remote wiping of data. 

Mobile device use in hospitals. 

How devices are used is changing. This document does outline key considerations and regulations that are applicable. The last sheet is an excellent summary. 

What are your thoughts on these NHS Digital resources?

Do not forget to subscribe to our various channels to be the first to hear more useful TipThursday bites, and as always:

Comment, share and keep eGPlearning. 

#TipThursday

00:0000:00

Podblast interview- Dr Aisha Malik - Doctors in Business

November 16, 2018

eGPlearning Podblast is the UK's leading primary care focussed health tech podcast by two Nottingham based GPs covering recent topics, useful clinical apps, interviews with primary care health tech innovators and in-depth perspectives on health tech.

Hosted by Dr Hussain Gandhi (@drGandalf52) and Dr Andrew Foster (@drawfoster).

In this episode, Dr Gandalf talks to Dr Aisha Malik owner of Doctorsinbusiness.org a website which is dedicated to getting doctors and medics more visible online.

We talk about her acceptance onto the Clinical entrepreneur fellowship led by Prof Tony Young (@DrTonyYoung).

We discuss if GPs are ideally placed to change the NHS.

I challenge Aisha to Make a video blog for all the eGPlearners to learn from regarding her experiences.

Aisha then explains her top 5 tips for using social media as a practice. See her Pulsetoday article here.

We then discuss the implications of consulting on social media including how that may differ from the work of Babylon, Pushdoctor and Doctor Care Anywhere.

I then ask Aisha her favourite work an non-work related apps. We talk about a project management app Asana and then discuss other methods like Siilo or Forward.

We then talk about her favourite non-clinical app- Audible - like the netflix of reading - ideal for any podcast listeners.

 

 

 

We finish off asking the perennial question. How would you spend £100 million on health tech with no red tape. 

To contact Dr Aisha Malik either on twitter or on the Doctorsinbusiness website. 

Here is your certificate of engagement.

In the next episode, we cover the implications of telemedicine in primary care- small topic ......honest. 

00:0000:00

Should you stand as a GP?

November 15, 2018

Sitting is the new smoking. Staying sedentary for several hours a day increases your risk of diabetes. So should you stand as a GP?

I remember visiting my GP as a child. Sit in the waiting room normally sullen and low because of yet another episode of tonsillitis. 

Then I was called into the doctor’s office. I would enter a room that CQC would now shut down in a heartbeat with mosaic rugs, plush furry chairs, and a beautiful mahogany desk.

And there was the GP….sitting behind his desk. I remember him moving in his chair to get some forms from a cabinet. I remember him asking me to stand as he examined me sitting in his executive chair, and I remember him always sitting behind a desk. 

Fast forward to a couple of years ago. I remember finishing work with my shoulders feeling tight, my lower back aching for a stretch, as I scooted in my chair to get a form from my cabinet next to my desk. It was at that point I realised I had been sitting in my chair for over four hours. 

I wanted to change this sedentary life. I had a chat with my partners and highlighted I would be changing my room. Shortly after I got a rising desk (Yoyo-90). 

I love it. The build quality is excellent with significant heft. The hydraulic risers are simple to clip and push my whole station upwards to allow me to stand. Initially I could only manage an hour or so before my legs tired out and I had to sit again. A further investment in a standing mat helped there. Within a month I was standing while doing all my admin. Then I took the plunge and stood while consulting with patients.

 

 

Should you stand as a GP?

Some will feel less happy about standing while consulting. I know in sharing my story I have heard several criticisms such as:

  • It means you are trying to rush the patient
  • To stand over a patient is to exert a power dynamic in the consultation
  • It means you are trying to hide the screen from the patient

Over the past year, I have not found any of these to be true. 

  • In my clinic, patients sit while I stand (see the chairs above). 
  • If a patient feels uncomfortable I will sit, however, I have only been asked this twice in the past 18 months.
  • When there is a need for additional empathy, I often sit next to the patient. 
  • I actively share my screens when needed with the patients. 
  • Patients often comment on the desk, about seeing similar in the media and how positive such changes are. 

Sounds encouraging and even our Secretary of State for Health and Social Care – Matt Hancock is very pro-standing desks. 

However, it is important to recognise that standing desks on their own is not enough.  This is a useful article and another here that comments on the opposing view. This includes complications of standing for long periods (tiredness, varicose veins, musculo-skeletal pain from adjusted positions of screens etc.)

Encouraging our patients to be more active is important. So for Self-care week, I am showing how it works in my practice.  Watch the video below and feedback your thoughts on should you stand as a GP?

#TipThursday

 

 

 

 

00:0000:00

When should I worry?

November 8, 2018

Hi #eGPlearners

Welcome to the weekly showcase of Technology-enhanced primary & learning resources from eGPlearning.

When should I worry? This is a common question for parents when looking after an unwell child. In primary care, this can often be a challenge for clinicians to manage due to parental anxiety, the expectation of treatments like antibiotics, concerns about antibiotic resistance and growing demand. 

A helpful resource which can be used with and for patients is the When should I worry booklet found at www.whenshouldiworry.com.

This short booklet provides clear and helpful advice on managing common conditions that can be self-managed by parents, with advice on self-care options, symptom management and importantly clear guidance on when to see further advice. 

The website even offers training on how to use the booklet effectively, and it is available in a variety of languages. Taking it one step further, you may choose to send parents the weblink for the booklet and for the English version: use this helpful case-sensitive shortlink: bit.ly/eGPlearningWSIW

For proactive practices, you could send this as a public information message to all registered parents or share via practice social media channels. 

Watch the video guide below and free to share your thoughts on this resource and as always:

Comments, share and keep eGPlearning. 

#TipThursday

00:0000:00

The NHS app - an eGPlearning Podblast perspective

November 2, 2018

eGPlearning PodBlast - Introducing the NHS App

Welcome to our deep dive episode on the upcoming NHS app - which we cover multiple areas of primary care and patient care. A highly opinionated episode which we encourage your comments and feedback on. 

1.00 Thank you Sponsor - HTN The Health Tech Newspaper (HTN)- an innovative daily news and opinion website for the health tech network.

1.40 Thank you to our followers: @SonaliKinra  @NottsLMC @NCGPANottm @Jacey_Melody @JThambyrajah @KalindiKrishna  @RcgpFaculties @2GPs_in_a_Pod , @DME_Health, @BenXGowland , @EvilGP and @drNickHarvey -creator of Digitalis

 

2.25 Andy has had a cold and been on a cruise

2.40 Gandhi has also had a holiday, working on TipThursday especially the Kardia Alivekor episode with a free resource on the episode available here. 

3.30 Today we are talking about the upcoming NHS app

 

We are going to talk about the app. This was inspired by a great article by our friends at Gizmodo. http://www.gizmodo.co.uk/2018/08/exclusive-heres-what-the-new-nhs-app-will-look-like-and-why-it-could-have-been-so-much-worse/

 

The intentions behind the app are exactly what you might expect: Make it easier for patients to access healthcare services, cut down on administrative burden, and eventually provide a means to connect with other health apps, like Fitbit and Apple’s Health app.

 

Jeremy Hunt set out “8 challenges” for the app

  • (7.20) Symptom checking and triage (i.e. figuring out if you’re just being a hypochondriac or whether you should be in an ambulance right now)- eConsultation, webGP, babylon AI
  • (13.00) Access to your medical records and security issues. 
  • (23.10) GP appointment booking
  • (28.20) Repeat prescription ordering
  • (29.50) Changing data sharing preferences
  • (31.38) Changing organ donation preferences
  • (33.38) Changing end of life care choices - DNAR medical decision
  • (38.50) Promoting “approved apps” to patients - see the NHS app library and @OrchaUK

(42.50) Summary of our views (including a compliment for Jeremy Hunt!!!!) including the issue of photo ID verification to use the app. 

These are discussed in turn during the show...

(49.00) Sign off and next episode spoilers

Do let us know what you think?

 

Click here for your certificate of engagement

Do not forget to subscribe on your platform of choice: iTunes, Podbean, Spotify or YouTube

Thanks for listening...

 

00:0000:00

eGP DRAMA - eGPlearning TipThursday

November 1, 2018

Hi #eGPlearners

Welcome to the weekly showcase of Technology-enhanced primary & learning resources from eGPlearning.

This week TipThursday covers a resource from the eGPlearning platform –  the eGP DRAMA plan

eGP DRAMA (eGPlearning General Practice Disaster Record And Management Action) plan is a fail-safe document used as an adjunct to you practice business continuity plan. 

It identifies and helps record pertinent practice-related information that if not available at key times can lead to significant stress and impact on the business of running a practice. Particularly with larger scale working, such information needs safeguarding and access at appropriate times. 

To store the document ensure either keeping a hard copy in a safe location or preferably store on an encrypted USB stick or password protected part of the practice intranet. 

This document is free for all eGPlearners via signing up below as part of the eGPlearner induction.

However, for the first week of this video, it is accessible directly via this link: www.egplearning.co.uk/gp-productivity

As always, comment, share and keep eGPlearning.

#TipThursday

00:0000:00

eGPlearning Podblast- Digitalis and Kardia Alivecor

September 14, 2018

eGPLearning PodBlast Digitalis & AliveCor Apps

Show Notes

 

Welcome listeners

 

In this episode we will be reviewing and test driving two exciting apps.

Digitalis - CPD and appraisal app developed by Dr Nick Harvey is a GP partner and trainer with the help of his team..

AliveCor - AF detection app and hardware

 

Mentioned in today’s episode

@health1tech

@NCGPANottm

@Confetti_ICT

@Notts_TV

@Digitalis_Tech

@AliveCor

@SonaliKinra

@BenXGowland

@jacey_melody



Host introductions

Dr Husain Gandhi, @DrGandalf52 , www.egplearning.co.uk/

Dr Andy Foster, @DrAWFoster , www.avoidingpuddles.com

 

Episode Sponsor:

HTN - Health Tech Newspaper, an innovative daily news and opinion website for the health tech network. www.thehtn.co.uk

 

What have your hosts been up to since last episode?

www.signpsotinghealth.com https://confetti.ac.uk

 

Portfolio career survey conducted by GPDQ shout out…. ,  https://www.gpdq.co.uk

 

Digitalis review

 

What is the Digitalis App

 

Who made it?

Dr Nick Harvey is a GP partner and trainer and his team http://digitalistechnology.co.uk/about-us/

 

App features and observations discussed:

  • Quickly add CPD entry, capture photos, documents, audio and video. Entries can be linked to CPD Curriculum and learning domains or PDP.
  • Free text search of your entries
  • Personalised my feed - Guidelines, HTN - our sponsor, BBC health news, Cochrane Database and many more. These can read and added directly to CPD
  • Notification & Messages
  • Share CPD activity, Ask questions, Link to other professionals, Ability to create and be a member of groups.
  • Andy is very excited about groups. Can facilitate creation of virtual study groups, peer motivation and discovery of learning and useful information.
  • Please join the eGPLearning Group!!!
  • Perhaps Digitalis will be able to crack the doctor-doctor messaging app market by using CPD and appraisal prep as the killer feature?
  • Ability to customise to your curriculum. RCGP curriculum available, but also other specialities and Royal Colleges Curriculums and other allied professionals such as nursing.
  • Potential to create groups spanning primary and secondary care and to ask questions about cases and care.

 

Any potential downsides

  • Links could be better
  • Aesthetics - could be better - but not too bad...

 

We would love to interview Nick Harvey or one of the Digitalis team in for interview?

 

AliveCor Live Unboxing

 

What is AliveCor?

Kardia Device and companion app for detection of Atrial Fibrillation (AF).

Some CCGs have been providing these to GP surgeries to assist with detecting AF.

Cost: $99.99

https://www.youtube.com/watch?v=2s2CsGGYnv0

 

Why would we be interested in detecting AF?

AF often produces no symptoms and can be present for long periods of time (months-years) before detection and treatment. AF increases the risk of serious conditions, particularly stroke and arrhythmias.

 

Let’s take a look

First impressions from Andy for us - live unboxing and demonstration

More considered impressions from Andy who has used in practice

 

Impressions

Nicely packaged

Single sheet with 2 steps to work. VERY EASY TO USE.

Worked well and straight out of the box

Works on ANY phone or tablet device - does not require a locked down device

Can then record outcome manually in patient notes or export results as secure .pdf.

 

How would we use this in practice?

Quick screening of at risk patients, those where AF suspected, long term condition reviews, flu clinics?

Why you should get the flu jab by Abraham the pharmacist -

 

Thanks for listening

 

Download your certificate of engagement here: https://www.dropbox.com/s/71ad7srm5g2h3jt/digitalis%20podblast%20certificate.pdf?dl=0

 

Please connect with us and discuss any of the topics in today's episode by…

eGPLearning Group on Digitalis app

@DrGandalf52 , www.egplearning.co.uk

@DrAWFoster , www.avoidingpuddles.com

 

Next time on eGPLearning PodBlast we will be taking a look at the upcoming NHS app.






00:0000:00

eGPlearning Podblast interview - Dr Gandalf- Hussain Gandhi

August 23, 2018

Shownotes

0.22- A shout out to our new sponsor- The Health Tech Newspaper (HTN)- an innovative daily news and opinion website for the health tech network. 

1.10- How Amazon and the Blue Yeti make our podcast possible.

1.50- The interview begins.

2.40 DrGandalf's favourite clinical apps- MDCalc

3.20- Star Realms - an awesome game

4.40- The return of Captain Jean-Luc Picard

5.00- The dawn of eGPlearning

7.40 How to keep momentum

9.00- DrGandalf's current activities (hats)

9.40- GPSurvival

9.50- S1 FBUG (Systm One Facebook User Group)

10.00 RCGP work

11.50 How Andy and Gandhi met

12.30 Joining Nottingham LMC

13.40 Representation of the profession

15.00 Getting into health tech

15.50 Artificial Intelligence in Primary care

19.40 DrGandalf's paradox to fix UK healthcare

22.20 Failing and how to handle it

25.20 Podmedics

27.10- DrGandalf's role in advancing health tech

28.30- TipThursday

29.40- Keybr

30.20- DrGandalf's heroes

33.10- productivity and how to be good at it

35.10 GDPR........

35.50 How to get into health tech

37.20 another shout out to our sponsors- HTN

37.50 Another podcast to listen to The General Practice Podcast by Ben Gowland

38.30- How would you spend £100 million on health tech if you had the chance? - ATM doctors

40.50- Telemedicine

43.20 Singing off and contact. 

To obtain your free certificate of engagement click here

00:0000:00

Artificial Intelligence (AI) in Primary Care

July 17, 2018

eGPLearning Podblast: Artificial Intelligence - Shownotes

 

This is a themed episode where we talk about Artificial Intelligence (AI) in primary care - the applications, risks and benefits to patients and clinicians.

eGPlearning Podblast is a health tech talk by two Nottingham based GPs covering recent topics, useful clinical apps, and interviews with primary care health tech innovators.

Hosted by Dr Hussain Gandhi (@drGandalf52) and Dr Andrew Foster (@drawfoster).

 

 Disclaimer  - We are not experts, but we are interested GPs, we are merely discussing our impressions, ideas and concerns and optimism in the hope that you may find this interesting.

 

Thank you:

@SonaliKinra @NottsLMC @NCGPANottm @jacey_melody @kalindikrishna @rcgpfaculties @2GPs_in_a_pod @mededbot @dme_health @karthikrishna86 @dr_zo

Update:

Andy: (1.15) - @ANorrisMP attended the practice

Gandhi: (1.38)



What is AI? (5.12)

Artificial intelligence (AI) in healthcare: is the use of algorithms and software to approximate human cognition in the analysis of complex medical data. Specifically, AI is the ability for computer algorithms to approximate conclusions without direct human input.

 

When thinking about A lot of people think of Artificial General Intelligence, an artificial agent that thinks like a human, but this is thought to be a long way off.

 

https://www.youtube.com/watch?v=qDrDUmuUBTo

HAL 9000 from 2001 A Space Odysey is a (rather sinister) example of Artificial General Intelligence.

 

AI is a combination of key technologies…

 

Key terms, definitions and technologies:

 

The 4th industrial revolution

Deep learning, algorithms, fast processing, storage capacity and ability to collect large amounts of data are the foundations of the 4th industrial revolution - AI.

 

Logic and rules based AI…

 

  • “Top down approach”- system designers provide the rules for computer to follow
  • Simpler than more modern approaches, but this can be very powerful
  • Examples include: Automatic tax return software, Qrisk, FeverPain, FRAX (7.16)
  • Already used for prescription safety like OptimizeRX (7.30) and advice, flagging investigation results
  • Could be useful for automating simple tasks like processing some blood results

 

Pattern based AI...

 

Machine Learning (7.53) - see our episode with Jon Brassey

  • Training a machine using data sets with known outcomes
  • The algorithm analyses lots of data with known outcomes, makes connections - thus training the model which changes its own approach as it learns
  • Eventually the software look at new novel data and reach reliable conclusion

 

Deep Learning (9.20)

 

Natural Language Processing

  • Key technology for understanding and communicating with humans naturally
  • Human communication is HARD to understand
  • Currently humans really have to adapt their behaviour to interact with computers, unnatural things - type on keyboard, use mouse, touch screen
  • Once can understand human speech and communication much more data available for training algorithms - progress in AI will accelerate.
  • Examples include: Dictation software - already here! - Dragon (13.30), Voice assistants (12.20) https://youtu.be/_ldoV5FQn0k , translation, learning from consultation transcripts

 

Computer vision

Similar to natural language processing in unlocking image and video data to train algorithms. Potential to initially impact, Radiology, dermatology, ENT(15.07), retinal imaging.



Implications for general practice…

Will it change things quickly or slowly?...

 

Some potential benefits of AI in General Practice:

  • Triage and screening supporting access and effective use of resources
  • Support medical practice, diagnosis and treatment. Big opportunity to improve quality, consistency, safety
  • Supporting and caring for patients - supporting social care
  • Accelerating medical research - data collection, processing, more data, quicker in new ways
  • Drug/treatment/device development

 

Special mention for...

@BabylonHealth - They are sometimes controversial, but are a British company leading the world in Medical AI!

Babylon to be installed as standard on Samsung mobile phones https://www.ft.com/content/e7035e0c-634e-11e8-a39d-4df188287fff

Partnership in  China https://www.digitalhealth.net/2018/04/babylon-ai-technology-china-tencent/



Potential problems with AI:

and Genomics(https://egplearning.co.uk/ramblings/podblast/egplearning-podblast-episode-10-genomics-and-bnf/) (19.10)




Effect on Jobs?

  • Mass unemployment or...
  • New problems and needs arise as old ones are surmounted
  • Potential new jobs in healthcare related to AI
    • Facilitating and explaining engagement with AI - Healthcare workers are complex communication experts
    • Training the AI
    • Maintaining the AI
    • Creativity in service design
    • Original thought and innovation
  • Focus on the right skills - creativity, innovation abilities, using and training technology



So… Are you feeling positive about AI in healthcare?

 

Thanks for listening and for your certificate of engagement click here

 

Subscribe, comment, share and keep eGPlearning. 



00:0000:00

Episode 10- Genomics and BNF

July 2, 2018

eGPLearning Podblast Personal Genomics Special Shownotes

 

In this episode, Andy describes his experience of using the 23andme’s personal genetics service. We discuss his impressions, both positive and not so positive as well as privacy concerns and what the future might hold for personal genetics and how General Practice might be involved. We also explore the use of the BNF clinical app.

eGPlearning Podblast is a health tech talk by two Nottingham based GPs covering recent topics, useful clinical apps, and interviews with primary care health tech innovators.

Hosted by Dr Hussain Gandhi (@drGandalf52) and Dr Andrew Foster (@drawfoster).

 

Shout outs:

@sonaliKinra, @ncgpaNottm, @nottsLMC

 

Gandhi update (1.50)

Fasting in Ramadan is not easy

Podcasting for innovait - the @rcgp AiT journal - check out the latest episode shortly with @doctormayur and @dr_zo

Thank you to all the #eGPlearners for helping with rebranding of @egplearning

 

 

Andy update (3.00)

On @nottstv talking about GP plus extended GP services in Nottingham.

 

App review: BNF Smartphone App (4.00)

https://www.bnf.org/products/bnfbnfcapp/

HANDI (Handbook of Non-drug interventions) website (10.00)

A useful collection of non-drug resources for clinicians and patients. 

 

Down to our Personal Genomics (10.30)

 

  • Definition: “Personal genomics or consumer genetics is the branch of genomics concerned with the sequencing, analysis and interpretation of the genome of an individual

 

Who are 23andMe?

US based startup founded 2006.

Direct to consumer personal genome testing

CEO Anne Wojcicki used to be married to google’s Sergy Brin, google an early investor

Spit in a tube and they will analyse your genetic material, mitochondiral and chromosomal and present the results

They give you the opportunity to:

  • See an ancestory report
  • Find genetic relations (who want to be found)
  • See a report about inherited traits - baldness, unibrow….
  • Be aware of genetics risks for serious health problems

 

The process?

  • Order the kit - £79 Ancestory, £149 full service
  • Register account
  • Spit in a tube and post back
  • Wait 2-3 weeks
  • HumanOmniExpress-24 format chip - partial SNP (single nucleotide polymorphisms) looks at parts of the genome known to vary between individuals.
  • Get an email saying results are ready
  • Look at results.
  • Can see
    • See an ancestry report
    • Find genetic relations (who want to be found)
    • See a report about inherited traits - baldness, unibrow….
    • Carrier status
    • Be aware of genetics risks for serious health problems

 

Ancestry

  • Allows users to view origins of mitochondrial DNA and nuclear DNA and see where ancestors came from around the world
  • Interesting, but beware unintended consequences and unwanted/unexpected information. May have implications for identity and family

 

Inherited traits

  • Largely for fun… Unibrows, Widows peaks, freckles and ability to smell asparagus and many more traits.

 

Carrier status

  • Innocently named, but quite serious stuff - Cystic Fibrosis and thalassemia carrier status for example. Information released without genetic counseling. Beware unexpected or unwanted information.

 

Genetic disease

  • When doing similar tests in this country within the NHS, an individual would undergo genetic counseling with an expert to ensure that the process and implications of testing are understood.
  • 23andMe allow you to see this information after clicking through just 8 screens, Beware unwanted information and remember that your family will share your genes, so you are also testing other family members as well. If you have a variant then a relative may have it too.
  • Explains that genetics is just one potential risk factor, environment important too, not diagnosis… “Talk to your healthcare provider to better understand how to manage your risk”...
  • If risk present then provides information about the test, the condition, treatments, how to manage risks and links to good quality information.

 

Privacy

  • Prominent information on website
  • Stated aim is to give you choice and control
  • Keep genetic information and personal information separate - linked via a confidential cipher
  • Under certain circumstances they may release data to law enforcement organisations
  • They will not share with insurance companies - Concordat and Moratorium on Genetics and Insurance - in effect until 2019!

 

What next for personal genomics?

  • 100,000 genomes project - people with established diagnosis of genetic disorder are having genes sequenced in search for new approaches to managing these conditions
  • Personalised medication and treatment?
  • Pre relationship testing/matching?
  • Insurance implications post 2019 moratorium
  • Pre-employment testing - Great film recommendation - GATACA

<iframe width="560" height="315" src="https://www.youtube.com/embed/DO_x-po_Nsc" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen></iframe>

Correcting genetic mutations or treating more directly?

Would Andy recommend?

  • This was an interesting and in places fun process - There is a temptation to recommend it to those who fully understand the risk and are interested, particularly with regards to ancestry and traits.
  • BUT… Andy cannot recommended due to:
    • Risk of unexpected information
    • Lack of intervention for risks uncovered
    • Privacy concerns!!!

Please let us know what you think?

 

Listen, subscribe and follow and feedback

 

For a link to the certificate of engagement click to download from here.

 

Thanks for listening and catch you next time!

 

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Interview with Jon Brassey- Trip Database

June 16, 2018

eGPlearning Podblast is a health tech talk by two Nottingham based GPs covering recent topics, useful clinical apps, and interviews with primary care health tech innovators.

Hosted by Dr Hussain Gandhi (@drGandalf52) and Dr Andrew Foster (@drawfoster).

In this episode, Dr Hussain Gandhi talks to Jon Brassey (@JRBtrip) of Trip Database

Trip Database is the UKs key evidence-based medicine search engine. 

We talk about Jon's journey to develop a unique and effective clinical evidence search engine that is free for all NHS staff (on contacting Jon via jon.brassey@tripdatabase.com) , how failed ventures can sometimes need resurrecting ( #bringBackTILT) , how AI and machine learning is changing the searching for clinical information and Jon's own advice for new health tech entrepreneurs. 

Additionally, listeners are also able to download a free certificate of engagement for their appraisal portfolios. Click here to download. 

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eGPlearning Podblast episode 8 - GDPR

May 25, 2018

eGPlearning Podblast is a health tech talk by two Nottingham based GPs covering recent topics, useful clinical apps, and interviews with primary care health tech innovators.

Hosted by Dr Hussain Gandhi (@drGandalf52) and Dr Andrew Foster (@drawfoster).

This is a themed episode where we cover the new General Data Protection Regulations (GDPR) and how we feel they will impact primary care. A must listen episode for GDPR wary clinicians. 

 

Shout outs:

Ben Gowland : @BenXGowland and owner of General Practice Podcast which we will feature on shortly.

Jacey Meloday @jacey_melody -can not wait to list- after physical exercise- consider Welltory

 

Likes:

Moodpath @moodpath

Shubs Upadhyay (@2GPs_in_a_pod)

Todd Berner @tberner_md

Keck Graduate institute @keckgrad

 

March episode:

Twitter:

@digitalpharmacist Mohammed said he will have to listen

@drjongriffiths thanked us for the mention

Hope regular subscriber @sonalikinra and her husband enjoyed listening to us on the drive away

 

Podcast feedback:

Markado Escano of young entrepreneur lifestyle 2.0 wrote positive comments and asked about shownotes - well we have them https://itunes.apple.com/au/podcast/young-entrepreneur-lifestyle-2-0/id1105756640?mt=2

Jules Hannaford of hong kong confidential wrote how interesting and informative she found the podcast, particularly episode 2 and she will pass on to her students aiming for med school.

https://itunes.apple.com/hk/podcast/hong-kong-confidential/id1321295078?l=en&mt=2

 

Do feel free to leave a review as well if you enjoy our episodes.

 

Updates: (2.45)

To try the Facebook quiz click here

GDPR - (4.22)

What is GDPR, how it affects primary care.

BMA GDPR page: https://www.bma.org.uk/advice/employment/ethics/confidentiality-and-health-records/general-data-protection-regulation-gdpr

ICO GDPR page: https://ico.org.uk/for-organisations/guide-to-the-general-data-protection-regulation-gdpr/

Nottingham LMC GDRP page: https://www.nottinghamshirelmc.co.uk/guidance/resource/gdpr/

 

App reviews:(29.20)

Cupris: (33.10) http://www.cupris.com/cupris-platform/

Forward (33.35) https://forwardhealth.co/

Siilo (35.35) https://www.siilo.com/

 

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eGPlearning Podblast interview - Dr Keith Grimes the Medical Virtual Reality doctor

April 5, 2018

keith_grimes_egplearning.png

eGPLearning PodBlast-  Dr Keith Grimes & Medical VR Interview + Show Notes

 

In this episode of the eGPLearning Podblast, we interview Dr Keith Grimes, a GP and Medical Virtual Reality pioneer.

 

We talk about how Keith became interested in VR and how he has been using it in his clinical practice. We discuss the potential for VR in healthcare and also some of the pitfalls. Keith describes some of the projects and studies he is involved in.

 

Keith also explains how he built his skills to use social media to promote and build a community around his interest in Medical VR, and his tips for combining a career in healthcare with another interest or passion.

 

This is a great listen for your commute, on the treadmill or relaxing at home.

 

Enjoy...

iTunes link: https://itunes.apple.com/gb/podcast/egplearning-podblast/id1325540249?mt=2

Stitcher link: https://www.stitcher.com/podcast/egplearning

 

Show Notes…

 

How to contact Keith and get involved in the Medical VR community:

 

Keith’s first experience with VR was through the arcade version of  Dactyl Nightmare:

 https://youtu.be/v6t69mp0ZhE

 

Modern VR products such as the Oculus Rift are a much superior experience

Project CAR - Oculus Rift:

 https://www.youtube.com/watch?v=vY6QRN6hI-Y&feature=youtu.be

 

Keith describes the 5 use categories for Medical VR:

 

  1. VR as an adjunct to existing treatments - To improve pain and reduce anxiety during interventions
  2. VR as a form of therapy - e.g. to treat phobias, anxiety, mental health problems
  3. VR as a diagnostic tool - Eye tracking and assessing responses during simulations - e.g. eye tracking to diagnose Autistic Spectrum Disorders
  4. VR for education and training
    1. Medical Realities: https://www.medicalrealities.com
    2. Shafi Ahmed: @ShafiAhmed5
  5. VR expanding a patient's understanding - empathy - living in someone else's shoes. What's it like to have dementia.

 https://youtu.be/Zch3fg0orzo

Downsides and Risks of VR in medicine:

 

  • Nausea and sickness - patients may unable to tolerate VR
  • The intensity of experience not suitable for some
  • Minimum Age, perhaps as low as 7 yrs
  • Many application involve simulated violence - unsuitable for some
  • Infection control - equipment needs to be sterilised between users

 

Keith’s current projects:

  • PREVENT ICU Delirium - Psychological Resilience Using Virtual Reality Exposure as a Novel Therapy to reduce ICU Delirium

    • Does VR pre-experience of intensive care unit reduce incidence and severity of postoperative delirium - about to begin small-scale study.
  • “See What I See” - Kent and Surrey trial service
    • Use of “Expert Eye” based on Google Glass, to allow Doctors to remotely visit care homes. Carer wears smart glass and is provided with remote expert support by a GP.

 

Entry level equipment to get a taste of VR and start using it:

 

Equipment to take things to the “next level”:

Oculus Rift https://www.oculus.com/rift/

HTC Vive https://www.vive.com/us/product/vive-virtual-reality-system/

Also you need a fairly powerful PC

Connect

 

Programming and developing VR tools

Unity https://unity3d.com/learn/tutorials/s/xr

Vuphoria https://www.vuforia.com

Unreal https://www.unrealengine.com/en-US/vr

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