The NHS app - an eGPlearning Podblast perspective

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...

eGPlearning Podblast- Digitalis and Kardia Alivecor

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

• Continuing Professional Development (CPD) App for iOS & Android, allowing recording of CPD activity using your mobile phone http://digitalistechnology.co.uk . Synchronises with Clarity Appraisal Toolkit, https://appraisals.clarity.co.uk , or export entries as .pdf file.
• Currently Free of Charge.

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.

Episode 10- Genomics and BNF

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!

eGPlearning Podblast episode 8 - GDPR

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/

Welltory, patient education and online pharmacies.

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 episode recaps our latest contacts and activities including finding more resources for primary care clinicians (4.47)creating videos for patient education (5.30), then a review of the wellbeing app Welltory (7.50). We finish off covering some recent encounters with online pharmacies and their activities (21.00).

Cupris, Moodpath and e-prescibing

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 episode begins with a review of our previous episode and individual updates(2.00) and then we cover an ENT focussed app Cupris (3.22), a depression assessment tool app called Moodpath (11.16) and cover a Nottingham based news story on eprescribing that may bring in national changes (21.44).

Headspace, NHS hackathons and Quicker app and digital triage with AI

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 episode begins with a review of our previous episode and then we cover the mindfulness app Headspace (4.12), NHS hackathons (14.20), and NHS Quicker app (21.30). We also talk more about the concept of using digital triage and AI in a primary care setting (17.30).

Pilot - Sleepio, GDm app, news and interview with Dr Andy Foster

SHOW NOTES:

Introductions and declaration of interests

Dr Andrew Foster:

• GP Partner Nottingham
• Director NCGPA – Nottingham GP Federation
• Creator of SignpostingHealth
• RCGP Vale of Trent Faculty Honorary Secretary
• Blog – www.avoidingpuddles.com
• Twitter – @DrAWFoster

Dr Hussain Gandhi:

• GP Partner Nottingham
• Former Chair RCGP Vale of Trent Faculty
• Treasurer GP Survival
• Owner SystmOne Facebook User Group
• Owner www.eGPLearning.co.uk
• Twitter – @DrGandalf52

NICE HEALTH APP BRIEFINGS:

• Sleepio Website
• NICE Sleepio Health App Briefing
• GDm App Website
• NICE GDm Health App Briefing

NEWS SUMMARY

GPatHand- Welcome improvement to access or cherry-picking healthy patients and destabilising General Practice?

Links:

• http://www.pulsetoday.co.uk/home/finance-and-practice-life-news/online-gp-provider-makes-push-for-patients-to-switch-from-their-practices/20035609.article
• http://www.pulsetoday.co.uk/your-practice/practice-topics/it/we-have-a-number-of-serious-concerns-about-the-gp-at-hand-service/20035632.article

Cancelled North West London CCG trial of Babylon AI symptom Checker

Links:

• http://www.pulsetoday.co.uk/your-practice/practice-topics/it/babylon-gp-appointment-app-ditched-over-fears-of-patients-manipulating-system/20035712.article
• http://www.pulsetoday.co.uk/your-practice/practice-topics/it/babylon-gp-appointment-app-raises-fears-of-patients-gaming-system/20035712.article
• http://avoidingpuddles.com/2017/11/30/chatbot-vs-nhs111-trial-cancelled-as-patients-game-the-system/

INTERVIEW: DR ANDY FOSTER @DRAWFOSTER

GP Partner with interests in general practice operating at scale and technology.

Leadership and other courses often available free of charge to GPs in East Midlands can be found at East Midlands Leadership Academy: http://www.leadershipeastmidlands.nhs.uk

Blog: www.avoidingpuddles.com

Innovative RCGP Vale of Trent Transitions 2017 day conference incorporating speed dating, showcase website, 360 video, presentation video and “Why GP, Why Vale of Trent” promotional video.

Event website –www.valeoftrent.org.uk

Blog post re. Speed Job Dating –http://avoidingpuddles.com/2016/07/03/the-worlds-of-speed-dating-and-gp-recruitment-together-at-last/

NCGPA Reception Active Signposting training product and website –www.signpostinghealth.com

Thanks for reading/listening, feel free to comment or share and look out for the next exciting episode