Health Technologies

Deep dive: what does ‘good’ look like in digital primary care? – htn

To gain a different perspective, we chatted with Thomas Porteus, founder and CEO at digital primary care specialists iatro. Thomas discussed the accessibility and usability of GP websites and what good looks like in this area.

Thomas began by stressing the importance of practices considering website accessibility in the same way that they consider physical accessibility. “A practice wouldn’t have three flights of stairs outside the door, so if you consider the website and the digital services the ‘digital front door’, then that’s really important.”

Thomas discussed how GP website accessibility is key to ensure that patients are able to easily locate and use available services: “If patients can’t find and use all of these digital services that are being paid for, or that practices are funding themselves, then it’s a complete waste of money. There’s no point having e-consultations if patients can’t find and access them.”

He went on to provide detail around his team’s experience in working with the new guidance from NHS England, as raised by Minal earlier in this piece.

“Most practices tend to think, ‘if it’s important, put a pop-up box on the website and make sure that it’s the first thing they see, that will definitely work’,” Thomas said. “Actually, as we know, when we’re browsing the rest of the internet, when a pop-up box comes up the first thing you do is close it and move on. You’re missing the message.”

Thomas referenced a statistic indicating that only 17 percent of patients could get past this kind of pop-up box displayed on GP websites, meaning that it was preventing them from actually accessing anything beyond it. “So what do they do? They call. They don’t try the website again.”

On the relevance of the new guidance, Thomas said it “has been a long time coming. It’s the first time practices have had something concrete to look at, to work through, and to maybe challenge suppliers on, to say, ‘actually this isn’t good enough’.”

Navigating usability and accessibility with suppliers

Thomas noted that he and his team see the issue of accessibility from both sides of the table, witnessing how a change designed by NHS England is put into place on the ground. Iatro. has both Practice365, a primary care website platform, and OneContact, an e-consult platform, which both run on the NHS’s frameworks.

He added that there is “no obligation in those frameworks for suppliers to not use pop-ups, or to make sure that they are meeting accessibility requirements – the accessibility is self-certified, so when you’re signing up on the framework you’re saying it’s accessible but no-one is checking. We spent lots of money and time checking we were meeting the standards, but there’s no guarantee that all of the suppliers have.”

Whilst the new guidelines are a step in the right direction, Thomas believes that there is a long way to go, especially to ensure that suppliers are on the same page.

When it comes to taking responsibility for ensuring accessibility and usability, Thomas said that Iatro. think of themselves as a “primary care technology business, in that order. We only care about primary care, and technology’s how we can help”. He added that when suppliers are from a different industry, and are perhaps primarily design-focused but working in primary care, that’s where the issues can arise.

Iatro.’s work with practices

We asked Thomas whether there were any projects that he and his team had worked on that they were particularly proud of, that demonstrate what good looks like.

“We work largely with individual GP practices, but we do work with ICBs and regions,” he said. “One project that we are probably most proud of is in Sunderland. We’ve been working with them for just over a year and have moved all of their sites over to our platform; and now we’re working with the individual practices to move everything over and upgrade the content. That’s been a really good collaborative experience, I think, for us and Sunderland.”

Another project highlighted by Thomas involved moving all 290 GP practices in West Yorkshire over to the Iatro. platform, which he described as “a massive change. You had a lot of practices who were suddenly having to use online routes, which they hadn’t necessarily thought about before. Being able to manage that for them was really useful.” Making this switch over to Iatro.’s platform meant maintaining consistency across the board, he said, especially in instances where the ICB would send out a request for all practices to add something to their websites, which Thomas and his team could then take care of for them.

“With Practice365, it’s about making sure that practices are getting, at a really reasonable price point, the level of service that they expect from their supplier,” he said. “We don’t talk about the tech with them, that’s not important; we talk about the outcome. The tech is for us to solve.”

When it comes to solving the issues surrounding tech, Thomas and his team are confident in the abilities of their solutions to integrate easily with practices and to ease common burdens for primary care services.

“OneContact is an e-consultation platform, but it’s also a long-term condition platform and it’s a QOF platform. Often we can help practices to digitise work they’re already doing. For example, if a practice already has an asthma form, it’s not about us designing a better version, it’s about allowing them to get this out to their patients easily; so for us it’s about understanding what the practice is doing and supporting them in doing that.”

Whilst Iatro. has their own clinical team, Thomas said, they recognise that practices also have fantastic clinical teams, so there’s “no ego there” when it comes to ensuring that the best forms are in use for the practice. For Iatro., it’s about supporting the practice to be able to do things the way they want to do them, and helping them to shape the demand that they’re experiencing.



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