Improving the way that GPs operate and building up a comprehensive health database.

GPs have extended the use of triage and phone and video consultations during the pandemic. I assume that, in the same way as different drugs were trialled to see which worked best to counteract the disease, these different practices are being evaluated to see what woks best for which patients and which diagnoses. There has also a large expansion in the use of home tests such as lateral flow tests and oxygen monitors. This could be considerably extended.

The NHS could develop a standard kit and range of diagnostic tests for use at home, based on the existing diagnostic steps that GPs follow. For example, it is already possible to get temperature, blood pressure, heart rhythm and oxygen levels as well as weight and height, and to take photographs of the affected part of the body. Lateral flow tests could be developed for diseases other than Covid. A range of blood testing tools could be developed using just a few drops of blood (as is currently done for INR). I realise that some considerable work would need to be done, but the development of the existing lateral flow tests, the development of the vaccines and the development of new ventilators show that these things are possible.

In parallel with this effort on the equipment and measurement procedures, an Internet diagnostician could be developed. It will check take the patient step by step through a diagnostic procedure, with the patient being able to provide the results from the various tests. In some cases, the diagnostic software will advise that the patient visit either their GP or A&E; and the system will enable the results of the tests to be forwarded accordingly before the patient arrives. In other cases, it may conclude that there is no need for medical intervention.

Of course, there is the risk of misdiagnosis, However, there is nothing to prevent the patient seeing either their GP or A&E if not satisfied. There is also the challenge of the patient carrying out the tests correctly. This last could be ameliorated by asking that the procedures be followed monthly, so as to familiarise the patient with them and to provide an additional diagnostic tool in that unusual results would be easier to spot.

GPs would have access to all these data and should review them from time to time to look for such peculiarities. It should be possible in some cases to take preventative action to avoid some conditions from developing.

In addition, the availability of all those data should help in analysing public health risk factors within the population and assist in the test and trace process for new diseases. An analysis of the data will also enable the Internet diagnostician to be improved and additional testing requirements identified. It could also be used in training new medical staff and as an aide memoire for current staff.

As with any data collection exercise, there is the impact on privacy, and the risks of misuse and unauthorised access. Security protocols will need to be established and monitored.

The development of such a system will take a little time but is eminently possible. In addition to those indicated above, there is the opportunity for the NHS to patent some of the developed equipment and, more importantly, to provide a world leading process in diagnosis, preventative medicine and public health analysis.

 

 

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