Northland GPs Revolutionise Delivery Of Primary Care

COVID-19 has encouraged Northland GPs to find new ways of undertaking patient consultations that are outside of the usual face-to-face model in order to prevent the risk of infection spreading, while still providing the same high level of care.

In March this year, when New Zealand was at National Alert Level 2, GPs in New Zealand were directed by the Royal New Zealand College of GPs (RNZCGP) to first have a ‘remote’ consultation with patients using text, email, phone or video before deciding where they need to be seen.

“Accessing healthcare from home is similar to online shopping, in that you end up with the service you were seeking in the comfort of your own home,” offered Dr Nick Chamberlain, chief executive, Northland DHB.

“You will pay the same price for the consultation however overall you will save money and time - there is no more sitting in waiting rooms and no more travelling across town and country.”

While there is a buzz in the healthcare sector about ‘virtual care’, Dr Andrew Miller; GP, owner of Bush Road Medical Centre in Whangarei and Clinical Director of Information Services for Northland DHB says what’s being provided isn’t virtual care.

“The word virtual almost implies that something isn’t real but GPs are providing a number of alternative modes of access to care which are definitely real. A video consultation is face-to-face but just not “in person” – it isn’t virtual.”

Dr Miller and his team are referring to new ways of working as simply providing “options for accessing care.”

In Northland, Mahitahi Hauora Primary Care Entity worked with general practices and Māori health providers to enable them to continue to deliver care to their patients while in lockdown.

Chief Executive Phillip Balmer says the 44 Mahitahi Hauora practices quickly adopted these new ways of connecting. They initially triage patients via phone to prioritise those who need a consultation right away, decide who might need to visit in-person and those who could have a phone or video appointment.

GP, Dr Conlin Locke, who owns both Raumanga Medical Centre and Rust Avenue Medical Centre in Whangarei, says in March both practices switched overnight to 95 percent of appointments being carried out either via phone or video call, where prior to this point, only 10 percent of consultations were undertaken in this way.

Dr Locke says the benefits of conducting predominately phone and video consults have been vast.

“Patients don’t need to take time off work to have their appointment, they don’t have to worry about means of transport or time to get to and from the practice, and calling from their own environment means they avoid sitting in a waiting room and potentially mixing with unwell, contagious patients.”

He says he anticipates the rate of uptake of phone or video appointments is likely to decrease as the COVID-19 risk in New Zealand decreases. “RNZCGP’s set an original target of 70 percent of consultations happening this way. I would actually like to see this continue going forward, as there are so many benefits for our patients if we undertake consults this way.

“Of course, there are some symptoms that patients present with that you have to get them to come in and see you for, such as ongoing abdominal pain, back pain, or lumps in the breast.”

An avid embracer of technology, Dr Locke also uses the Manage My Health portal which enables his patients to book their own appointments and view lab results on line. He has even developed his own video consultation tool. Called ‘Doconline’ that is currently only being used in Dr Locke’s two practices and may be something he looks to expand in future. The tool allows the doctor or practice to automate a link for patients to log in to a video call.

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