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“Something needs to happen out of the ordinary for people to wake up and take the initiative to change”
General practice’s “forced adoption” of digital health technologies over the COVID-19 pandemic was an unexpected opportunity for progress, Canterbury researchers say.
In a last-minute change of thesis topic that coincided with COVID, PhD candidate Nargis Mashal studied 16 general practices across the country during the first six months of the pandemic.
Published in the latest New Zealand Medical Journal, the paper investigates the enablers and barriers to practices adopting digital healthcare over COVID-19.
One of the strongest enablers of “digitalisation” was the “now or never” reality that lockdown introduced, Ms Mashal says.
Her research focuses on “digitalisation” of general practice over the COVID pandemic – this refers to the optimisation of healthcare through the use of technological systems.
She explains digitalisation is significantly more advanced than “digitisation” – which is simply collecting analogue data and storing it on a digital plaform.
The pandemic provided general practice with no option but to go digital, as the announcement of the first national lockdown gave primary care just 48 hours to set up processes.
The bureaucratic system within health usually makes change very difficult, but Ms Mashal’s interviewees told her there was no time to waste on considering future implications.
“We have done three years of work in 48 hours,” many primary care staff told her.
There is plenty of innovation and research within health, Ms Mashal says, but always in terms of treatments and medical advancement. The digitalisation of services was never prioritised.
Many digital health systems adopted in response to COVID-19 are not new. Electronic referral systems, video consultations and Manage My Health were already in place, but just not being used or used efficiently.
Regulations that had previously created barriers to digitalisation were lifted, for example, no longer requiring a doctor’s written signature on a printed script unless it was for a controlled drug.
Efficient electronic prescribing would never have happened without COVID, she says.
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Ms Mashal’s research included 86 semi-structured interviews with primary care staff at 16 different practices across Aotearoa New Zealand.
She received a range of feedback from general practice staff and found they all agreed the digital transformation was the only option at the time.
The majority of prescribers reported they love the convenience of digital prescriptions, but some expressed concern about the quality of care provided digitally.
Ms Mashal says one or two interviewees told her they prescribed less medicine than usual over digital platforms as they were more cautious of misdiagnosis.
Digital consultations introduce a risk of misdiagnosis or a missed opportunity for holistic care, but it is difficult to know the impact of that yet, she says.
Ms Mashal says this is not the first time primary care has had to adapt in the face of a disaster. The Canterbury researcher was also involved in creating a digital tracking system after a lot of patient information was lost as a result of the Canterbury earthquakes in 2011.
That disaster highlighted the need for a South Island-wide system.
“Something needs to happen out of the ordinary for people to wake up and take the initiative to change.”
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