Martin Hefford, CEO
Tū Ora Compass Health is writing from a 12 week sabbatical in the
UK, hosted by the Kings Fund in London and the Health Service
Management Centre in Birmingham.
18 August 2019
Brecon, and Babylon
if you have an
interest in politics, it’s an intriguing time to be in the UK.
Alexander Boris de Pfeffel Johnson is ensconced in number 10 and,
with the Brexit Party eating the Conservatives from the inside, is
undeterred by the prospect of a no-deal Brexit. I was visiting
Brecon in the Welsh mountains on the day the Conservatives lost that
seat in a byelection to the Lib Dems (who support remaining in the
European Union) leaving Boris with a parliamentary majority of one.
A snap election is looking likely.
Labour came fourth
in Brecon, and seem to be in a poor state to fight a general
election. But it may not matter anyway because, although a majority
of MPs are against a no-deal Brexit, the executive (Boris) can
apparently push ahead without parliamentary agreement, and there is
now probably not enough time to have an election before the 31
October deadline. One timeline suggests that the earliest an
election could occur would be on the day Brexit happens – making
the results somewhat moot. Now there is talk of a grand coalition of
parties to force Boris out and avoid Brexit. And I thought NZ
coalition politics was tricky… It’s like watching a slow-motion
Babylon is the
Brexit of medical politics in England. Babylon has introduced a
controversial form of disruptive innovation with its “GP at Hand”
service set up in direct competition with regular NHS GPs. They
offer a digital-first service: an AI symptom checker, then a video or
voice consultation with a GP, followed (if required after a virtual
consult), by the option of an actual physical consultation. The big
drawcard is that you can get a video GP consult within hours, whereas
most GPs here have two week waiting times for routine appointments.
A recent evaluation of the service indicated that users were younger,
more affluent, and less complex than the average NHS patient, leading
to a suspicion that the service is cream skimming the worried well.
Interestingly the evaluation showed that many patients preferred
voice over video consults.
I decided to be a
mystery shopper and registered for the GP at Hand service in London.
On registration, I was asked lots of questions by the Babylon AI chat
bot as part of an intake assessment process. The results are shown
graphically in my ‘’digital twin’’.
included a disproportionate interest in my thryoid functioning,
probably because the fact that my mother had a goitre came up in the
assessment, and Babylon AI hasn’t been told about the lack of
iodine in NZ salt.
I also tried the
Babylon AI symptom checker; I sprained my ankle sometime back and
used my remembered symptoms to answer the very numerous Babylon
questions. At the end the AI concluded there was a 90% likelihood
that I had a broken or cracked ankle bone. A sprain didn’t seem to
occur to it, so perhaps not quite ready for musculoskeletal medicine
this blog, I had an exacerbation of my asthma and used the GP at Hand
Service for real. Same day video consult – script pick up from
nearby pharmacy with a follow up physical consultation a few days
later. My verdict? It’s a video front end to a fairly traditional
model of care. In NZ the whole thing would have been dealt with by
secure messaging between me and my GP through the patient portal
(convenience plus continuity). I would have needed neither the video
consult nor the physical visit. But Babylon GP at Hand doesn’t
provide secure messaging to your GP. They do give good access to
your notes – but so does my GP in Wellington. Though I expect the
service offering will keep improving, Health Care Home practices in
NZ having nothing to fear from Babylon in its current state.
gets the last word on disruption: “My
friends, as I have discovered myself, there are no disasters, only
opportunities. And, indeed, opportunities for fresh disasters."
GP at hand App
Bablyon digital 'twin'