Doctor’s surgery is now using AI for appointments- not working

[Cnthnfne]

my GP surgery will now text a patient a form if they want an appoint. You need to fill in the form explaining why you need an appointment, it will be reviewed by a doctor and a receptionist will phone to arrange an appointment.
it is now not possible to book an appointment with a receptionist.
sent in a form early yesterday morning and I haven’t heard back. I will now need to phone them to chase up.
would take 3 mins under the old system. Plus, no allowances for people who don’t have mobile or don’t know how to use the internet: the elderly or the most vulnerable.

If it becomes socially acceptable to effectively exclude many older people from accessing essential public services, then we won't be able to complain when the same thing happens to us in later life. Which it will. We will all get old and there will new technological advances all the time . Some of us will keep up, but many won't. The time to protest about exclusion of the elderly is now, while we are younger.

It isn't AI. Which company??

Look at it the other way. The system allows more of the run of the mill, day to day, appointments to be fulfilled quicker. It therefore provides slack in the system for those who need another way to access it, for more complex issues, or those requiring f2f. All the GP's locally allow phone ins if you cannot access e-consult.

Does it really matter if it's AI or not? It's a shit system that doesn't work.

My GP does something similar. I'm able to fill in the form, and know how to 'game' it so it doesn't send me to A&E for everything 🙄. I always say on the form how to contact me (text/email). Where it falls down is them randomly phoning me a few days later, because I don't and can't have my phone with me during working hours. They leave a message telling me to call, but then I have to try to fit that into my lunch break ('you are number 54 in the queue ' ...). I have an autoimmune condition, so mostly things aren't urgent, but I need to be seen/have blood tests in a timely manner. I've pretty much given up, there's a private GP practice a few miles away, I go there 🤷

I'd also like to know if they have done impact/risk assessments on this 'system'.

I agree with those saying it's not AI, but it isn't ideal.

It works okay for things where you might need a same day appointment- i.e. you get a phone call back, arrange an appointment, all good.

If you need an appointment but are at work, it's very tricky- I can't always answer the phone at work, and my signal at work is also very poor. If you don't answer, or get cut off, there's no option to say "can you please call back in 2 minutes when I'm in a private room/somewhere with signal etc". I fully accept they can't hang around forever, but it does make it difficult to access healthcare.

I'm also not sure how it works in terms of routine appointments etc. I'm supposed to have a medication review at some point soon, for a new medication I've started- I couldn't book an appointment whilst at the surgery, and there doesn't seem to be a good option for this on the form, either...

Overall, I do think it's probably better than the "call at 8am" system if you're acutely unwell and need help there and then, but for more routine stuff it's not as good as speaking to a person?

It’s not AI if your answer is decided by a human not a robot.

But I also worry so much for elderly patients. My grandad who recently died was in his 90’s and tech savvy but I know people 30 years younger than him who would struggle.

I wish they’d just have the old systems for people who need it because let’s face it 90% of people ARE tech savvy and will use the AI form.

What’s the company?

They really shouldn’t be calling it AI when it’s not AI

It does - we all need to understand when decisions about us (medical, financial etc) are made by a human and when they're made by a machine.

The machine may make better decisions than the human at times! So I'm not saying AI shouldn't be used in this or any other setting. But the description does need to be clear and we all need to start to understand the difference.

My surgery use this and it seems to work quite well. You need to state on the form if you are only free at certain times. People must realise how short of GPs we are. They can’t just magic up more appointments.
If you need to come in they will give you a face to face appointment.
People still try to make appointments for viruses they have had for less than a week!

Everyone needs to exaggerate their symptoms

Only way to get seen it seems!

Whether it’s AI or not depends on the system being used and the settings. E consults are (usually) triaged by a human. My practice has just started using something called KLINIK. KLINIK is “AI supported triage”. The forms are first triaged by AI. This means the human (at my practice usually a paramedic not a GP, which is a whole other conversation…)* sees them in the order determined by the AI. The company have plenty of case studies on their website, but I can’t find any peer reviewed evidence that supports the safety and efficacy of this system. (This is not to say there isn’t any: I have only looked briefly.)

DOI I am a retired hospital doctor.

*I’ve personally found the primary care paramedic at my practice to be excellent. I’ve had a very bad experience with the PA. Bottom line: people need to know who is assessing them, and what that person’s qualifications and scope of practice are.

We've got a similar system at ours. It isn't AI. And if a person can't use the online form they can either go in or phone and the reception team will input the information for them into the same triage form that's available online.

We've found it works well. There are no walk-in/minor treatment clinics within miles of us, there's just our rural GP. OH had an infected bite that wasn't clearing up with over the counter treatment. Submitted the form at 7am with a photo, a member of the medical staff reviewed it mid morning, agreed it didn't need a face-to-face appointment but did need antibiotics, gave OH a quick call to confirm no issues with prescribing them and a prescription was put through to the practice dispensary before 12. I know pharmacists can prescribe antibiotics now but that wasn't an option until a couple of months ago.

Meant OH didn't need to take a day off work to deal with a medical issue which was minor but could have got worse quickly (cellulitis can be nasty for people with certain conditions) and medical staff get to keep the face-to-face appointments for those who really need them. On another occasion I used the same triage form and they had me in for an emergency appointment that day.

I know these kinds of systems aren't foolproof but it seems wrong that there are still GP practices that leave patients repeatedly redialling at 8 am in hope of getting an appointment a month later. It doesn't need to be like that.

Look at it the other way. The system allows more of the run of the mill, day to day, appointments to be fulfilled quicker. It therefore provides slack in the system for those who need another way to access it, for more complex issues, or those requiring f2f. All the GP's locally allow phone ins if you cannot access e-consult

My mum's surgery does not. They use a system called Klinik which is switched on 8-4 on weekdays. You "have" to use it. They won't make appointments in person or over the phone.

I have filled it in a few times for her, and once she went into reception, mentioned the Equality Act and said the onus is on them to make reasonable adjustments, not her (they told her to get a friend to fill it out for her). They then filled it in for her, which is hardly efficient, either.

I would show her how to do it, but as it's switched off most of the time, I can't unless I am with her on a weekday.

Like phone apps for car parks, these systems break the law. They are fine as options, not fine when made compulsory.

I should say though, that the system works well when you know how to use it.

The issue is making sure that those who can't use it don't fall by the wayside.

Yabu the issue is, as always, with the people using the system at the surgery not the system itself. It works exceptionally well at my surgery, but they seem to be really well organised so responses are swift.

My GP said this E-consult system is to be rolled out to all the GP practices by the end of the year. I quite like it, but I can see how it might not be easy for e.g older people to use.

The eConsult form at my GPs only 'opens' at 8 am, and is closed once they have too many. So no, you aren't waiting on the phone, but you better have the site open and be ready at 8 am, as it normally closes by 8.04 am!

My GP has an online form and it works very well. It is much better than being on the phone for ages or awkwardly trying to explain your problem to the receptionist and being at their mercy whether you get an appointment or not. Also handy to be able to include photos. I always hear back the same day and sometimes within minutes if it’s for my toddler.

And definitely nothing to do with AI. This term is widely misunderstood.

Yes people tend to assume that every GP operates this in the same way.

In practice there are different e-consult products which have different options and every GP sets it up for their own practice. The experience will be very different across different practices even for those who are able to use it and find it convenient.

Sitting at your screen ready to pounce as if for Taylor Swift tickets is hardly user friendly for groups already experiencing digital exclusion.

My surgery are switching to Accurx soon, apparently. But I imagine it will be the same story!

Like a PP said, it works if you're able to access it and are ill and at home. If you're working and commuting, and it's more routine appointments, well, it really doesn't work for me at all. I don't wish to discuss my uterus on a commuter train/at a bus stop, and many of us can't use our phones at work, or are able to take calls like this, which require privacy, at a moment's notice.

We have the same system.

I like that I can now put everything in writing in advance. It means that I'm a little less likely to forget something.

The problem comes when I'm told that a GP will call back on a particular day but with no time given. I work in a primary school, where basic safeguarding means that I can't keep my phone in my pocket. And even if it were allowed, I can't drop everything to go and answer it when it eventually rings.

The system is also only open for a very short period at 8am. If you don't get on it fast, that's it until the following day. The surgery is also now removing the option to phone them, which means that it's either the app or nothing.

People still try to make appointments for viruses they have had for less than a week!

Maybe, like @BatshitCrazyWoman and me, they are immune-suppressed and following NHS instructions to seek prophylactic anti-biotics and/or anti-virals as soon as possible and certainly within 5 days, from their GP surgery.

And perhaps, like me, the GP surgery's new software still doesn't have them coded properly as being immune-suppressed, confusing both the long-suffering staff and patients.

We really shouldn't judge other patients' clinical needs and how they are forced to navigate these new systems. Perhaps we could offer help and some understanding. Luckily my GP's receptionists listen patiently and at least try to sort something out. But they clearly all hate the new software packages (patient records and the e-consult system).

I was talking generally. My sister has a suppressed immune system because of drugs she takes.

but as I’m finding out, the NHS doesn’t give a shit about the elderly
Apart from when they could use them as a tool to get people to accept Covid restrictions