NHS ‘GP at hand’ via Babylon Health tests in London–and generates controversy

click to enlargeThe GP at hand (literally) service debuted recently in London. Developed by Babylon Health for the NHS, it is available 24/7, and doctors are available for video consults, most within two hours. It is a free (for now) service to NHS-eligible London residents who live and work in Zones One through Three, but requires that the user switch their practice to one of the five ‘GP at hand’ practices (map). Office visits can be scheduled as well, with prescriptions delivered to the patient’s pharmacy of choice.

Other attractive features of the service are replays of the consult, a free interactive symptom checker, and a health record for your test results, activity levels and health information. 

While the FAQs specify that the “practice boundary” area is south of Talgarth Road and Cromwell Road in Fulham, and north of the River Thames, it is being advertised on London Transport (see advert left and above taken on the Piccadilly Line) and on billboards.

Reviewing the website FAQs, as telemedicine it is positioned to take fairly routine GP cases of healthy people (e.g. colds, flu, rashes) and dispatch them quickly. On the ‘can anyone register’ page, it’s stated that “the service may however be less appropriate for people with the conditions and characteristics listed below”. It then lists ten categories, such as pregnancy, dementia, end of life care, and complex mental health conditions. If anyone is confused about these and other rule-outs, there is a support line. 

Babylon Health is well financed, with a fundraise of £50 million ($60 million of a total $85 million) in April for what we profiled then as an AI-powered chatbot that sorted through symptoms which tested in London earlier this year. This is a full-on telemedicine consult service with other services attached.

Now to the American view of telemedicine, this is all fairly routine, expected, and convenient, except that there’d be a user fee and a possible insurance co-pay, as more states are adopting parity for telemedicine services. We don’t have an expectation that a PCP on a telemedicine consult will take care of any of these issues which Babylon rules out, though telemental health is a burgeoning and specialized area for short and long-term support. But the issues with the NHS and GPs are different.

First, signing up to ‘GP at hand’ requires you to change your GP to one in that program. US systems are supplementary–a telehealth consult changes nothing about your other doctor choices. This is largely structural; the NHS pays GPs on a capitation basis.

mHealth Insight/3G Doctor and David Doherty provide a lengthy (and updated) analysis with a critical view which this Editor will only highlight for your reading. It starts with the Royal College of GPs objections to the existence of the service as ‘cherry-picking’ patients away from GPs and creating a two-track system via technology. According to the article, “NHS GPs are only paying them [Babylon] £50 a year of the £151 per year that the NHS GP Practice will be paid for every new Patient they get to register with them” which, as a financial model, leads to doubts about sustainability. Mr. Doherty advises the RCGPs that they are fighting a losing battle and they need to get with mHealth for their practices, quickly–and that the NHS needs to reform their payment mechanisms (GPs are compensated on capitation rather than quality metrics).

But there are plenty of other questions beyond cherry-picking: the video recordings are owned by Babylon (or any future entity owning Babylon), what happens to the patient’s GP assignment if (when?) the program ends, and patients’ long-term care.

Oh, and that chatbot’s accuracy? Read this tweet from @DrMurphy11 with a purported video of Babylon advising a potential heart attack victim that his radiating shoulder pain needs some ice. Scary. Also Digital Health.

Nokia’s second act to spotlight healthcare?

Building its way towards a comeback is Nokia, once a global power in mobile phones and now, after selling its handset business to Microsoft two years ago, strictly (and profitably) in telecom networking equipment–for the time being. In April there was the €15.6 bn Alcatel-Lucent acquisition which includes famous research powerhouse Bell Labs; in January it launched the N1 Android tablet in China and days ago a “virtual-reality camera”. It also will license its name to other mobile phone makers when their non-compete expires in 2016. The real value of Nokia rests in its IP and worldwide patents which can be used in multiple areas. Since 2012 it also staked a claim in healthcare with the Nokia Sensing XChallenge for innovation in remote health monitoring. Mentioned but briefly in the Reuters article is that their technologies division is working on health-related projects. Deliberately staying below the radar? Hat tip to David Doherty (@mHealthInsight) via Twitter to remind this Editor of Nokia’s health ‘chops’. 

mHealth guide to the 2015 Mobile World Congress

click to enlargeFor our readers attending the annual Mobile World Congress (MWC) extravaganza 2-5 March, there’s plenty on health tech to be found, but the MWC organizers on their website don’t make it easy. Filling the gap smartly is David Doherty on mHealth Insight with his annual mHealth guide to the 2015 Mobile World Congress–both presentations and exhibitors. Personal logistics is important as the 70,000 delegates jam Barcelona and the 2nd Health & Wellness @ Mobile World Congress organized by the European Connected Health Alliance (ECHAlliance) is held at two venues. Save it on your mobile and let it be your guide.

Around the mHealth Summit in 70 pictures

Courtesy of mHealth Insight/3G Doctor, David Doherty takes the LIFE magazine approach and delightfully, you feel like you are there. He hosted a get-together at his booth on Monday (many pics), stops by AliveCor, Alere Connect (hello Kent Dicks), the Venture+ Forum (see Lois Drapin’s earlier article; hello Richard Scarfo, director of the Summit and Pat Salber of HealthTechHatch crowdfunder and the DoctorWeighsIn), VNA Health Group, investor in many things Esther Dyson, Google Glass Explorers, Samsung’s Galaxy Gear smartwatch and the ‘panini generation’ courtesy of AT&T ForHealth. But you’ll have to page all the way down to see the last shot of an ‘wild, wooly and yo-ho-ho’ AliveCor demo in My thoughts on the 2013 mHealth Summit as it happens…

mHealth Summit: the warmup

click to enlargeEven if you are not attending the mHealth Summit starting Sunday near Washington, DC, we’ll be covering selected topics through our correspondents on the scene.

News and highlights:

  • Founding organizing partner mHealth Alliance is relocating from the UN Foundation in Washington, DC to Johannesburg, South Africa to be closer to its work in developing countries. Release.
  • If you follow David Doherty of mHealth Insight (3G Doctor) as we do (and he does us), his mHealth/LinkedIn group will have an informal meetup at their booth #917 on Monday, 6-7:30pm. More information. He will also be speaking.
  • FierceMobileHealthcare’s preview
  • A spotlight on Sunday’s activities

Official Tweetstream: @mhealthsummit   Hashtag: #mHealth13

Update 9 Dec: Bad weather in the area has delayed many participants or changed travel plans. MedCityNews has a timely listing of speakers’ Twitter usernames to follow here.

Telehealth & Telecare Aware is a media partner of the 2013 mHealth Summit.