Neil,
I took over the care of 2,750 patients registered on the list of UK General Practitioner (GP - family doctor) patients from a retiring doctor in Manchester in 1979.
I saw patients every 7.5 to 10 minutes according to the circumstances and provided 0 to 10 visits a day. The average patient had 4 consultations a year. Infants and patients aged over 75 had the most consultations each per year. The elderly required the most visits per patient.
Women of childbearing age had twice as many consultations as men and of course attended more than men when their children were poorly. Women were usually the health adviser and health provider in tbe home.
Our General Practicee responsibilities were within the domains of direct care, preventative care, health promotion and continuing care. Continuing care included "multimorbidity management", which still has not been tackled in its most efficient form. (A shared record is part of tbe answer!)
On average I had 40 minutes a year with each patient within which to take histories, examine, complete and order tests, diagnose, explain, obtain consent, prescribe or refer for further care and to educate. It was just not possible to cover all this ground satisfactorily and health information, lifelong shared records, lifelong patient education and lifelong oatient empowerment seemed esential but missing.
I heard Avedis Donabedian propose a "structure, processes and outcomes" method of auditing and planning healthcare in the 1980s.
Most of the processes of General Practice are abstract - communication, thought, memory, information, calculation, analysis, trend spotting
I believe that we have to use AI, digital, mobile health and telehealth to supplement - and, yes, to replace - current medicine and care provision if we are ever to achieve UHC in primary care.
Mammals developed six layers of intelligent cortex 200, million years ago.
Human society has used writing, illustrating, memorising and mathematics for millennia. Now societies have progressed to using AI for shopping, entertainment, finance, sales, holiday, group communications and insurance brokering, banking, etc etc. Hopefully health will be as important or more important than wealth ad tbe objective.
"Who polices the police" might be interesting - how do we oversee something that is more clever than we are? Stuart Russell of Berkeley University gave four Reith lectures on this topic and I will find andxsens a link.
I will also look for a link to a recorded UK House of Lords enquiry into AI and health which illustrates sone of the human sides of AI and health. [not sure what this sentence means, is there another way of saying it?]
Richard Fitton
HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data Email address: richardpeterfitton7 AT gmail.com
