Talking HealthTech: 340 – Make healthcare delivery and access easier for GPs and patients. Dr Ben Hurst, HotDoc

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Being a GP these days is a pretty tough gig when you think about all the issues leading up to the pandemic and then coming off the past few years of what GPs needed to deal with during COVID. Now that there’s that ongoing discussion around Medicare remuneration and workforce burnout. Technology can play a role, and one company that’s been supporting GPs through a lot of these turbulent times is HotDoc.

Joining Pete today is Dr Ben Hurst in an audio episode that was recorded at their offices in Melbourne. In this episode, you will hear what it was like for HotDoc during those crazy busy times of powering a lot of the vaccination bookings around Australia. You’ll hear what the vibe is on the ground for GPs today and what they need and also how HotDoc is thinking about the future needs of anyone providing outpatient health care services, plus much more.

Catching up on the Last Few Years

Since Pete and Ben last spoke, the advent of COVID-19 took place, and like any health tech company, the pandemic changed the game for HotDoc. They got to play a big role in helping to usher in some of the telehealth stuff, in the vaccine management space and provided for the respiratory clinics too.  In fact, HotDoc has had over eleven million vaccines booked through its platform. The pandemic created a tough but rewarding experience. 

HotDoc is a clinician solution, but patients are familiar with it, and because of its increased presence during the pandemic (getting over three million bookings per month), HotDoc has become a brand that a lot more patients and Australian consumers are aware of. Now, HotDoc is really keen to start focusing on some of the post-COVID challenges, especially around accessing healthcare.

Growing into Other Markets

The HotDoc solution serves the GP market primarily but has recently grown into other markets because Ben and his team are trying to make it easier for patients to navigate healthcare. Some patients, especially those with chronic diseases, might use HotDoc for their GP, and then they might have their specialist referral on the fridge and their radiology behind their desk, in some nook that they can’t even reach down and get. 

One of the challenges is not just booking on behalf of themself if they have a team, but also booking on behalf of their family. So, HotDoc is keen to make it easier for Australians to access healthcare, especially because it can be hard to find new clinicians. 

The Current State of the GP Landscape

GPs face a lot of challenges, such as operating a business when the system doesn’t support a good financial model to do so and also dealing with patients’ expectations. The challenges are real, and they come at all levels. During COVID, GPs were just assumed to be the stopgap. They were expected to make things okay; they were expected to explain all the changes that are happening to patients, even if they have zero input to the government and even if they receive comms the week after.

Providing that knowledge and that information about stuff that they didn’t even know about and having to counsel people during such an arduous time when mental health was at an absolute peak contributed to burnout. In one of the recent surveys, seventy-three per cent of GPs have experienced burnout over that time, twenty-five per cent are planning to leave the profession in the next five years, and only fourteen per cent of graduates are planning to become a GP. 

Not only did they have a really tough time during the pandemic, but post-COVID, there’s a shortage of GP services and patient demand is at an all-time high; however, the GPs haven’t had a proper break. The issue is not just the burnout either; the profession has been under attack. Once upon a time, being the community doctor was a role that garnered absolute respect, and now it’s a bit downtrodden. GPs often do all this incredible work, but perhaps patients and other facets of our health industry just don’t appreciate what they do. Plus, they don’t get properly financially compensated. 

How are GPs Responding?

HotDoc did a survey at the end of last year that they’re about to publish called the Changing Landscape of General Practice. They surveyed several things, but one of the focus areas was the changing business model. Of the cohort of 800 respondents, one in six stated that they were bulk billing only. If you roll back the clock five years, it would be more like one in two. Not only is it only about sixteen or seventeen per cent, but most GPs who consider themselves bulk billing today have plans not to be bulk billing in the future. 

Moving away from bulk billing may not be a great thing for population health. But one positive from it is that medical centres are no longer completely beholden to the archaic Medicare system that has been holding them back for a very long time. They can now innovate different models of care that allow them to provide a great patient experience and also charge appropriately for it, and this helps the industry move forward. Hopefully, they can get the balance right so that there can be mixed clinics that can do some means of testing so that people who can’t access care can still get bulk billing services. 

Innovating Different Models of Care

GPs are now able to implement practices and solutions to help them run better clinical practices. There are two sides to this; one is running a better business, and the other is providing good patient care efficiently. Though they intersect, they’re also slightly different.

Running a more efficient business is also looking at supply-demand economics. There are types of appointments, such as the ones on Monday morning, after work and on the weekends. But from their research, HotDoc found that most clinics, even private clinics, charge the same irrespective of the scheduling time. All clinics that provide services after hours and identify the peak hours should charge for that. This actually does two things. First, it makes their business model more sustainable, but it actually enables them to provide more bulk billing services for patients who can’t afford it.

Another example is that even though a year and a half ago, it was okay to charge privately for a telehealth appointment, only about thirty per cent of clinics are actually privately charging for these appointments. The reason is largely because it’s a complicated process to undertake if it’s being done the standard way. Technology could be a positive enabler just to simply help clinics to charge for the service that their patients are probably happy to pay for.

HotDoc and other services make it quite easy to collect payment details upfront and hold it in escrow until it’s been signed off. 

Async 

At the end of the year, HotDoc did a vision, and one of the things that Ben learnt was that  Async is a really important opportunity to provide a health service much more efficiently and conveniently to patients. 

The classic healthcare experience is the patient gets in their car, finds a park, waits in the waiting room, and sees the doctor for twelve minutes. With COVID, this novel approach of telehealth arose, where the patient and the doctor need to be there at the same time, but they don’t need to be at the same place; that’s called remote sync. Then there is Async, which not only doesn’t require the patient to be there at the same time, the doctor and the patient don’t have to be there together simultaneously. So, it’s remote and it can be done at different times. This model is perfect for situations like patients who only need a repeat script from their regular doctor for a chronic condition, a repeat referral, delivery of clinically insignificant results, a medical certificate and even basic acute consults.

This is one of the benefits of not basing your business model solely on this archaic Medicare system that is failing healthcare. When you can charge privately, you can start to deliver services that can be both efficient for the doctor and the patient. But the challenge is that Medicare provides zero compensation for delivering that type of asynchronous service. The only way to do it is by having some sort of technology where the patient and doctor can communicate securely, and the patient can appropriately put through their transaction for the delivery of that service. 

This is something that HotDoc has been doing for about seven years now, but only about eight per cent of their customers use it. However, they’ve noticed that within the last six months, the utilisation of that product doubled. 

What to look for from HotDoc?

The HotDoc team is really excited by the ability to make a regular clinic able to provide efficient services through this async approach. A major focus for them is to help clinics develop a more sustainable business so that patients can get much more convenient care and make managing their health from this side a bit easier. 

HotDoc will also be looking at chronic disease management. It seems chronic disease management has become a little bit of an admin game, where a lot of it is about making sure that you’ve completed the forms and asked the patients lots of questions, but often the patients are confused by that experience. As such, the HotDoc team is trying to streamline that process and make chronic disease planning more meaningful for both the patient and the provider. 

_{Source talkinghealthtech.com}