Helen Salisbury: Disruptive innovation—technology is not the problemBMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l1091 (Published 13 March 2019) Cite this as: BMJ 2019;364:l1091
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Helen Salisbury says before new drugs are approved we must prove they are safe and at least as good as what they replace. Should we not add that if they are only as good as what they replace they should not be more costly?
Competing interests: No competing interests
I agree that technology is not the problem, it has much more to do with system change. Technology can be an enabler, but only in the service of the right goals, not for its own sake.
Some recent policy initiatives start from the technology such as video consultations, without considering the problem they might solve or whether the technology is appropriate.
As we offer video equally alongside messaging, telephone and face to face consulting options for both patients and clinicians, we are in a position to compare take up and video is surprisingly low.
What is urgently required is independent evaluation of "technologies" in the broadest sense of means of system operation, which may include digital, so that clinicians, commissioners and policy makers can make informed choices.
The problems to be solved are all too evident, in terms of patient waiting times, GP workload and shrinking workforce. There is no time to lose, and a four year academic publishing cycle is simply too slow. We need evaluation within months.
Competing interests: Chief Executive of GP Access Ltd which provides askmyGP, an online platform enabling communication and workflow between patients and GPs, including video and online consultations.