'Computer doctor' to replace GP

Sue Leonard

The bedside manner of the GP is to be replaced by that of a "computer doctor". A voice-activated 24 -hour helpline, Excelicare Direct, is being pioneered in Scotland.

It allows patients to have their medication monitored to retrieve test results and to order repeat prescriptions without the need to seek an appointment with their GP.

Instead of meeting their doctor to discuss their medication, patients call the helpline and answer recorded questions by pressing numbers on the keypad.

In a pilot scheme, patients suffering from rheumatoid arthritis are asked if they have stopped taking the drug Sulphasalazine. If they have, it asks: "why did you stop taking the drug? If it was due to side effects, press 1. If you were unable to get the drug, press 2. If you thought the drug was not helping, press 3. If you stopped taking it for any other reason, press 4."

Responses are logged and any problems are referred to doctors by email.

The system, which is being targeted at conditions such as epilepsy, blood disorders, heart disease and diabetes, also offers lifestyle advice and asks patients how they are feeling. It is being tested on patients at Glasgow Royal Infirmary (GRI).

The scheme will be studied by the Scottish executive, which has faced criticisms over waiting lists and waiting times. It has been forced to admit that six National Health Service trusts have closed their lists and has been accused of fiddling waiting lists figures.

This weekend patient watchdogs raised concerns that computerisation was going too far, Margaret Davidson, chief executive of Scotland Patients Association said people would miss the personal touch and may be left feeling stressed and frustrated trying to get through to the phone line.

The trial in Glasgow is being funded by a pharmaceutical company and is backed by the NHS through the Scottish Telemedicine Action Forum.

Dr Ragan Madhok, a consultant rheumatologist based at GRI, believes the pilot study will improve the quality of care and increase the time that doctors can spend with their patients.

Some patients mistakenly took drugs daily when they were meant to be taken weekly, he said. The computer would enable time to be spent assessing disease rather than monitoring drug usage.