Thursday, 14 March 2019

From a discussion with Drs Saqib Mukhtar and Mark Baker

1. First of all MediChain’s doctors will be registered on the GMC (General Medical Council), will be on the GMC performers list and have 5 yearly revalidation cycles. This primarily ensures that the pool of doctors available are appropriately qualified.

2. Once this is established it is followed by a rigorous interview process where the doctors have to go through 3 different clinical scenarios to ascertain their level of understanding and competence in managing patients over video-call. As part of the revalidation cycle each doctor will have yearly basics life support, anaphylaxis and child / adult safeguarding training as mandatory. Without this no doctor can work for MediChain. The purpose is to make sure that the doctors are practicing safely and according to good medical practice guidelines from the GMC. This is very important as there are a number of GPs that work only in the private sector this therefore means that they are not part of the 5 year revalidation cycle. It is expected that MediChain will not employ these GPs, as the quality of care provided cannot be validated. In essence each GP employed will also be working in and for the NHS, thus being able to transfer these skills over telemedicine/video call.

 3. There will be pre-interview training guidelines and materials to guide doctors on required standards and skills. This will allow doctors to prepare effectively, making sure that they know what is expected of them and allowing them to practise or think through how they will need to perform.

4. This will be performed by the Clinical director of MediChain. Reading material and guidelines include:

4.i GMC guidance on good medical practice.

4.ii Safeguarding policies.

4.iii Prescribing policies.

4.iv Managing conflict of interest

4.v MediChain’s best practices for consulting via video call. Each policy will need to be signed with a short self assessment to ensure that the doctors are compliant and competent. The above are necessary standards for CQC (Care Quality Commission) compliance.

5. The process is equitable to online personal professional development, and will count as learning hours for the doctor that they can put in to their appraisals. This can be done in house with MediChain or using an external provider.

6. Any concerns or questions will be directed to the Clinical Director, this will help promote a positive open and sharing environment where everyone learns from each other. Furthermore this will also drive Improvements in system processes.

7. Once we have ensured that the doctors are competent and fully compliant, an interview process shall be conducted by the Clinical Director, with three different scenarios/clinical consultations to be performed over video call. This will assess not only the clinical skills of the doctor but how well they adapt and perform in consulting patients in this manner.

8. Once the candidate has been provisionally accepted the following training takes place:

8.i System training - ensuring that the doctor is competent at working and using the MediChain system.

8.ii Video call training- performed by the Clinical Director I.e the basics of consultation including good lighting, broadband connection, confidentially to minimise disruption/interruption etc.

8.iii Bi annual audit of all calls with an annual appraisal for each doctor. This will maintain quality thus improving standards of care.

8.iv Regular MediChain Clinical meetings to discuss issues, significant events etc.

9. User Experience is key to acceptance and growth of Hypatia and so every part of the interaction needs to delight both patient and doctor. To this end we've been talking to and designing processes for this with the orchestrater of one of the world biggest retail chains going online, to make sure that the processes exceed patient (and doctor) expectations in a way that previous telemedicine systems have not done.

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