Following a successful pilot of the NHS app in 34 registered GP practices, the government are now looking to implement this offering across England in the hope that it will be similarly well-received. The current structure of the app allows patients to look up their symptoms, book GP appointments, fill repeat prescriptions, and most importantly gain access to their online GP medical records. Following a two-step verification, patients can easily access their own medical history and have it to hand if necessary. This gives people a better opportunity to start seeing patterns in their own health records and potentially empower them to seek out an earlier diagnosis.
One of the major issues with rare diseases is the time it takes from initial presentation to diagnosis, in the UK it is approximately 5 years. Part of the challenge is that many rare disease symptoms can initially appear quite commonplace Understandably, GPs as the 'gatekeeper' within the NHS, will likely look to treat these more commonplace symptoms or potential misdiagnosis rather than suspecting a rare condition. This causes a delay in referral to a specialist who is more likely to be able to order the tests required to diagnose a rare disease. This delay, in turn, can result in life-altering consequences, as well as an additional expense to the NHS.
Although, this app does not solve the diagnosis problem, what it can do is empower the patient to track and monitor their own symptoms and condition. Many patients do not see the connections between their symptoms, going to their physicians for each isolated symptom or event. Having access to their own medical records may help them (and their GP) to keep a better track of their illness and trigger a request for a referral. The app may also help patients navigate and log their visits to different specialities, tracking their journey to diagnosis, provide them with greater confidence and control and to help them feel more supported by their GP.
Not only will it help the patient, but it will also help the GP. In a study by Esther de Vries in 2018, GPs stated that one of the biggest issues was identifying rare patients against the backdrop of the wider patient population. Having a digestible format, such as a mobile app, for patients' symptoms and health records means that it will be easier for GPs to spot those tell-tale signs that would indicate a rare disease.
As the app is rolled out to the general public in England, it will be interesting to see if there is an impact on diagnosis time generally, but particularly for rare diseases. Many academics believe this could have a large impact, though there may be development requirements to make the app a better tool for all patients, not just rare.
Innovative tools making use of modern data-driven methods linked to electronic patient files in GP practices (or hospitals or pharmacies) are most likely to get a desirable outcome for this problem.