Telehealth tool built in a week to safeguard GPs and staff

Doug Hendrie

3/04/2020 2:03:20 PM

The free open-source tool will help practices shift rapidly to telehealth and keep staff safe during the coronavirus pandemic.

Phone showing 'please wait in your car' SMS.
The humble text message can help keep staff and patients safe.

Developed by Australian programmers, the new ClinicArrivals tool is designed to keep patients out of waiting rooms to reduce infection risks by using text message communication, with telehealth integrated into existing practice management systems also included.
The idea came after long-time digital health advocate and GP Dr Nathan Pinskier saw a need for the tool, and pitched it to Grahame Grieve, the creator of world-leading healthcare standard FHIR.
Mr Grieve visited the practices of Dr Pinskier and Dr Mukesh Haikerwal to see the problem firsthand.
Armed with that information, he and a team of volunteers from the FHIR community built the program within a week, and began testing it across Dr Pinskier’s five practices. The prototype application launched this week.
‘Everyone has got to do their bit, and this is my bit,’ Mr Grieve told newsGP.
When a patient makes an appointment for a video call consultation, the app will send them a text message with instructions and a link, with a reminder text beforehand.
That same link arrives in the GP’s practice management system, allowing GPs to click the link and begin the call. The video calling technology does not require downloading an app or signing up, which can be a deterrent.
Patients who may have coronavirus and have booked a face-to-face consultation can be sent text messages advising them to stay in their car, with further instructions able to be sent safely by text.
Translators or third parties can also be added to the calls.
‘Telehealth hasn’t been widely used in urban areas, and I could see there was a major disconnect in the workflow. It’s not just a matter of buying headsets and clicking a link,’ Dr Pinskier told newsGP.
‘I call this tool the glue. It integrates the process from making an appointment through to the telehealth consultation, bringing everything together – telephone, video and face-to-face consults.’
‘It automates the workflow process and takes some of stress away from reception staff.
‘What Grahame and his team have been able to do is build this in a really rapid cycle. It’s an amazing bunch of people.’
In coming weeks, the tool will be made into a ‘zero touch’ user-friendly application. At present, users would need IT support to get it running.
Mr Grieve said the tool is designed to solve two linked problems – the issue of patients in waiting rooms potentially spreading the coronavirus, and the pressure on reception staff to message patients directly to ask them to stay outside.
‘It wasn’t maintainable, to do that by hand. It needed be automated. GPs don’t want to deal with system change, so we wrote something that sits on the side, without any changes to their systems,’ he said.
‘After years of not being able to do telehealth, now it’s been brought in in a two-week period. That means existing solutions aren’t integrated – but that’s no good for a GP, it has to embed into their workflow.’
Mr Grieve said the common workaround of using WhatsApp or Facetime video calls will not be possible to maintain in the future.
‘We got this out there ready to go in seven days. That’s pretty good,’ he said.
Mr Grieve said rather than turning it into a commercial product, he hopes that the approach he’s taken will be adopted by the makers of other practice management systems.
Going forward, Dr Pinskier predicts the tool may have many additional uses – such as being able to send tailored text messages to specific cohorts, such as people with diabetes.
Other health IT vendors have been scrambling to adapt to the new environment of universal telehealth and the coronavirus, with online appointment booking software makers also rolling out telehealth options.

More information on the new ClinicArrivals tool is available online.
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Dr Kylie Anne Bown   4/04/2020 6:53:20 AM


Dr Kishore Nallapu   4/04/2020 6:56:41 AM

How do you we access it please

We (20 Doctors) are struggling at our practice

Dr Keith Andrew McArthur   4/04/2020 9:14:52 AM

Please publish a hyperlink!

Dr Snehal Patel   4/04/2020 10:30:59 AM

This is a fantastic solution to a very common and pressing challenge especially for the front desk staff. Well done !! Please let us know when this is ready for widespread use and if its compatible with MD/PS ?? Thanks :))

newsGP   4/04/2020 10:55:01 AM

Thanks for your comments. The tool is available here -

Dr Sharon Poh Choo Vasey   4/04/2020 12:05:00 PM

Sounds awesome and well designed - where do we sign up?

Dr Nell De Graaf   4/04/2020 12:13:13 PM

Looks like a fantastic solution 🥰

Dr Andrew Warren   4/04/2020 2:29:20 PM

Awesome work Grahame and team. Obviously with such tight timeframes documentation will not have been a priority; going forward though an implementation guide that can be given to a clinic's IT provider will be key to getting this into the hands of those of us who need it. At the moment I can't see the majority of practices having the tech know-how to work with it in its current state (e.g. building a Visual Studio project is going to leave even the IT guys staring blankly).

Dr Philip Ian Dawson   4/04/2020 6:50:30 PM

We have looked at a few. GPConsuting is also Australian designed and web based so nothing to install it too sends a link to the patients. Unfortunately it got overwhelmed and crashed. There are over a dozen in use in USA, we seem to be settling on the doctor has to sign up for a free account, paints get an emailed link or text and click on phone tablet or PC aand then appear on the doctors screen as waiting, then when ready the doctor clicks to start the consult. Works well on apple and Android and PC. Says it needs Chrome or Firefox browsers only, which seems to be the case on PC, all new android handsets use chrome as default, apple seems to work on safari on, but chrome was installed on the ones we tried. Simply create an account with your work email and a password and you are good to go! Patients ring our receptionists for an appointment and are given the option of face to face if no respiratory symptoms, a phone consult, or a video consult or skype

Dr Paul Grinzi   5/04/2020 11:50:50 AM

Please publish a Conflict of Interest statement (if there are none, please explicitly state so) - this article reads like an advertisement akin to a 'A Current Affair' scoops.