Written evidence submitted by Zoom (FGP0265)
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Zoom is an American video communications platform. It was founded in 2011 with a mission to transform video-first unified communications and is headquartered in San Jose, California. We currently employ over 5,000 people worldwide and continue to expand. We have an office in London and currently employ over 150 people across the United Kingdom.
Zoom was formed in 2011 because we felt there was a better way for people to communicate and work together. When the pandemic started, Zoom stepped up to expand the delivery of services to governments, families and businesses across the world, transforming the way we live, work and socialise. During the first lockdown in May 2020, Ofcom estimated that over 13.2 million adults across the UK used our platform and Zoom was the most downloaded app from the Apple app store in 2020.
We are proud of the way people turned to us during the pandemic, but this was an acceleration of changes already underway - a decade's transformation took place in 12 months. As we build forward from the pandemic, Zoom will be at the heart of the UK’s recovery, helping organisations across the public and private sector.
We are known for our best-in-class video conferencing tools, but also offer a growing range of other solutions including Zoom Rooms (to manage hybrid workplaces) and Zoom Events and Webinars, which enable people to come together remotely for everything from major conferences to yoga classes. We also offer Zoom Phone, which enables organisations to replace expensive fixed line telephone lines with an all in one, cloud based telephony service that combines phone and video into one, single unified platform for all their communication needs.
The worst global health crisis in 100 years forced the healthcare community to change where and how it cares for patients, with telehealth playing a number of critical roles during the COVID-19 pandemic. Unified communications platforms like Zoom enabled healthcare organisations to communicate and care for patients when doing so in person was not always possible, and so we are keen to share our perspective on the future of general practice, particularly as it relates to virtual healthcare provision. We have answered questions in detail where our experience as a telehealth platform has given us relevant insight.
At Zoom, we are privileged to have thousands of healthcare customers around the world. Here in the UK, we are in active use in 75% of NHS trusts and over 300 NHS organisations, and have hosted in excess of 2.1 million meetings for the NHS over the last twelve months, lasting for a combined 400 million minutes. Our NHS customers include partners such as Sussex Partnership NHS Foundation Trust, Southern Health NHS Foundation Trust, Midlands Partnership NHS Foundation Trust, and Great Ormond Street Hospital for Children NHS Foundation Trust.
In March 2020, when lockdown restrictions were first introduced in the UK, many healthcare providers quickly and successfully adapted to video conferencing and, within 10 months, 44.7% of GP appointments were taking place online using remote consultation platforms. In line with this, we have seen the use of Zoom increase significantly since the start of 2020 in general practice, including to enable video consultations between GPs and patients, collaborative team meetings between healthcare professionals, and training. Even as it has become easier for doctors to see patients in person, Zoom continues to host as many as 250,000 unique NHS meetings every month.
The pandemic has shown the potential for telehealth to increase patients’ access to specialists, particularly for those living in rural or remote areas. Virtual visits have also played a role in reducing no-shows and appointment cancellations, which cost global healthcare providers billions of pounds a year, and nearly 75% of telehealth patients reported high satisfaction with their experience. By enabling many non-urgent healthcare services to be delivered online, Zoom will have an important role to play in helping the NHS tackle backlogs.
What are the main barriers to accessing general practice and how can these be tackled?
Some of the main barriers to accessing general practice include: a lack of patient choice in how services are accessed; insufficient access to appropriate healthcare in rural areas; and limited availability of appointments. The pandemic has shown the potential of healthcare technologies to tackle some of these issues and improve the delivery of healthcare, including by reducing costs for practices, helping them to use resources more efficiently, increasing access to care, and improving patient outcomes. We propose that the expanded use of telehealth across the NHS should be considered part of post-pandemic recovery and NHS reform.
During the pandemic, the increased use of telehealth bolstered public health systems and improved health equity by reaching populations that have long been underserved or struggled with access to care. To a far greater degree than we have seen before, people living in rural areas, patients lacking reliable transportation or the ability to take time off work, and those with medical conditions that made it difficult to leave the house are now able to receive care when and how it’s most convenient for them.
For many people, outdated GP booking systems are a significant barrier to care. This is made explicit in NHS England’s ‘Our plan for improving access for patients and supporting general practice’, which cites the analogue telephony provision in most GP surgeries as a key contributor to the backlog in appointments burdening the NHS. By providing one unified platform for virtual care and communicating with patients, cloud based technologies like Zoom have the potential to transform how GP surgeries manage both virtual and in person appointments, reducing the number of cancellations and the costly impact of no shows. Zoom can be integrated seamlessly into existing Electronic Patient Record systems, meaning it is straightforward for practices to organise consultations over video without the need for a separate system. Ultimately this leads to more choice and higher quality care for patients, and additional features that support GP surgeries, such as the ability to offer ‘virtual waiting rooms’ in which patients are both safe and able to access helpful health information.
To what extent does the Government and NHS England’s plan for improving access for patients and supporting general practice address these barriers?
At Zoom we fully recognise the importance of face-to-face healthcare provision, but we also believe the Government and NHS England should consider the significant progress that has been made over the past two years in digital healthcare. This will help to ensure they don’t miss out on opportunities to improve the delivery of services. We were pleased to see patient choice mentioned in the plan, and believe there should be a particular emphasis on this, acknowledging that many groups value having choice over how they access virtual healthcare, whether by phone or video. This trend is likely to continue: consumer adoption of telehealth more than tripled from 11% in 2019 to 46% in April 2020, and Frost & Sullivan predicts the telehealth market will see a sevenfold growth rate by 2025.
What are the impacts when patients are unable to access general practice using their preferred method?
Patient choice is central to the high quality provision of healthcare. When patients are unable to access general practice using their preferred method, the quality of care is diminished and they are less likely to receive the care they need.
Reform to general practice should take into account that while some patients prefer to see their doctor in person, others prefer to access care virtually. This will also vary depending on the particular health concerns. A one-size-fits-all approach will likely increase barriers to accessing services and fail to take into consideration lessons learned from the COVID-19 pandemic.
What role does having a named GP—and being able to see that GP—play in providing patients with the continuity of care they need?
It is hugely important that patients are able to see their GP and have continuity of care. This includes giving patients a choice about how they see their GP, rather than assuming that face-to-face provision is preferable for all patients.
What are the main challenges facing general practice in the next 5 years?
In the next five years, general practices will face increasing challenges if they do not adapt to the recent pace of change seen during COVID-19, embrace technology and work to learn lessons from the pandemic to embed positive elements in the long term.
During COVID-19, general practice has faced enormous challenges and during this time the way patients interact with these services has changed substantially. Some of the changes taking place have been enabled by increased digital adoption and the rollout of existing technologies, which has been accelerated by the pandemic. According to McKinsey, telehealth utilisation has stabilised at levels 38 times higher than before the pandemic, ranging from 13% to 17% across all specialties.
Healthcare organisations are now routinely using high-quality video to:
● Provide care to patients directly in their homes;
● Enable providers to continue seeing patients and keep open their practices;
● Assemble global teams of medical experts for consultation and collaboration;
● Allow frontline healthcare workers to examine patients remotely to conserve PPE and reduce their risk of exposure.
To make the most of the technology that is available and avoid falling behind, in the next 5 years general practices should:
● Embrace high-quality, reliable audio and video, so care providers can communicate with, examine, diagnose, monitor, and treat patients virtually, even those with low bandwidth or outdated devices;
● Adopt technologies that enable GPs to upgrade phone calls to video calls with the click of a button - as Zoom Phone can.
● Ensure technology meets all of a practice's clinical and administrative needs, including integration with patient charts, medical devices, diagnostic tools, and other clinical applications, to streamline patient care;
● Provide a user-friendly, easy-to-access experience that accommodates all patients, including those with special accessibility needs and low digital literacy;
What can be done to reduce bureaucracy and burnout, and improve morale, in general practice?
The pandemic has exacerbated some of the challenges faced by general practices, particularly due to increased demand, the backlog in appointments, and COVID-19 restrictions. It has also shown how technology can play a role in helping to mitigate some of these challenges. Digital solutions have been shown to make the lives of GPs and other care providers easier by simplifying processes, improving efficiency and saving time. In this way, embracing technology has the potential to prevent the causes of burnout, including overwork and bureaucracy, and improve staff morale by allowing GPs to focus on their primary function as care providers.
Using technology to reach people directly in their homes during the pandemic not only helped to prevent the spread of COVID-19, but revolutionised how providers treat patients in ways that reduced pressure on GP surgeries. For example, telehealth has become essential to:
● Providing primary and urgent care for common ailments like colds and earaches without exposing patients to risk of contracting coronavirus;
● Conducting mental health appointments;
● Triaging patients with COVID-19 symptoms from home;
● Remotely monitoring patients with chronic conditions like heart disease or diabetes;
● Supporting healthy lifestyle changes, such as weight management or medication adherence.
Dec 2021