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Dr Chris Whittle is the Founder and CEO of Q doctor. He studied both his medical degree and BSc in Neuroscience at the University of Edinburgh. It was during his anaesthesics training programme in 2015 that Chris decided to combine his interest in IT with his problem solving skills. Q doctor represents the fruit of that work and is now the leading CQC regulated platform delivering video consultations for NHS organisations. Chris is also a NHS clinical entrepreneur fellow with a keen eye on new healthcare startups.

 

Interview

Firstly, what does Q doctor do?

Effectively what Q doctor does is use video consulting technology to put both patients and clinicians together. Now that sounds like a very simple ask, but the complexity comes with fitting this into the dynamics of the NHS, especially when you consider all the different types of patient pathways in the NHS and their associated requirements. As a patient you go into the system and you might have called 111 or 999, or perhaps have gone to your GP or you might even be going to an outpatient appointment. Those interactions have very different flows in terms of who you are talking to first, who you get referred to and where the information is passed.  Our system manages all of that and then gives the NHS hierarchy the right data control view of what’s going on. This helps demonstrate the benefit from a business case model perspective to the NHS system i.e. what is video actually delivering or what is video consultation delivering that telephone consultations are not.

We first started in General Practice by linking up doctors with patients. Then we went on to customise the platform towards the 111 setting, becoming the best video provider in this setting. Since then we have established ourselves in the ambulance service, care homes, community providers and outpatient clinics. They all have slightly different needs from a patient flow perspective.

How did you make the shift from anaesthetics training to Q doctor founder? Do you miss the clinical aspects of the NHS?

I was working full-time in anaesthetics within the South Coast & Wessex area when I started speaking to various clinicians about the problems within the NHS. I am someone who likes to solve problems and discuss with others how systems can be improved. In addition to that I have always had a bit of an interest in IT.

So during a period of annual leave, I started to delve into programming. From there, I went on to build a very early stage minimal viable product. I think it just had chat functionality at the time with no video involved. However, it was enough to take to some investors. I found some angel investors with backgrounds in healthcare and showed them my plans as well as how we would proceed to market. Meanwhile I was also reading a 5-day MBA book on commercial fields to make sure I had a credible and sustainable business model.

I’m not currently working clinically, while the company is in full flight.  The parts I miss are more than made up for with the clinical exposure I get with managing our platform and services at scale and helping clinicians directly. As a result I feel like I am seeing all aspects of healthcare. Now I am involved in moving things forward and so see myself as a clinical entrepreneur.

I think it just had chat functionality at the time with no video involved. However, it was enough to take to some investors.

What is unique about Q doctor when compared to other tele-health companies?

I think there are a couple of aspects to that. The first and probably most important factor is our proximity to the NHS and the NHS heritage. We built this right from the very beginning with NHS doctors. We built Q doctor in partnership with NHS organisations who want sustainability, visibility and a hierarchical view. Arguably the best and most recent example of this has been our work in Lincolnshire. We managed to establish the use of our platform across the whole county with the entire primary care network i.e. hospitals, community clinics etc. This enabled us to showcase a complete visibility of what was going on in the healthcare system – a feat that I don’t believe has been historically achieved in our sector!

Additionally, the patient satisfaction is practically a given because the technology has been tried and tested with patient user groups. That has been something we knew would be helpful. Our focus has always been on how we ensure that the platform is delivering for the NHS and making it better. With that perspective I feel that we have an extra edge.

Most other tele-health companies have come through from a private healthcare perspective. Hence their approach is often: we have this video platform that patients or the NHS will pay for because it’s so convenient. There are more video software providers for the NHS than ever before. The key marker that differentiates us is that we started from within the NHS and built our platform in mind of the value it would specifically add.

The key marker that differentiates us is we started from within the NHS and built our platform in mind of the value it would specifically add.

And, how did you arrive at the name Q doctor?

It actually came about through one of our directors who was heavily involved in the creation of the QRISK scoring tool associated with cardiology and heart disease.Q doctor is the company trading name but the main product is called Q health that, as you can tell from the name, reaches across a lot of health professional groups.

What have you made of the Covid-19 pandemic, and how has it affected healthcare delivery?

Clearly there was a massive response to the pandemic and, bearing in mind that we are being geared towards preparing for a potential second wave, it has been good to see the freedom and openness to innovation. The pandemic has allowed greater delivery of remote consultations. Obviously that is something we are reaping the benefits of, as we were before the pandemic came along. I think one of the positives, not that there are huge positives to a pandemic, but one positive is that you can clearly show that patients can get safe and effective care delivered remotely. This cannot always happen, and I am certainly not advocating the replacement of face-to-face consultations, but there are a lot of cases where significant healthcare interventions can and have been delivered remotely.

We were in a really nice position to help out during the pandemic as we were already delivering a digital locum service to GP practices. This involved linking GPs from various parts of the country into GP practices through video. We had the infrastructure set up and links to the NHS network with secure and functioning laptops ready to drop at people’s homes. As a result, we were able to turn to the NHS during the pandemic and say we have a solution in this product that is currently being used for a slightly different purpose.

We were able to turn to the NHS during the pandemic and say we have a solution in this product that is currently being used for a slightly different purpose.

What have been the biggest challenges for you and your team in this Q doctor journey?

Pre-pandemic the main challenge was how to build the business case and prove that video consultation does X Y and Z better than telephone consultation. We still focus on this aspect a lot. In fact, as part of our ongoing business case we ask clinicians for feedback as to whether this method provided more information than a telephone consultation would have done.

Since the pandemic, there is a lot more willingness to consult remotely and the benefits are clearer than ever. The challenge now is delivering our product sustainably and at scale particularly across all the different work from home environments that have become commonplace.

Data security is another huge challenge. We have to make sure we address it transparently. People are quite rightly worried about what happens with their data and whether there are people out there mining their data. There is definitely an underhanded aspect to digitisation that is happening so quickly. Right from the beginning we spent a lot of time on security. We go through central frameworks and are on a platform called GP IT Futures that ensures we’re accredited around security. We have been in a fortunate position because we have been NHS-centric since the early days and this has allowed us to follow the latest guidance on what we should be doing with NHS data. You can’t get it wrong and hope for forgiveness in this scenario. It is not the way trust is built and the element of trust is key to this process.

We go through central frameworks and are on a platform called GP IT Futures that ensures we’re accredited around security

What tips and tricks would you give to a younger version of yourself knowing what you know now?

I believe it is very important to seek support from those who have done it before you. This is particularly significant in healthcare where the NHS has typically been very slow moving in adopting new technology. There are ways in which you need to orientate your thinking to make sure you arrive at some tangible value that the NHS organisation can realise. So I guess I would tell my younger self that you need to focus on making sure that the NHS organisation understands what the benefit is here and how are you proving that. You can definitely achieve that more succinctly or more speedily by talking to people who have innovated for the health service before.

I believe it is very important to seek support from those who have done it before you.

What are the biggest barriers to doctors becoming entrepreneurs?

I think it comes down to how they manage to balance the day job and their innovations at the same time. Sometimes the barriers or challenges can be found on the legal front. Concerns can arise over intellectual property if doctors consider the employer the owner of their product simply because they are employed.

That is what makes the NHS Clinical Entrepreneurs Program great. Its focus is on helping frontline innovators remain in the NHS to actually innovate within it and complement it. It provides an avenue for more and more clinicians to be able to team up and innovate together.  That teamwork is invaluable in overcoming the aforementioned challenges. Consequently when you have 2 or 3 clinical co-founders the workload can be distributed appropriately from an early stage.  The shared responsibility also means that you do not lose out on the benefits of clinical interaction, which is paramount because it provides a real time finger on the pulse as to what is and is not needed in the development of an idea or product.

Sometimes the barriers or challenges can be found on the legal front

And to finish, you have a keen eye on health start-ups. Are there any digital health start-ups in particular that have caught your interest?

There are others in tangential spaces to us such as a company called E Consult. They put a lot of work into building a clinically-safe triage tool, and are the biggest triage provider in primary care.

From our viewpoint it made a lot of sense to partner with them during the pandemic because they had a product that was tried and tested.

There are also a number of companies working in the wearable technology domain. They are looking at exciting things such as monitoring vital signs remotely. We are constantly analysing the landscape for which of these is the best to feed into our platform and enhance it further.

We are constantly analysing the landscape for which of these is the best to feed into our platform and enhance it further.

 

 

 

 

About The Author

Binyamin Adio

Binyamin Adio is a final year medical student at King's College London. He also works as a clinical pharmacist for BMI healthcare in elective surgery and oncology. Acute Internal Medicine is the specialist field in which he aspires to work. Binyamin's interests are medical journalism, clinical entrepreneurship and functional medicine.

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