dr arvind madan hurley group & nhs england primary care
TRANSCRIPT
We need:Better AccessBetter Health OutcomesGreater Practice EfficiencyReduced Commissioner Costs
What is ?1. Self-help tools that allow patients to safely manage a proportion of
their own needs without visiting the practice, PLUS2. Condition-specific questionnaires which gather patient histories and
convert them into structured summaries for their GP to triage asynchronously
This improves patient access and speed to treatmentBUT CRUCIALLY
It also improves practices efficiency and reduces urgent care usage.
Developed by clinicians for clinicians, through a collaboration between Hurley Group and EMIS Health.
Constructing a SolutionPatient
identifiable?Agreed
response time?
Comms loop
closed?
Optimisesdata
capture
Betterfor
patient?
Better forGP
efficiencyBetter for
CCG? Scalable?
Email No No No No Yes Supply-leddemand? Against IG No
Text No Maybe Maybe No Yes Supply-leddemand?
Pilot Stopped Maybe
Webcam Yes Yes Yes Yes Yes Supply-leddemand
Pilots Awaited
Yes, but supply-led demand
The Task• Create comprehensive history gathering
questionnaires on many common general practice issues
• Patient focus e.g. language, tone, simplicity• Amplify the impact by combining it with self-
management options to top-slice appointment demand
The Team• Highly accomplished GPs • 5 authors and 30 reviewers• Deep user experience input • Design Council involvement • Astute programme architects• Stakeholders - MDU/MPS/MDDUS,
CQC, HSCIC and NHS Choices)
eConsult Yes Yes Yes Yes Yes YesReduced Urgent Care
Yes
Why not Email/Text or Webcam?
How we construct each eConsult
eConsult is designed to tick all the right boxes
Click First Strategy
Symptom Checkers
Pharmacy Advice
111 ClinicianSelf Help eConsult
Own GPPatient Access
Via Practice’s own Website
Tailorable for local services
Self-help and 111 options
Simple flow guide
Geared towards enticing patients
planning to call or come to the
practice in to going online, creating
both patient convenience AND practice efficiency
eConsult banner linked to any
Practice website
Patient Experience
Generic templates
Administrative helpNew
New
Patient Selects or Searches for their issue
Patient Self-manages or selects to eConsult
Patient Self-manages or selects to eConsult
Patient Self-manages or selects to eConsult
Patient Self-manages or selects to eConsult
Patient Self-manages or selects to eConsult
eConsult process
eConsult process
eConsult process
Red-Flag questions are embedded in
each questionnaire to intercept patients
with serious symptoms and
direct them to take urgent action immediately
eConsult process
eConsult process
eConsult process
eConsult process
Practice Workflow
Symptom checkers
Self-help videos and
articles
Sign-posted content
eConsult NHS 111
No Action Required
No Action Required
No Action Required
No Action Required
Admin monitor shared
mailbox for eConsult reports
Task for Clinician
40% Offered Prescription
NHS Mail
20% Telephone Consultation
40% Offered Appointment
Clinician reviews
eConsult report
Average 2.9 mins per eConsult
60% Managed remotely
Call Patient back
eConsult exampleNew
Benefits from the PilotImproved Access
9 1 in 5 patients used the website at least once9 83% FFT and 95% state website is good or excellent9 High uptake by under 45’s, ethnic minorities and 2/3 women9 33% from mobile phones
Better Health Outcomes9 Earlier treatment9 Digital disinhibition e.g. depression, rectal bleeding9 Red-flag questions prompt action e.g. cancer detection
Increased Practice Efficiency9 1/3rd use self-help and 18% then self-manage9 60% of eConsults closed remotely9 Only 3% of eConsults due to supply-led demand9 9 self-help uses for each eConsult generated9 Easily accommodated in normal working day of GP
Commissioner Savings9 14% of users said they would have gone to urgent care9 3 for 1 return on investment e.g. Southwark CCG saved £360K9 More time for complex cases = reduced LTC complications
6Months
20Practices
10CCGs
133kPatients
Testimonials
Easy to navigate and very informativeYou may not need to come in at allSaved a lot of time for meMore people would use it if they were aware
Technically very simple and no jargonMuch quicker with no waiting Was able to go straight to pharmacistHighly recommend as first port of call
Fantastic ideaI’m not a computer whizz, but really easyFollowed step by step on my mobile phoneWas a better option for me
What patients say…
TestimonialsWhat practices say…
What Commissioners say…
Media coverage
eConsult is the way forward in 21st Century patient access to primary care. Our patients like it as it provides prompt, convenient access to address their concerns and needs. Our GPs like it as it as it provides a time efficient and safe way to manage a wide range of patient health issues.Dr Ajit Kadirgamar Clinical Lead for The Practice +
Giving patients the option of self-managing presenting conditions is definitely the way forward in terms of extending patient choice and helping to manage the increasing demand faced by our GPs, especially when this is supported by an option to eConsult if further assurance is required.Feedback from patients using it in South Essex has been very positive … just wish I had this option at my own GP practice in Kent!Jeanette Hucey, Associate Director of Transformation Basildon and Brentwood CCG
Now availableto over 1M
patients in UK
Price/Features• 63p per registered patient per annum
• £200 of patient promotional material per practice included
• GP Web Solutions website for each practice included (or integrated in to the existing practice website)
• Remote Deployment
• 1-2-1 Remote Training (if required)
• 24/7 Telephone & Email Support
• Continual Product Development
• Continual Maintenance
• Secure Hosting
• CQC Approved
• Content powered by NHS Choices
5 Steps to Go Live
1. You quantify your
requirements and inform us
We send you the Quote
2. You Return the
Quote Acceptance
form
We discuss and confirm
your requirements
3. You confirm details online
We send you the Contract
4. You sign the Contract
5. Mobilise•Choose promotional material•Teams watch training video
We add eConsult to practices websites
Go Live
Purchaser
EMIS Health
Future DevelopmentsBetter Content• Pre-appointment and follow-up templatesBetter FeedbackPop-up, post-eConsult and patient surveys feed an automated dashboard for practices and commissioners to log-in and reviewInteroperability with all Clinical Software Systems• eConsults sent directly into workflow manager in EMIS Web• Read coding of data e.g. smoking and alcohol statusIntegration with out of hours and urgent care services • A&E and UCC versions of eConsult • A&E and GP waiting room kiosk versions• App for rapid access from smart devices
SummaryMany talk about how existing general practice is unsustainable but few provide real solutions...
9 Better access 9 Better outcomes 9 Better use of practice resources9 Commissioner savings
Access
Efficiency
Quality
Thank you