Deep Dive into Patient Online
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Alan McDermott, Regional Director Patients and Information, NHS England Masood Nazir, National Clinical Lead, Patient Online NHS England Trevor Fossey, NHS England Patient Working Together Group
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Deep Dive into Patient Online
- 1. Alan McDermott Regional Director Patients & Information NHS England
- 2. Patients and Public Will be able to: a) more effectively share in the responsibility for their health and welfare b) have more convenient access to NHS Services Clinicians/Practices Will be able to devote more of their time to supporting the clinical needs of patients rather than dealing with administrative and support tasks that patients can carry out for themselves NHS Will benefit from improved health outcomes for patients, increased patient satisfaction and reduced administrative costs
- 3. Online appointment booking Online repeat prescriptions Online access to records
- 4. 647,560 866,465 819,144 890,480 893,268 977,331 888,314 1,022,8011,060,302 1,248,620 6,516,3686,656,527 7,003,498 7,392,2187,575,2157,758,2117,845,1897,973,649 8,290,5728,413,199 0 2,000,000 4,000,000 6,000,000 8,000,000 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar No. of appointments booked/cancelled online No. patients enabled for online appointment booking Linear (No. of appointments booked/cancelled online) Linear (No. patients enabled for online appointment booking) January 2016 • 8.4m patients enabled for online appointment booking • Increase from 6.5m in April 2015 – 29% increase • 1.2m appointments booked/ cancelled online • Increase from 0.6m in April 2015 – 92% increase DNAs are lower with online Appointments % DNA Appointments booked conventionally 4.3% Appointments booked online 2.5% Number of Appointments Booked/Cancelled Online
- 5. 1,181,1871,252,3441,265,7511,322,0371,319,9011,340,6431,355,9781,399,2511,397,0881,491,463 6,222,877 6,496,386 6,839,541 7,221,6227,393,0077,564,3917,647,2677,777,473 8,096,6588,216,096 0 2,000,000 4,000,000 6,000,000 8,000,000 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Repeat Prescriptions Ordered Online No. Patients Enabled Linear (Repeat Prescriptions Ordered Online) Linear (No. Patients Enabled) January 2016 8.2m patients enabled for online prescriptions ordering Increase from 6.2m in April 2015 – 32% increase 1.5m repeat prescriptions ordered online Increase from 1.2m in April 2015 – 26% increase Number of Repeat Prescriptions Ordered Online/Number of Patients Enabled for Online Repeat Prescriptions
- 6. 5% 11% 12% 15% 20% 24% 29% 36% 44% 52% 60% 68% 78% 92% 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 1-Jan 8-Jan 15-Jan 22-Jan 29-Jan 5-Feb 12-Feb 19-Feb 26-Feb 4-Mar 11-Mar 18-Mar 25-Mar 1-Apr *Preliminary Statistics %Enabledforonlineaccesstorecords No.Practices
- 11. • Minimum 10% of patients registered for online services at each GP Practice, 25% in transformation areas • Minimum 20% of patients registered for online services at each GP Practice, 50% in transformation areas • Patients able to view information from all clinical settings across the health system • Patients able to write into their GP record • 15% of patients using Apps / smartphones to access NHS services • Patients able to view information from all health and social care settings • Paper free at point of care
- 13. 18.5% Of activity takes place at the weekend On a typical weekday 47.1% of activity is either before 08:00 or after 18:00 Every appointment booked and each prescription ordered is one less to deal with manually.
- 15. Improve safety Look up medical jargon Improve health control Improve knowledge and health literacy Improve access and convenience Reduce errors and duplications Less pressure on staff Increase use of SMS Save phone calls Increase patient satisfaction Improve communication with patients Administrative time saving Source: http://goo.gl/49oD49 Saving time and resources
- 16. www.england.nhs.uk Under 40 In England 15 million people have a long-term condition. Most individual long-term conditions are more common in people from lower socio-economic groups, and are usually more severe even in conditions where prevalence is lower. GP appointment Outpatient appointments Inpatient bed days http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and-disability/long-term-conditions-multi-morbidity AGE PATIENTS WITH LTC Over 60 58% 14% 50% 64% 70%
- 17. www.england.nhs.uk This is an example of categories of information that patients may see. This may be presented differently by each supplier. Demographics Allergies/Adverse Reactions Medication (dose, quantity and last issued date) Immunisations Results (numerical values and normal range) Values (BP, PEFR) Problems/Diagnoses Procedure Codes (medical or surgical) and codes in consultation (signs, symptoms) Codes showing referral made or letters received (no attachments) Other Codes (ethnicity, QOF) Some of the information in list above will depend on what your clinical system is able to routinely display.
- 18. www.england.nhs.uk Free Text Letters and Attachments Administrative Items • Diary Entries/Recalls • Special Notes/Warnings • Tasks/Emails/Internal Messages The following categories are examples of items that are not required to be displayed. However, you may choose to make them available.
- 19. www.england.nhs.uk New practice baselines Detailed interviews with patients Promotion to the public Building benefits evidence Case studies and videos preparation For other suppliers focus on preparation Focus on enabling record access where system in place Answering practice and patients queries Developing guidance & policies Engagement (CCG and LMC engagement, workshops for practice managers, training for CSUs/HISs)
- 20. A patient’s experience of using Patient Online Trevor Fossey Member of the Patients Working Together Group (PWTG) Twitter: @Trevor Fossey Email:Trevor.Fossey@Outlook.com
- 21. Power of Information • On PPG agenda/ engaged • Easy read version Personal access to GP Records My personal journey to access to my personal records at: Regis Medical Centre, West Midlands Access to GP record • Jan 2014 • Experience Benefits 20152014 Transactions available • Online Medication • Online Booking Promote benefits • PPG to support • Share benefits at workshops & via Social Media 2016 Support others & GP • Including via LCGs & C4CC • Demonstrate benefits • Overcome Barriers 2017 Embed in culture • Encourage CCG to support • Online access as ‘the norm’ for all citizens 20132012
- 22. Personal experience since Jan 2014 Three main benefits Outcome: Able to review note at home, and contemplate – and take self-help action Issue fully resolved, no medication or GP time required • Proxy access – since November 2015 (current) • Blood Test results – February 2015 Outcome: Outcome: 30 minute diabetes annual review completed within 10 minutes, & more value Time saving & better control of diabetes reduction in Hb1Ac level Able to review notes at home, and contemplate – and share when appropriate Enhanced Integrated care provided, with benefits of all being ‘in the loop’ Able to ‘take time’ to review blood test results at home, using resources available online Identify issues more focused consultation. Saved time & more value Health of partner deteriorated and regular home visits & ongoing treatment Visits include from various agencies, clinicians/nurses and specialists • Mental Health – March 2014
- 23. View GP records online Overview/summary of experience • Greater involvement in own wellbeing • Feel more in control & engaged with my own health • Less risk if I have future issues peace of mind and ‘at ease’ • More inclined to visit doctor if required, because I can then see and review what has been put in the records (‘man thing’?!) • Now feel that Physical Health is on a more equal footing with Financial Health • Good foundation for the future & easy to access Personal experience: Summary Records online “has first enhanced the relationship that I have with my GP practice - and I am confident that it will improve my health & wellbeing and the person for whom I care”
- 24. Vision and scope workshop – Summary (which identifies barriers to wider engagement?)
- 25. Trevor Fossey • Patient representative on the PWTG • Co-Production member & Shadow Co-Chair • Coalition for Collaborative Care • Lay member of Black Country LCG • Member of Regis Medical Centre PPG Mobile: +44 7932 223 449 Email: Trevor.Fossey@Outlook.com Twitter: @TrevorFossey#PatientOnline LinkedIn: http://www.linkedin.com/pub/trevor-fossey/15/b44/10a Thank you for your attention Questions?
Notes de l'éditeur
- About 15 million people in England have a long-term condition. Long-term conditions or chronic diseases are conditions for which there is currently no cure, and which are managed with drugs and other treatment, for example: diabetes, chronic obstructive pulmonary disease, arthritis and hypertension. Long-term conditions are more prevalent in older people (58 per cent of people over 60 compared to 14 per cent under 40) and in more deprived groups (people in the poorest social class have a 60 per cent higher prevalence than those in the richest social class and 30 per cent more severity of disease). People with long-term conditions now account for about 50 per cent of all GP appointments, 64 per cent of all outpatient appointments and over 70 per cent of all inpatient bed days. Treatment and care for people with long-term conditions is estimated to take up around £7 in every £10 of total health and social care expenditure. Projections for the future of long-term conditions are not straightforward. The Department of Health (based on self-reported health) estimates that the overall number of people with at least one long-term condition may remain relatively stable until 2018. However, analysis of individual conditions suggests that the numbers are growing, and the number of people with multiple long-term conditions appears to be rising. Socio-economic distribution of long-term conditions Most individual long-term conditions are more common in people from lower socio-economic groups, and are usually more severe even in conditions where prevalence is lower – for example, stroke. General Household Survey data (2006), analysed by the Department of Health below, shows those from unskilled occupations (52 per cent) suffer from long-term conditions more than groups from professional occupations (33 per cent).
- For Example Diagnosis codes – Asthma, Suspected UTI, Viral illness (in readcodes this is mainly the codes starting with a letter eg H33) Codes about signs and symptoms – anything patient reports or doctor finds – cough, vomiting, abdominal tenderness, normal heart sounds Procedure codes – operations, injections, ear syringing, dressings etc – anything we do to the patient Administrative codes – everything else! – ethnicity, occupation, recalls, QOF codes, exemption codes, referrals (8H…), letter to patient, etc etc Practice Level Configuration All coded data Patient Level Configuration Control to enable this option set on by default Desirable Requirements Control to enable this option to be evaluated in each system ? Enabled on case by case basis
- Implementation approach for Jul – Sep Transactions first Better performing practices – from now Use practice managers network to spread the word Select specific low performing practices, use strategy Begin case study interviews Strategy for low performing practices Prioritise practices to contact Implementation Lead phone call offering support, including contact with high performing practices locally Engage CSU/HIS services etc. to provide assistance if appropriate Data analysis Use data to demonstrate activity in CCG areas