Health tech slides 12 june 2019
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Browne Jacobson, Deloitte and DoctorLink are pleased to invite you to our first joint health tech seminar with leading industry thought leaders. This will be a practical session, sharing experience from across the NHS and beyond to inform options on how to improve services, break down silos and focus on population health outcomes. This event is exclusively for Commissioners, GPs, and Policymakers keen to understand how new integrated care systems and models of care can meet the needs of their local population and can be implemented pragmatically and affordably to drive improvement goals and achieve better health, better care and better value.
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Health tech slides 12 june 2019
- 1. 12 June 2019 Re-imagining care - enabling integrated care systems in the digital era
- 2. The transition to integrated care Population health management in England https://www2.deloitte.com/uk/en/pages/public-sector/articles/population-health-management.html
- 3. 3 The case for change Source: Office of National Statistics: National life tables 2015-2017. • Average life expectancy has increased, but the rate of improvement has stalled. • There is inequality between regions (e.g. East of England, vs. North East England) and within regions, suggesting that deprivation rather than geography is the cause. • While growing numbers of people are living longer, extra life years are not always spent in good health due mainly to an increasing prevalence of long-term chronic conditions, such as coronary heart disease, chronic obstructive pulmonary disorder and diabetes.
- 4. 4 Health systems are coming together to address challenges and build population health capabilities to improve outcomes England’s changing policy landscape - the move towards integrated care systems Regional Health Economies formed Sustainability and Transformation Partnerships (STPs) 42 (was 44) Integrated Care Systems Health Systems Support Framework to help systems purchase Population Health Capabilities 14 For an STP to develop into an ICS it has to take on a budget for a defined population’s health provision; and amongst other things, show it is capable of the efficient implementation of an integrated Population Health Management (PHM) strategy. In 2018, recognising the need for shared care records to underpin an effective ICSs, NHS England established five Local Health and Care Record Exemplars (LHCREs). The objectives of these are to support care delivery, integration of health with care, improve co-ordination & provide a foundation for health analytics & PHM
- 5. 5 Enablers of PHM - key building blocks & critical success factors The recent NHS Long Term Plan moves policy further, based on Integrated Care System (ICSs) as the main organising principle for delivering a PHM approach. Our report identified four building blocks for PHM: Infrastructure, Insight, Interventions and Impacts and nine critical success factors for achieving PHM:
- 6. 6 6 Primary Care Networks: supporting extended primary care at scale Locality (or “place-based”) level in larger ICS areas, e.g. London Boroughs within an STP / ICS footprint Integrated Care System partnership working at a whole system level Integratedandalignedjoined-upworking Integrated Care System Locality PC Network Circa 30,000 – 50,000 population Integrated System working Delivering better care and achieving better outcomes, given demand increases and workforce pressures, requires new ways of sharing information to support new ways of working Individual General Practice Level Practice Level
- 7. 7 Keep well patients well • Lifestyle • Public Health Advice • Screening • Apps / Wearables • Near Patient Testing • Retail Genomics PCN HOURS Options when feeling unwell Patient Health Journeys General Practice • nhs.uk • NHS App • Practice Websites • Online /video Consultations • Practice Receptionists • Care Navigators • GP / Practice Nurse Triage • GPs • Practice Nurses • Physician Associates • Clinical Pharmacists Community Based Primary Care Network Services (30-50K) • nhs.uk • NHS App • Hub Website • Directory of Services • Online / video Consultations • Hub Receptionists • Care Navigators • Nurses • GPs • Social Prescribing Link Workers • GP Access Hub • Nurses • Physician Associates • Pharmacists • Physiotherapists • Paramedics • Social Prescribing • Mental Health Therapists • Midwifery • Health Trainers • Smoking Cessation • Sexual Health Clinic • Substance Misuse • Community Nurses • Specialist Nurse-led Teams • Specialist Outpatients • Frailty Team • Intermediate Care Beds • Some Diagnostics Urgent Care • nhs.uk • NHS App • Directory of Services • Online / video • 111 Call Handlers • and range of clinicians • Ambulance Service • Community Pharmacies • General Practices • Access Hubs • GP Home Visiting Services • UTCs Digital Phone Face to Face
- 8. The Insights We Have developments in population health analytics https://www2.deloitte.com/uk/en/pages/public-sector/articles/population-health-management.html
- 9. 9
- 11. 11 Population Health Demand Planning
- 12. 12 Identifying Population Health Priorities
- 13. 13 Care Model Design – Complex Care Hub
- 14. 14 Iterative Learning Cycle 1. Plan your evaluation framework 2. Learn from other systems 3. Clearly define cohorts Top Tips
- 15. 15 Investing in Population Health
- 16. What Approaches Work – Tackling some common ‘thorny issues’ that facilitate data use Gerard Hanratty
- 17. GDPR & DPA Processing Personal Data The Truth
- 18. GDPR: a framework not a barrier — The GDPR provides a framework within which to make decisions around how you use personal data; — There are some fixed points and specific requirements but it is important to understand that the GDPR builds on the existing legislative framework that was in place pre 25 May 2018 and that it provides a flexible framework that can be used in different ways, depending on the purpose of your processing
- 19. Consent: not the only basis — The significance of consent under the GDPR has been over- stated — The changes that were introduced clarified what was valid consent but the GDPR does not require you to use consent when processing personal data, including special category data — In the context of health data, Article 6(1)(e) and 9(2)(h) provide a good starting point (and it is important to note that 6(1)(e) is not restricted to public bodies exercising statutory functions)
- 20. What does the ICO say about consent? — The ICO’s guidance clearly states that “Consent is one lawful basis for processing, but there are alternatives. Consent is not inherently better or more important than these alternatives… — Consent is appropriate if you can offer people real choice and control over how you use their data, and want to build their trust and engagement. But if you cannot offer a genuine choice, consent is not appropriate. If you would still process the personal data without consent, asking for consent is misleading and inherently unfair. — If you make consent a precondition of a service, it is unlikely to be the most appropriate lawful basis.” (emphasis added)
- 21. Transparency — Even if you do not use consent as the basis for your processing, you are still required to be open and transparent with data subjects about the ways in which their data will be used. — There are specific requirements that apply to children and the GDPR places emphasis on transparency information being “plain English” and drafted with the particular audience in mind
- 22. Don’t forget…confidentiality — As well as considering the GDPR, when you are considering using health data you also need to be aware of the common law requirements of confidentiality and how these might apply — Streams and Google DeepMind
- 23. Practical tips — Map out your proposed data flows and the ways in which the data will be used — Carry out a DPIA — This will help inform your analysis of what legal basis best applies to the proposed processing
- 24. Information Governance — Policy alignment across integrated care partnerships and systems • Local policies across public authorities • NHS Digital - Data Security and Protection Toolkit (DS&PT) • NHS England&Improvement — Housekeeping • What personal data do you hold? • Can you list all data which you hold and where it is?
- 25. Integrated Care Systems — Primary Care Networks (neighbourhood) + Integrated Care Partnerships (place) = ICS’s (system) — Aligned polices are needed for data to flow and improve health & social care delivery — Data platforms/systems need to integrate and talk to each other — New data systems should be ICS compatible and enable national sharing…..(Paula)
- 26. Paula Dumbill Contracts: Building for Integration
- 27. Agenda •The landscape •The “big contracts” challenges to disaggregation Timetable, process, term and termination Exit management, IP •Re-procurement challenges Form of contract Building for diverse requirements Delays, risks, dependencies and assumptions •Integration by design Collaboration, performance, change management, governance
- 28. Out with the big service contracts — Leveraging the potential of technology — Enabling patients to take active role — Enabling staff to access and advise — World-class digitalisation
- 29. The challenges to disaggregation • Term and termination • Termination in part • Exit Management • IP ownership, continuing rights to use
- 30. The re procurement challenges – Form of contract and frameworks – Project / solution focussed – Building for diverse requirements – Dealing with delays, risks, dependencies and assumptions – Planning for exit, IP ownership and AI
- 31. Portrait of Edmond Belamy $432,500
- 32. Integration by design Create contract structure to facilitate integration Building the bridges: Performance and reporting Change management Governance Security Collaboration
- 33. To summarise Challenges to disaggregation – termination, exit and IP Challenges to re-procurement – form of contract, requirements, contractual mechanisms for agility Tips and techniques for integration by design
- 34. Any Questions +44 (0) 115 976 6059 Paula.Dumbill@brownejacobson.com Gerard Hanratty gerard.hanratty@brownejacobson.com +44 (0)7921 685815 Paula Dumbill
- 35. Reimagining Primary Care A case for change, primary care at scale Mindy Daeschner
- 36. Primary care now - surviving? Workforce • Inability to recruit to most staff groups. • Significant proportion of primary care staff coming up to retirement Financial • Funding not kept pace with demand • Rising cost of provision Quality issues Demand Estates & IT • Patient Expectations • Frailty & Complexity • Shift of care from acute to primary • Many Practices operating out of poor estate • Lack of investment and fragmentation in IT systems & support
- 37. The emerging system to support ICS Financial Supporting individuals to manage their own care through self-care, care navigation and improving patient activation Neighbourhood 30 - 50k Primary care Networks that bring together local health and care professionals around natural local neighbourhoods of care – improving integrated ways of working and more joined-up pathways; and embedding population health approaches Groups of local primary care networks that work alongside partners in secondary care, mental health and with CCG’s and local authorities, to: • Integrate health and care services • Work preventatively to stop people becoming acutely unwell • Care models to redesign care Place 250-500k System 1+m Providers and commissioners collaborating to: • Hold a system control total • Implement strategic change • Take on responsibilities for operational and financial performances • Population health management NHSE(2018) NHS Expo presentation
- 38. A workforce for integration, with a strong focus on partnerships spanning primary care, secondary and social care Primary care at scale: A form of primary care network
- 39. 70Since the inception of the NHS, there has been little change to the model of how patients access general practice and urgent care… 1948 - 2018 YEARS OF THE
- 40. Meanwhile other sectors have fully embraced digital technology to fundamentally change the way they engage with consumers
- 41. What is our approach? Most Common Transactions • Appointments • Symptoms Assessment • Repeat Prescriptions Relevant Services for the Patient • Best-in-class • Brings them back! Real Benefits for the GPs & ICS • Demand Management • More satisfied patients
- 42. Doctorlink - the digital front door Improved policy making Harmonised financings flow Regulation Governance
- 43. NHS Primary Care and Digital Specialist Sami Nur
- 44. • 16 million calls to NHS 111 • 350 million GP Consultations • 24 million visits to A&E • 1.4 million patients everyday
- 45. Surgeries are ready for change
- 46. Digitising triage and advice can make this more of a reality than a ‘promised land’ Opportunities Concerns - Manage demand for in-surgery appointments, especially same day. - Provide support & advice 24/7 – alleviate burden on out of hours. - Integrated appointment booking. - Reduced strain on reception. - Direct patients to the most appropriate form of care. - Integration with existing IT systems. - Transitioning patients & changing behavior's. - Suitability for patient-list demographic. - Reliability of technology & indemnity.
- 47. Outcomes in SWL • Implemented in 33 practices Dispositions (all practices)
- 48. What could a new era for surgeries look like? More time to see priority patients Satisfied patients Less receptionist time spent on the phone or dealing with front desk enquiries Overall cost savings due to efficiencies Effective & efficient consultations
- 49. Case study – Portland Medical Centre • Since the roll-out of Doctorlink in October 2018, >3,200 patients have registered for the service, representing 27% of Portland’s patient list. • 23% of those patients have re-routed to alternative care, such as emergency services and home care • Over 40% of patients are accessing the service out of standard opening hours.
- 50. New ways of working Primary Care Networks and ICS’s provide more opportunities to deliver uniform digital transformation on a larger footprint New GP contract heralds major change in Primary Care Workforce
- 51. Empowering the patient, empowering the system Andrew Gardner - CEO
- 52. What are the patient’s pain points? Waiting time to see a clinician Having to wait on the phone for long periods of time to get through to the practice Can only phone the practice for an appointment during a certain time Appointment running late Users see the receptionist as a blocker / trying to stop them getting the appointment they need
- 53. What is our approach? Deliver value to the patient and the system Most Common Transactions • Appointments • Symptoms Assessment • Repeat Prescriptions Relevant Services for the Patient • Solve their pain points! Real Benefits for the GPs & ICS • Demand Management • More satisfied patients
- 54. The digital channel is a great way of engaging the patient in their health care We can provide and receive comprehensive information which is not possible over the phone Educating and encouraging the patient to use the channel is vital to drive up adoption What is the solution to managing patient demand? On-line advice Self care Long term condition management
- 55. Simplifying the Patient Journey (24x7) The right model to ensure success Pathways Clinical Algorithms Outcome disposition • Possible conditions • Urgent / timescales • What to do • Educational info • Face to face • Video consultation • Messaging • Call back • Web chat Engagement Call to action (CTA) • Real-time • Scheduled • Referral Intelligent mapping Condition = Service • Urgency + opening hours • Skill sets required • Diagnostic required • Location to patient Services Service listings • Service A – plus CTA • Service B – plus CTA • Service C – plus CTA Services can be bricks & mortar, hub & spoke, digital Ability to localise service prioritisation Transfer Simplifying the Patient Journey (24x7)
- 56. General Patients understand what Doctorlink is trying to achieve and agree that patients need to be triaged to deal with the increasing demand on the practices “It sounds like a great idea and I understand people need to be triaged. That’s why I signed up” - Judith “I am pleased to see they are looking to manage the increasing load on the surgery. On the face of it, it looks good.” - Paul “I think DoctorLink is an excellent tool, especially at a time when it's so hard to access a GP” - Diane
- 57. New channels of communication are convenient for patients and allow GP practices to transform the way they use their resources and the resources they use
- 59. Check symptoms 24/7 • Proven algorithms • Clinically approved • Takes an average of 4 mins • Fully indemnified
- 61. Book an appointment • Integrated into results • Easy to navigate • No more waiting on hold
- 62. How VC works for patients Login Doctorlink Patient dashboard Check symptoms Choose a slot if eligible Confirm appointment Check-in Video consultation with your practice doctor
- 63. Appointments redirected Over 15% of patient’s are being recommended homecare for their treatment, who would have previously presented for a surgery appointment. This could continue to rise to around 20%.
- 64. Results to date
- 65. Questions?
Notes de l'éditeur
- So why should people look at population health? Well when you look at some of the health outcomes in the UK, there is significant room for improvement. Life expectancy is slowing down and did not improve between 2015 and 2017, a UK first for a number of years now. What’s important to look at is not just LE, but Healthy LE – which is the number of years a person spends in good health. What we are seeing is a growing number of people having a prolonged period of time towards to the end of their life in bad health – as they are living with complex co-morbidities from their LTCs.
- So, PHM is not a new concept – it has been around for years, and indeed our report includes a number of case studies on international examples in Germany and the US that have been around for years. But why is the UK got such a focus a focus on it at the moment? Well 2 reasons – first is the development of STPs, and their transition towards becoming ICSs; and second is the publication of the LTP in January 2019 which gives significant emphasis to PHM. 44 STPs – become 42 through merger. Becoming ICSs – BUDGET, GOVERNANCE, PHM strategy. Other important policy change is the development of LHCREs – of which there are 5 atm. The ambition behind these is to support the interoperability of technology systems across a region to support direct patient care, improve care coordination, provide health analytics and PHM, and enabling patient engagement and activation
- The way report is structured is that it identifies four building blocks for PHM: Infrastructure, Insight, Interventions and Impacts and nine critical success factors for achieving PHM. For each CSF we have set out key actions ICSs need to take and have offered some case studies from the UK and Internationally on recognised best practice. The slide overleaf goes into more detail in each.
- 1. We’ve all heard about how big data and AI are about to have a profound impact on our lives. Whether it’s Elon Musk talking about the singularity or IBMs Watsons beating humans at complex games which require strategy and instinct, the potential of advanced analytics is well publicised. 2. I work in health analytics and it’s true that we are in a period of rapid innovation, advances in data technology and analytical techniques absolutely do have the potential to change the way we deliver healthcare for the better 3. In some specific applications there may well be big bang events but in practice there is likely to be a steady trickle of innovation over the next few decades, in part because we need to learn how to safely integrate the technology into well-established ways of working. 4. I’m going to talk about some practical applications of modern analytical techniques to common health care challenges with a focus on population health
- 1. Population health is great example of an area where analytics is having an increasingly significant impact today. 2. Using modern analytical techniques we can generate a deep understanding of the unique health profile of a population, and at the same time we can quantify how well the local health and care system is managing those specific health needs. 3. Risk stratification and population segmentation are some of the tools we use in population health analytics. Risk stratification in particular is widely used today and has been for some time, GPs and other health professionals use risk data to proactively reach out to individuals at risk of attending A&E. 4. These are often the patients who are under the radar, who don’t routinely access primary care and predicting the risk of an adverse event can be a very effective way of improving outcomes for these individuals. 5. Increasingly health systems are beginning to use the same data and risk algorithms applied to a population health profile to predict what demand on health services is going to look like over the next decade or so, for whole systems and whole populations. 6. Rather than just drawing a line through a trend of ever increasing A&E attendances and predicting that ‘next year there will probably be 5% more because that’s what happened for the last few years. 7. We’re able to say ‘these population segments (these specific types of patient) will have a high probability of turning up in A&E over a defined period and based on their health profile here are some strategic investments you could make to prevent that. 8. This forms the basis of population health analytics, we’re using data to generate an evidence base for more integrated health services. Health services which are tailored to the ever changing health needs of our population.
- 1. Often the first step is defining the do-nothing or unmitigated baseline position. This involves modelling what demand for services is likely to be, given what we know about population changes. 2. We then compare this to available funding and calculate whether the system is projected to have sufficient resources over a given period of time. 3. More often than not demand is projected to grow at significantly higher rates than funding allocations. This is the continuation of a trend which most systems will recognise in the form of the operational pressures they experience day to day. 4. When you quantify it over a longer period of time you start to see that traditional reactive demand management strategies are not sufficient to bridge the gap. 5. Population health demand models can help give systems perspective on the scale of the challenge and importantly support the case for investment in preventative medicine and population health management.
- 1. Many of you will be familiar with population health profiling. We use data to understand the prevalence of and relationship between different clinical and demographic markers in a population. This enables us to segment a population into different groups of patients based on any number of factors. 2. In this example we have segmented a population of about 40,000 thousand into 9 different groups based on different levels of complexity and risk, so this could be a neighbourhood, locality or one very large practice. But we can do the same thing at any level, place and system level work equally well and are often used to highlight system issues. 3. Within each segment we can quantify various useful KPIs, in this example we are measuring the total cost of care, and we have a macro view of quality, performance and outcomes for each of the 9 segments. 4. Traditional management information in healthcare measure the performance of providers and service lines which has it’s place but with population health we are measuring the system in the context of its population. 5. This technique has many useful applications, one of which is identifying priority population segments for population health management. 6. We can customise this approach for any population to identify which measures stand out and which segments may benefit from intervention. 7. Like all data driven approaches this isn’t as simple as just plugging in a dashboard and getting all the answers, there is a lot which goes on alongside it, including working with local clinicians and public health professionals to shape the method. 8. The aim is to define specific groups or segments of patients which the system is going to target with its population health management strategy. And we can use the data to quantify the opportunity and make informed judgements on the level of ambition on a realistic timeline.
- 1. Once a system has identified and validated priorities the next step is to consider care model design. I’m going to talk you through an example from a leading UK health system where they have been using population health to design innovative new health services for a number of years 2. This example starts with data. That’s a really important aspect of population health, we use data throughout the process, from identifying opportunities, to modelling mitigation strategies and evaluating impact. 3. This health system knew they had an elderly population and they knew that they needed to come up with innovate new ways to manage a high number of complex and frail patients. 4. So they enlisted an academic partner to first of all understand the relationship between complexity and the total cost of care in their health system. 5. This might seem like a strange place to start but this insight was critical to the business case for the care model design. If you’re going to spend money on a new service you need to understand how you’re going to generate a return. In this case the return was from avoiding costly long length of stay emergency admissions for a particular type of patient. 6. The service they implemented was a complex care hub. It was a great idea, they enrol a small number of high risk generally frail, always complex patients into a service where a care co-ordinator would directly support the patient and ensure they experience joined up and well co-ordinated health and care services. 7. We used the data to calculate the total cost of care for these patients based on their demographic and health profiles and then predicted the risk (which acts a proxy for probability) that they would be admitted to an acute bed in the next 12 months. 8. If the service was successful at avoiding some of these admissions then we could spend a fairly healthy sum of money on it and still provide a net benefit to the health economy. 9. This is a great example of a service most would agree makes a lot of sense if you can find that magic balance between investment and return on a timeline which is viable with very restricted annual budgets.
- 1. Targeting the right patients for this sort of service is critical, many patients would benefit from a care co-ordinator but it can be a relatively expensive service to operate so we need to ensure that the patients we enrol are those most in need. 2. Population health is an iterative process, it’s not one of those things which you can expect to get right first time. Even highly successful integrated care systems can learn from their evaluation data and refine their care models. In our experience learning from and reacting to evaluation data is one of the most important aspects of population health. 3. A lot of energy goes into getting a new service off the ground and a common mistake is expecting a significant measurable impact in unrealistic timeframes. 4. Emergency admissions even for high risk patients are still relatively rare events and we need to be careful about measuring regression to the mean. Ultimately you need data to evaluate a care model and the more you have the better. 5. But we can’t wait years to learn whether we’re having a positive impact on patients and the health economy so here are some of our top tips: Plan your evaluation framework in advance – often evaluation is an after-thought, when measuring change from a point in time we need a reference point from before the intervention, so particularly if your evaluation framework involves collecting new KPIs then start as soon as possible, before the care model is implemented is a good thing. Learn from other systems – do your research and use the networks available in the NHS to look at comparable populations and learn from best practice. Clearly define cohorts – some evaluation methods involve using control groups to measure change in a target cohort. This is an over simplification but the more specific your cohort definition is the easier it will be to evaluate.
- 1. We have covered quite a few different capabilities quickly and it’s easy to get lost in the detail so to sum up, for me population health analytics is really about helping systems make informed decisions about ‘who’ they need to focus on managing more effectively, and providing them with the evidence base to make it happen. 2. Most people recognise that preventative medicine is a no brainer but in an already stretched, publically funded health system it can be difficult to divert recourses from front line care. 3. I believe a big part of the reason that we don’t see more preventative care is a lack of robust evidence. Population health analytics gives you the numbers. The Numbers you need to understand the long term implications of not managing population health. And the numbers you need to start investing in those short term tactical cash releasing interventions which target the highest risk patients. 4. The 5% of patients near the top of the pyramid who are going to account for 70% of resource utilisation next year. The same 5% of patients who would really benefit from a health system which has a deep understanding of their needs and organises itself around them.
- This isn’t a new subject and we’re already preaching to the converted Surgeries are crying out for change Our recent research echoed that GPs want the current model to adapt in order for primary care to survive and that med-tech will make an impact on reducing the growing burden on surgeries The question is more about what the best solution is We’ve seen initiatives implemented that haven’t always worked out (i.e. the contention around the effectiveness of NHS 111) which doesn’t always fuel appetites to try new solutions There’s also a plethora of new platforms and apps, which all promise something different, making it difficult to know which one is really going to make a difference However, one area that is becoming widely acknowledged for it’s potential impact is the digitisation of triage In the past, taking triage out of the hands of doctors has been a contentious issue But in this era of being asked to do more with less, there’s increasing recognition that if there’s a safe, reliable and effective way to automate triage in general practice, then that could allow GPs to concentrate more on treatment We had heard this anecdotally…..obviously why saw an opportunity in the market But when we conducted our recent poll, we asked GPs about this. I’ll be honest, we held our breath and expected mixed results However, the response was overwhelmingly positive 96% of GPs said they would be interested in trying digital triage, 56% of which said definitely so Obviously this is just a snapshot, but the sentiment of it shows that there’s a real appetite to understand, and potentially use it when appropriate
- This isn’t a new subject and we’re already preaching to the converted Surgeries are crying out for change Our recent research echoed that GPs want the current model to adapt in order for primary care to survive and that med-tech will make an impact on reducing the growing burden on surgeries The question is more about what the best solution is We’ve seen initiatives implemented that haven’t always worked out (i.e. the contention around the effectiveness of NHS 111) which doesn’t always fuel appetites to try new solutions There’s also a plethora of new platforms and apps, which all promise something different, making it difficult to know which one is really going to make a difference However, one area that is becoming widely acknowledged for it’s potential impact is the digitisation of triage In the past, taking triage out of the hands of doctors has been a contentious issue But in this era of being asked to do more with less, there’s increasing recognition that if there’s a safe, reliable and effective way to automate triage in general practice, then that could allow GPs to concentrate more on treatment We had heard this anecdotally…..obviously why saw an opportunity in the market But when we conducted our recent poll, we asked GPs about this. I’ll be honest, we held our breath and expected mixed results However, the response was overwhelmingly positive 96% of GPs said they would be interested in trying digital triage, 56% of which said definitely so Obviously this is just a snapshot, but the sentiment of it shows that there’s a real appetite to understand, and potentially use it when appropriate
- I’m acutely aware that GPs are already sick of being ‘sold’ to particularly in terms of technology that promises to deliver the holy grail But this kind of change is possible through digital triage although the case naturally needs to be assessed with rigour Talk through the bullets on the slides, with emphasis on the concerns and barriers
- So, based on this, I ask you to step back from the granularity of the day to day and let your imagination run loose Visualise a new kind of surgery experience – one that is better for GPs, support staff and also for patients One where ‘time’ is more freely available Time to see priority patients, time to have meaningful and efficient consultations, time to plan for a surgery’s progress, or time for a better work life balance It’s also key for patients – saving them time by advising them if they don’t actually need to see a doctor, giving them access to medical advice from their surgeries whatever the time of day, giving them the opportunity to conveniently access a new prescription etc
- In a bid to address increasing demand for appointments and retain patients wanting video consultations, the Portland Medical Centre in Croydon, South West London (SWL) has implemented Doctorlink. Doctorlink is a digital health solution that provides a digital front door to primary care services, taking patients online via a symptom checker and triage, giving patients 24-hour access to healthcare and allowing GPs the time to focus on patients in need. Doctorlink is working with the SWL Health and Care Partnership, as well as the Croydon GP Collaborative, to reduce the administrative burden of triaging patients and move away from a first come, first served system, to serving those in most need. A GP from the Portland Medical Centre, Dr Ravi Tomar, is playing a lead role in implementing innovative new online services, including GP video consultations, currently being piloted with patients for the first time. Dr Tomar believes that advancements in tech, such as video consultations, will play a large role in improving primary care services. “We are a Future Forward practice creating the GP surgery of tomorrow. Online tools like Doctorlink will help to reduce demand on services, offer better access for patients seeking care, and transform the experience for working GPs helping us to attract and retain talent.” Video consultations are seen as critical for sustaining the practice by retaining patients they might otherwise lose to other online providers who are predominantly taking low maintenance patients away from traditional practice lists. Their introduction is expected to unlock other advantages, including a reduction in infections acquired in the waiting room and better utilisation of consultation space across the practice. Since the roll-out of Doctorlink in October 2018, >3,200 patients have registered for the service, representing 27 per cent of Portland’s patient list. 23 per cent of those patients have re-routed to alternative care, such as emergency services and home care, and over 40 per cent of patients are accessing the service out of standard opening hours. The video consultation service is currently being piloted and will be offered to patients presenting through Doctorlink who would otherwise normally be treated in a face to face appointment but would prefer the convenience of a remote consultation. When he qualified as a GP in 2018, Dr Tomar was the only one of his fellow trainees to pursue a full-time career in general practice, which is indicative of the staffing crisis currently facing his profession. Pressure is building on GPs to work longer hours to meet ever increasing demand from an ageing patient population and an increasing prevalence of complex chronic conditions whilst many GP vacancies remain unfilled. The latest national GP Worklife Survey found that 39% of the 2,195 GPs surveyed were likely to quit the NHS by 2022, representing as many as 2 in 5 GPs. Dr Tomar is among a new generation of GPs seeking ‘portfolio careers’ that comprise a diverse range of disciplines, responsibilities and interactions with patients. Dr Tomar sees huge potential for technology to help GPs feel more fulfilled by enabling more flexible working conditions and allowing them to focus on the patients that really need their help. This approach is being enabled by the Portland Medical Centre, which is leading the way for the practices of tomorrow. https://www.portlandmedicalcentre.co.uk/
- So, based on this, I ask you to step back from the granularity of the day to day and let your imagination run loose Visualise a new kind of surgery experience – one that is better for GPs, support staff and also for patients One where ‘time’ is more freely available Time to see priority patients, time to have meaningful and efficient consultations, time to plan for a surgery’s progress, or time for a better work life balance It’s also key for patients – saving them time by advising them if they don’t actually need to see a doctor, giving them access to medical advice from their surgeries whatever the time of day, giving them the opportunity to conveniently access a new prescription etc