We need: Better Access Better Health Outcomes Greater Practice Efficiency Reduced Commissioner Costs
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- Jesse Byron Beasley
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1
2 We need: Better Access Better Health Outcomes Greater Practice Efficiency Reduced Commissioner Costs
3 What is? 1. Self-help tools that allow patients to safely manage a proportion of their own needs without visiting the practice, PLUS 2. 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 treatment BUT 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.
4 Constructing a Solution Why not /Text or Webcam? Patient identifiable? Agreed response time? Comms loop closed? Optimises data capture Better for patient? Better for GP efficiency Better for CCG? Scalable? No No No No Yes Supply-led demand? Against IG No Text No Maybe Maybe No Yes Supply-led demand? Pilot Stopped Maybe Webcam Yes Yes Yes Yes Yes Supply-led demand Pilots Awaited Yes, but supply-led demand econsult is designed to tick all the right boxes econsult Yes Yes Yes Yes Yes Yes How we construct each econsult 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) Reduced Urgent Care Yes 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 selfmanagement options to top-slice appointment demand
5 Click First Strategy Via Practice s own Website Patient Access Symptom Checkers Self Help Pharmacy Advice 111 Clinician econsult Own GP Tailorable for local services
6 Patient Experience econsult banner linked to any Practice website Simple flow guide New Generic templates Self-help and 111 options New Administrative help Geared towards enticing patients planning to call or come to the practice in to going online, creating both patient convenience AND practice efficiency
7 Patient Selects or Searches for their issue
8 Patient Self-manages or selects to econsult
9 Patient Self-manages or selects to econsult
10 Patient Self-manages or selects to econsult
11 Patient Self-manages or selects to econsult
12 Patient Self-manages or selects to econsult
13 econsult process
14 econsult process
15 econsult process
16 econsult process Red-Flag questions are embedded in each questionnaire to intercept patients with serious symptoms and direct them to take urgent action immediately
17 econsult process
18 econsult process
19 econsult process
20 Practice Workflow Symptom checkers Self-help videos and articles Signposted content NHS 111 econsult No Action Required No Action Required No Action Required No Action Required NHS Mail Average 2.9 mins per econsult Call Patient back 40% Offered Prescription 20% Telephone Consultation 40% Offered Appointment Clinician reviews econsult report Task for Clinician 60% Managed remotely Admin monitor shared mailbox for econsult reports
21 econsult example New
22 Benefits from the Pilot Improved Access 1 in 5 patients used the website at least once 83% FFT and 95% state website is good or excellent High uptake by under 45 s, ethnic minorities and 2/3 women 33% from mobile phones Better Health Outcomes Earlier treatment Digital disinhibition e.g. depression, rectal bleeding Red-flag questions prompt action e.g. cancer detection Increased Practice Efficiency 1/3 rd use self-help and 18% then self-manage 60% of econsults closed remotely Only 3% of econsults due to supply-led demand 9 self-help uses for each econsult generated Easily accommodated in normal working day of GP Commissioner Savings 14% of users said they would have gone to urgent care 3 for 1 return on investment e.g. Southwark CCG saved 360K More time for complex cases = reduced LTC complications 6 Months 133k Patients 20 Practices 10 CCGs
23 Testimonials What patients say Easy to navigate and very informative You may not need to come in at all Saved a lot of time for me More people would use it if they were aware Fantastic idea I m not a computer whizz, but really easy Followed step by step on my mobile phone Was a better option for me Technically very simple and no jargon Much quicker with no waiting Was able to go straight to pharmacist Highly recommend as first port of call
24 Testimonials What practices say econsult is the way forward in 21 st 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 + What Commissioners say 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 Media coverage Now available to over 1M patients in UK
25 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 Remote Training (if required) 24/7 Telephone & Support Continual Product Development Continual Maintenance Secure Hosting CQC Approved Content powered by NHS Choices
26 5 Steps to Go Live Purchaser 1. You quantify your requirements and inform us 2. You Return the Quote Acceptance form 3. You confirm details online 4. You sign the Contract 5. Mobilise Choose promotional material Teams watch training video We send you the Quote We discuss and confirm your requirements We send you the Contract We add econsult to practices websites Go Live EMIS Health
27 Future Developments Better Content Pre-appointment and follow-up templates Better Feedback Pop-up, post-econsult and patient surveys feed an automated dashboard for practices and commissioners to log-in and review Interoperability with all Clinical Software Systems econsults sent directly into workflow manager in EMIS Web Read coding of data e.g. smoking and alcohol status Integration 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
28 Summary Many talk about how existing general practice is unsustainable but few provide real solutions... Better access Better outcomes Better use of practice resources Commissioner savings Access Efficiency Quality
29 Thank you
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