Delivering healthcare in a digital world

Prime Minister’s Challenge Fund: An Operational and Digital Transformation of Primary Care

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The savings achieved for a DLS Access PMCF Wave 1 project, based on 65,000 patients are outlined below.

Costs are based on a transformed operating and workforce model that incurs no additional cost, which can be achieved with clear leadership and a commitment to change across the project.

Telephony costs were not increased in this project by using a common telephony model, which delivered economies of scale as practices connected into the HUB.

Many other benefits have been seen across the business as well as a return on investment from the savings this project has achieved including:

Achieving savings of £15 per patient with additional benefits.

Patient Population 65,000

Patient savings of installing DLS Access £

Per patient savings on DNA Per patient per annum saving on reduced A&E visits Total per patient saving by installing DLS Access

3.23 18.26

21.49

Annual savings for patient population £

DNA’s based on 72% reduction

A&E attendance based on 18% reduction

Total annual savings for patient population

209,950.00

1,186,900.00

1,396,850.00

Cost to install DLS Access £

DLS Access model of £5 +VAT per patient per annum

390,000.00

Return on Investment (shown as savings) £

Savings for whole patient population

Per patient saving

Per patient return on investment

1,006,850.00

15.49

3.58

Prior to transformation, this Primary Care organisation, like many others, did not record patient traffic across online or remote channels. Similarly, while clinical record systems document number of appointments and factors such as DNAs, there were no reporting mechanisms for these Key Performance Indicators (KPIs), so it could not be used as management information to drive business efficiencies.

As a one year PMCF project, it was vital that valid powerful results were visible and could be used to evidence the model’s long-term sustainability. The project requirements necessitated a baseline and monthly data comparison. We included additional KPIs to allow the practice to evaluate its business in real time, providing the capability to measure and respond to day-to-day changes.

Data from clinical record systems, telephony reports, web traffic analytics and online appointment requests were collated and reviewed daily in a bespoke dashboard. Clinical data included the number of used and unused of each appointment type at each practice, the number of DNAs and the percentage of remote consultations that resulted in a face-to-face appointment.

This rigorous approach to management information ensured the project was able to measure and report on its success.

Transformed Service Model

DLS helped this organisation deliver a clear and achievable digital strategy, which subsequently won a place on the PMCF programme.

In order for the project to then succeed DLS delivered two core elements, the enabling digital products and the service and business transformation.

Post award, the design phase underpinned the strategic vision and direction for the project. Stakeholder and patient workshops were used to understand the current and future business model and services, existing access channels, content, patient workflows, data security and governance.

This outlined the new digital care pathways and access channels, which the DLS technical team used to deliver the digital service elements. DLS transformation and operational resource worked with the organisation, as one team, to transform the existing service; standing up a new clinical contact center and extended hours health hub, along with new standard operating procedures, patient pathways, governance and security policies.

DLS also provided a launch and roll-out plan, with supporting internal communications and external marketing plan to ensure patients and stakeholders were clear about the changes and new models of access.

The operational team benchmarked key performance data at the start of the project and developed dashboards and reporting structures as described earlier in this document.

The service and digital elements delivered are outlined below:

Creating Management Information, Data Analysis and Benefits Tracking.

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Underlying Technology

The programme is underpinned and enabled by the latest digital and interoperability technologies. This digital platform delivers functionality for three users.

Patients,for whom the system provides online access to localised primary care services, healthcare professionals, syndicated content and self-care tools using every-day communications tools such as telephone, smartphone apps, Skype and the internet backed up with common identity management and personalised health records environment.

Care co-ordinators and managers for whom the technology will provide a single view of the patient across multiple systems allowing for better case management, appropriate patient signposting to the correct services and clarity on the complete patient pathway.

Clinicians, commissioners and Business Managers for whom the system will open up management reporting systems across the whole care population landscape, integrating across multiple clinical systems to deliver clear and focused business planning.

Tier 1:Patient/CitizenUser Applications

Tier 2:Business Managementand Care CoordinationUsers

*Data Exchange/APIs*

Tier 3:Clinical/Professional Users

Identity Management

Business Engine

Content Services

Secure SocialNetworking

Personalised Care Planning

On Demand accessto specialist content

Patient Access toMedical Records

Telehealth andself support appsScheduling Apps

Self Care Tools and Content Patient Feedback

Personalised Health Records

PatientIndex

Booking &Scheduling

ContactCentre MGT

Reportingand M.I

Virtual Caseload

MGT}

GP 1 GP 2 Community Acute Social

Communication Apps:

• Instant Messaging• Voice• Video• Imaging• Telephony

Far from a world of queuing patients outside each practice each morning and many days spend waiting to get an appointment, these days, consultation requests are made by registered patients using their phone, a smartphone app or via a web form.

All requests are directed into the ‘Health Hub’ and handled by trained call centre operatives.

The Health Hub team puts each patient on a call-back list for the requested healthcare professional who then aims to call the patient back within an hour, either by phone or Skype, whichever the patient requested. This system provides same day primary care access for the groups patient population, without opening for extended hours. Out of hours demand is managed better and patients are seen quicker.

Developing a new standard in primary care customer service

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