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, 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.

Constructing a Solution

Patient identifiable

?

Agreed response

time?

Comms loop

closed?

Optimises data

capture

Better for

patient?

Better for GP

efficiency

Better for CCG?

Scalable?

Email No No No No YesSupply-led demand?

Against IG No

Text No Maybe Maybe No YesSupply-led demand?

Pilot Stopped

Maybe

Webcam Yes Yes Yes Yes YesSupply-led demand

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 Clinician

Self HelpeConsultOwn GP

Patient 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

Patient friendly language

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

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 1/3rd 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

66MonthsMonths

2020PracticesPractices

1010CCGsCCGs

133k133kPatientsPatients

Testimonials

Easy to navigate and very informative You 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 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

SummaryMany 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

talkto@emishealth.com

Thank you