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Tackling the referred pain of digital patient referrals

As NHS England mandates that faxed referrals are phased out, and trusts look to alleviate the grind of manually re-entering details between different IT systems, SynApps Solutions’ Chris Brice charts a practical, pain-free way to exploit NHS Digital’s e-RS referrals service more fully – which delivers for patients, trusts and NHS budgets

On the face of it, NHS trusts are already making progress with electronic patient referrals. Steadily, GPs and patients are defaulting to the NHS Digital’s e-Referrals portal which will soon be mandatory for primary care referrals, to guarantee payment for services. Yet, although this is widely understood – and despite an appreciation that referrals by fax, email or other manual means are not efficient or easy to trace – a large majority of patient referrals are still being handled using complex, time-consuming workarounds. Even where requests are channelled via the NHS e-Referral Service (e-RS).

This undermines the purpose of the NHS e-RS, which is designed not only to provide a single central digital platform for capturing and coordinating patient referrals, but also to streamline associated processes, speed up treatment, and provide reliable traceability of a patient’s progress and status.

So what is preventing total take-up of the broader digital experience – where referrals pass quickly to the right person, and targets of faster patient diagnoses and treatment are met?

The issue is two-fold.

First, NHS Digital hasn’t yet developed its own workflow-driven applications to make it easy to pass referrals through the system automatically and track and report on progress.

Second, the diversity of IT systems used by GPs and hospitals has proved a barrier to integration. As a result, primary care providers have resorted to faxing and emailing referrals. For their part, hospitals have printed and scanned those requests, manually re-entering and tallying these with patient records held elsewhere on their systems. Rather than accelerating case flow-through or alleviating administrative workloads, this has often created more work and delay. It is not unusual for a trust to be manually re-entering details of 15,000 referrals per month. Some major trusts accept up to 50,000 patient referrals daily.

Joining the dots

For the NHS e-Referrals programme to have its intended impact, digital processes need to be joined up end to end. Then they can start to exploit intelligent automated workflow. That includes prompt diversions of cases to more appropriate specialists or services (inside or beyond the immediate hospital); and complete traceability and reporting – with rules-driven alerts, to ensure that no case enters an administrative cul-de-sac or slips through the cracks, and that critical performance targets are not missed.

All Acute trusts are aware that the current piecemeal situation cannot continue. As of 2020, faxed referrals will no longer be accepted, and NHS services already face the prospect that they will not be paid for referrals accepted through any channel besides the e-RS portal. So trusts and their primary care practitioners might as well ensure that the e-RS leads to perceptible benefits for staff and patients.

Fortunately, approved NHS Digital development partners SynApps Solutions and Alfresco have already put in the groundwork to deliver end-to-end electronic referrals solutions. These offer trusts all of the integration; rules-based workflow; process automation; monitoring, prompting and reporting required to fully harness the benefits of digitising patient referrals.

From electronically capturing patient requirements and connecting these to patient records; to accelerating the triage process and clinicians’ acceptance/refusal/redirection of referrals; to vigilantly monitoring, prompting and reporting on referral-to-treatment progress, our combined, modular solutions are designed to extract maximum early benefits from NHS Digital’s e-Referrals initiative for everyone concerned.

The expected benefits are substantial – including efficiency gains of 60-70 per cent compared with manually processing, checking and following up on referrals and progress to treatment.

And that’s aside from the benefits to patient safety, as cases are proactively tracked and escalated thanks to automated rules in the system. Robust compliance and performance measures, meanwhile, will help ensure that trusts are paid in full and within acceptable timeframes for the cases they have accepted.

None of this needs to be an upheaval or costly exercise for trusts, either. Our solutions can be run in the cloud as well as on premise, and there are significant grants available for trusts ready to make the full transition now. Funding is applicable especially where organisations come together on joint projects, in line with NHS England’s Sustainability and Transformation Plan. Each trust can go at its own pace too, or prioritise how it tackles its respective migration to a fully digital referrals scenario. That’s because the SynApps Solutions/Alfresco solution suite is modular, offering trusts the flexibility to concentrate on just the capabilities they seek right now.

IDCR: A great new way to help clinicians via a single view of a patient’s complete medical history

Chris Brice catches us all up SynApps’ work to help NHS and local authorities’ better share key medical information

As many of you are aware, SynApps is one of the leading providers to the NHS of a very special and actually highly desirable solution called the Integrated Digital Care Record, the SynApps IDCR.

IDCR is a solution that encompasses everything that every NHS Trust, and an increasing number of local authorities, across the UK are trying to achieve – being able to provide a cradle to archive view of a patient, finally joining up all the different back office systems that a physician needs to access to give us a total view of that patient.

More importantly, this can be extended to include not just the information within an NHS Trust, but also a GP system in a local government/external stakeholder Shared Care Record scenario – enabling a clinician, or any approved person who has access to medical records, to see everything that relates to a person, from when they were born to an archive scenario.

An open, highly functional, approach

The IDCR is an enabler to allow access to all these different systems. Ultimately it will become your integrated digital care record for easy secure access across the NHS and beyond.

Why? Because it’s designed to allow all relevant stakeholders, including social care, local authorities, clinicians and GPs, to access your clinical record or social care record. And as it’s architected to be a simple open source, open product that allows you to log in through a portal and then have access to all of the information, it’s revolutionary – and at the moment, we believe we are the only provider who can delivery this on demand. Chief Clinical Information Officers (CCIOs) in the NHS that we’ve talked to tell us they want a single view of all information irrespective of what system if comes from or where that system is, and what make this really interesting is this includes external systems too.

Our solution, then, will allow you to have a single view from any device, anytime from anywhere, from of all of the multiple, different systems, including any case notes or paper that’s been scanned. It can also provide a tracking system to overcome some real issues organisations are having with the referral to treatment (RTT) pathway that means you the patient has to be seen within a certain period of time – something all Trusts, of course, have to monitor, report on and is mandated against with significant fines if they miss their targets.

The SynApps IDCR provides a total view of any GP notes, any x-rays, any illness or ailment you’ve ever had where you’ve had engagement with the social care system, you’ve had engagement with the GP, with an NHS Trust, all displayed in a single view, in a timeline view – which means it’s a really  secure means of providing that real time link to  a patient or citizen or somebody who’s in social care in one single view and could also track where they are in the process.

Save resource

At the moment most Trusts are running over 90% of their referral targets – which sounds like a very high percentage, but the reality is, the ones that fall out are where you see horrible negative local or national press… yeah, the terrible times somebody who should have been seen because they had a serious cancer wasn’t seen, or they got missed for some reason and actually died.

Failing to address this means there’s a huge risk that you’ll miss your NHS compliance targets… and if you miss those targets, you could potentially receive significant fines or even worse go into special measures and all that that implies.

It could also save you a lot of resource, time too; by providing integrated digital care record and a RTT pathway tracking system rather than a validation system, – going from 30 to 40 people down to maybe three or four people to track, not validate, how this works.

Got to make sense, right? If you agree – drop me a line and let’s see how we can get an IDCR to help you with some of your heavy lifting!

Chris Brice is SynApps Solutions’ Director Sales & Marketing

From FOI to Keep Fit: Why You Need a Community Engagement Platform

SynApps has started to work with key customers on a very exciting new frontier in local government – digital outreach

Local authorities are very good at dealing with their service users on social care or benefits: they know who they are, they’ve got systems to deal with it.

But what they’re not doing so well is addressing the greater or wider community… which is a problem, as UK local government now has a much bigger remit to engage with residents.

We think we may have something to help – what we’re calling our new community engagement platform that can join up all your different departments that might want to engage with the community and provide a really, easy platform to connect all of your teams internally as well and reach out to the wider community.

The best way of explaining is this: if you or I make a FOI (Freedom of information) request to our local Town Hall, it would likely struggle to provide information back within the 21 days that’s required, because it has several separate departments, run by separate teams, all running separate software systems – and they have to go through a physical ring round, email round type of check to be able to respond to our FOI request.

Clearly, it would be much better if I make an inquiry, be it FOI or ask about where I can park my bike on my next big jaunt across the local terrain, that I get pointed to a portal or website where I can find the information I am looking for as well as check what information the council holds on me, which of course has to be available to me as part of the new GDPR compliance regulations.

Great for me – I get my biking info. But it’s also great I argue, for the authority, too. What’s happening now is that the local council has to engage with the NHS. More and more have responsibility for the local CCG too, as well as GP practices. They also have a social care system, they work with the emergency services, probably the local University level, too.

My point? Community engagement is about not just linking the council’s internal systems, but having the ability to share this information across the whole local area. A good example is a council currently working with us to build a properly linked-up, self-service solution that allows me, the citizen, to look at my council information, look at my NHS record, look at my GP system record and, if I’m in a social care environment –  look at that information, too.

And it can go further. How about allowing the local authority to advertise events and things going on in its community every time I log in.  It can also ask me questions like, what are your hobbies, what sorts of sports do you do, what are your interests? And, if I pick boxes, it will then start to feed me information on those things.

A big driver here could be the Keep Fit and Healthy regime councils are now being mandated to deliver. Just think about how great it would be to combine all of that content into one place.

We think this solution is a great way to engage with your community and deliver relevant, up to date, information, and I hope you have a minute or two to check out some more of the detail here, or by dropping me a line at chris.Brice@synapps-solutions.com.

Digital Case Management: Why it’s A Lot More Than Just Giving Social Workers iPads

SynApps has growing interest from the UK social care sector for its new digital case management offering

When it comes down to it, digital case management is basically a means of managing the ingestion – the capture – of case files for social workers by multiple means, including email, self-service scan stations, MFDI copiers (as well as back-scanning archives), and then pushing that information through a workflow.

What do I mean by workflow? Well, it’s a structured business process to properly capture the important information and then file it centrally, safely and digitally into an ECM repository, for example.  Then providing a series of alerts that not only notify the key members of the social care team about what they need to know, but with built-in escalation and an SLA that allows every case file to be managed and monitored to help you with a very key area of compliance – the Ofsted Inspection.

Overcoming paper

Our work here often involves a scenario where you have four hundred-plus social workers, a number of NHS Trusts, multiple GP practices but all working off a paper store of information. That means that every time a social worker goes out to meet a new potential client, they have to request information and that information is then delivered as a paper file.

For sure, what we’re looking to do is replicate that with an electronic version – so, rather than carrying a huge file and having to make notes via paper in front of any potential social care person,  it’s all digital – you scan everything, ingest it (i.e. capture emails), file any Word or Office documents and then, by searching the content repository, pull it together into a simple electronic document, then be able to take the case file on site, carry out the work they have to do and update the file electronically.

This is great – and a big advance for many a social work team compared to where they are today. For sure we are not the first to attempt this – there are lots of systems on the market already claiming to help at the sharp end like this. But what we’re doing that we think is better, is automating the end to end process and securely filing all of the case file information in order into a central repository and then integrating it with your whole social care system.  Now you can start to really reap some benefits.

End to end automation

Now, when a social care worker logs into their social care system, the complete case file is available in front of them – and you have the beginnings of a truly ‘end to end’ view of the whole case file; with all the information relating to this particular person – including their NHS or GP record, and social care record.  It’s all available in a dashboard, with any new information updated automatically in real-time and yes, your team has access to that information on an iPad and/or Android device.

It’s no longer a paper-based system, it’s a completely automated, electronic system – which offers real cost and labour savings, better record keeping for compliance and a way to improve the overall quality of your council’s service delivery, and genuine overall improvement in a very key, but often very financially strained, core process.

I think it’s pretty powerful stuff. Take some time to explore it more here or drop me an email at chris.Brice@synapps-solutions.com.

Thanks, and speak soon!

Chris Brice came on board as our new Director of Sales and Marketing here at SynApps Solutions Ltd back in May

Sandwell & West Birmingham Hospitals Move To EPR And Digital Working

 

 

 

Sandwell & West Birmingham Hospitals NHS Trust (SWBH) has recently embarked on a significant digital transformation project

The aim in healthcare is for patient care to be provided seamlessly and with continuity across any combination of service providers – from acute and mental health Trusts to community GP practices and pop-up clinics all the way out to caregivers out in the field.

Sandwell & West Birmingham Hospitals NHS Trust (SWBH) is a busy, multi-site organisation. In the past financial year alone, it handled 199,437 attendances at A&E, 650,000 community contacts and 526,945 out-patient appointments. Clearly, information and its correct routing matters a great deal at SWBH. To put that in context: in the month of January 2017 alone, the Trust moved no fewer than 35,000 individual patient records around the institution.

SWBH has recently introduced a digital content management approach to medical records, aiming to make sharing medical data easier and more practical. The approach uses a content management platform from Alfresco, while being implemented and project managed by SynApps Solutions.

The Trust’s chief informatics officer, Mark Reynolds, explains some of the motivation behind the project. “We’re helping make information sharing a lot smoother via a set of changes that will eventually get us to a full EPR (electronic patient record). That’s going to happen in 2018, and it will set us up for the opening of new facilities the year after. However, what we are currently engaged in is a move to an increasingly paperless way of working to help build the foundations for that future.”

The trust is currently digitising the new documents that come through its doors. “This isn’t a project about making all of our archives paperless, but a way to make the Trust more nimble and EPR-ready,” adds Reynolds.

Advantages of this approach include valuable early benefits – freeing up office space on its sites as paper storage starts to become less important. SWBH is also able to redeploy some of its admin staff who would have been tending all that paper.

To achieve this, SWBH decided on a very pragmatic Open Source approach. This brings advantages in terms of commitment – such freeware can be adopted on a zero-cost basis with a view to a bigger commitment when commercially viable. The Trust also wanted to only work with a supplier who had sold into the NHS, and so would understand its issues and not need any hand-holding.

The Alfresco content management system to manage digital content, implemented by SynApps, met those criteria, and SWBH was happy to start the records digitisation project with those partners.

The right decision

It’s early days at SWBH for this new way of working. “Although our case note scanning project was not without its difficulties, we are now at a stable state where digital documents are the norm and not the exception. It’s a good lead-in for our new EPR as staff are becoming more accustomed to digital case notes.”

“In terms of what clinicians do, the benefit is very marked – those 35,000 records move around electronically, not on trolleys, finally.”

In terms of addressing our information archives, Reynolds sees that as a longer-term project that can be progressed in partnership with the Trust’s records supplier. “We decided that the best use of our resources was on the new medical documentation and getting that digitised first – and I think our results show that this was the right approach.”

The author is Chief Informatics Officer at Sandwell & West Birmingham Hospitals (SWBH) NHS Trust

A Local And Practical Patient Care Project That Works

SynApps is a proud supporter of a big cross-sector patient medical data initiative. Gary Britnell explains why

You may have noted in our News section that SynApps is to exhibit at the upcoming Great North Care Record (GNCR) Network Event at the end of the month.

If you’re not familiar with the GNCR, then I’d like to briefly bring you up to speed, then explain why SynApps is an enthusiastic backer of the initiative.

The Great North Care Record project is a serious attempt by the NHS to use technology to improve the way patient information is shared at a local level. Its two key values: everything has to happen with patient consent, and all work is bent towards finding real, practical ways to improve patient care and to help the NHS to run more efficiently.

You may have heard those values espoused before. We’ve all observed ambitious national data sharing programmes come and go. However GNCR, by starting at a local, pragmatic level, has achieved a lot more than some of its better-publicised forebears.

For example, all of phase one of the project’s rollout is complete. In practical terms, that means over 11,000 views of GP records in participating institutions in secondary care are carried out digitally per month.

All eyes are now on phase two, which is focused on exploring how all the health and care settings involved in patient care can have the ability to instantly access and share real-time patient information.

So it seems the emphasis is consistently on delivery. Next week at Newcastle Racecourse, attendees from clinicians working across a range of healthcare settings, social care practitioners and research colleagues are coming together under one roof to share ideas about how the Great North Care Record can improve patient care. We’re looking forward to presentations from senior healthcare policymakers and experts, as well as NHS Trust chief executives from across the North East.

The bottom line is that we have a digital patient-sharing programme that is making progress in the NHS, and that’s something we all need to applaud. And learn from and share best practice out of.

See you in Newcastle?

That’s why SynApps, a veteran of data sharing in the NHS and a trusted supplier of clinical content support to multiple NHS Trusts will be at the Great North Care Record (GNCR) Network Event (November 28).

If you want to come along and meet SynApps, please get in touch at info@synapps-solutions.com. **Also, don’t miss your chance to win two Amazon Echos, kindly provided by key technology partner Alfresco.**

By the same token, if you are a UK healthcare professional don’t forget to get your free place here.

Gary is SynApps Solutions’ Head of Healthcare

Synapps To Exhibit At Key Networking Event For Clinicians On The GNCR Topic

We will shortly be exhibiting at the The Great North Care Record (GNCR) network launch event late this month.

The event for health care clinicians, scheduled for Newcastle Racecourse, NE2 5PH on Tuesday, November 28, 9am-1pm, aims to bring together clinicians (working across a range of healthcare settings), social care practitioners and research colleagues to share ideas about how the Great North Care Record can improve patient care, and which SynApps is delighted to be a part of.

Come along to our stand to find out more about how SynApps Health Practice can assist you in managing data.

The Great North Care Record project is all about improving the way patient information is shared, with patient consent, as a way to improve care and helping the NHS to run more efficiently.

To secure your free place at the Newcastle GNCR event, please click here