We spoke to Dr Ben Brown of Langworthy Medical Practice about its adoption of PATCHS, the online consultation tool that is backed by Advanced. We asked Ben how PATCHS is helping Langworthy overcome day-to-day challenges during the pandemic, and discussed the huge difference it is making to staff and patient care.
What was life like before PATCHS?
“Before we started using PATCHS, we operated like a traditional General Practice with nearly all our appointments booked on the phone by a receptionist. Like a lot of practices, we had problems with access – appointments were usually booked on a first come, first served basis - and there was a huge rush on the phones each morning as patients scrabbled for appointments. If they were lucky enough to get one, they usually had to wait about three weeks or longer to be seen, which often led to complaints and poor feedback. It was difficult for us to prioritise based on clinical need, so patients that required more urgent attention sometimes couldn’t get it. We also had no data on the patients that weren’t able to get appointments, so we couldn’t really tell if we were meeting their needs.”
How has Covid-19 impacted the practice and your approach to care delivery?
“As a result of Covid-19 we moved to a Total Digital Triage approach as recommended by NHS England using PATCHS. We informed all our patients via text message that to get help from a clinician they’d need to submit a request via the practice website using PATCHS. Receptionists and a recorded message on our telephone system also directed patients to the practice website. This moved nearly all our patient demand through PATCHS, and has dramatically reduced the pressure on the phone lines and reception team. It also means that the phone lines are freed up for patients that can’t or shouldn’t use PATCHS - for example patients with dementia or those in emergency situations - though it’s worth noting that carers can use PATCHS on behalf of patients if they have permission. Now things are getting back to normal we're really seeing the benefits with calls dropping from 350 per day pre-lockdown to around 200 per day today. This has meant urgent patient requests can now get through on the phone lines, and we can manage the other requests in our own time based on clinical priority.”
What are some of the main benefits you have seen since implementing PATCHS?
“PATCHS has changed the way in which we work for the better. In the past we used to have back-to-back appointments with patients each day with no effective triage procedures - often we’d see patients that didn’t need a face-to-face appointment, and everyone would get 10 minutes regardless of how simple or complex their problem. Now we spend most of our time communicating with patients via PATCHS as over 85 per cent of requests don’t require a face-to-face, video, or even telephone consultation. Most PATCHS consultations take anywhere from one to eight minutes to complete, and for more complex patients we can take longer if necessary. That‘s the beauty of PATCHS: instead of having pre-booked appointments all the same length, there’s flexibility in your day to take longer with patients that need it - and of course, take tea breaks when we want too! We process about 160 requests per day for a population of 20,000 patients, and although we're still in the evaluation stage working with my team at The University of Manchester - I estimate that PATCHS has reduced waiting times for patients to get help from us from three weeks to three hours on average.”
What challenges have you been facing and how has PATCHS helped you overcome them?
“The biggest challenge at the beginning was managing the unconstrained demand, especially during lockdown when so many patients were contacting the practice. It felt unsafe at times when we didn’t have enough staff due to sickness or because they were self-isolating. However, PATCHS allows us to limit the number of requests per day dependent on the number of staff we have available. This has made things much safer - and patients can still phone the practice if it’s an emergency. We've also found that turning off patient access to PATCHS out-of-hours and directing them to the appropriate services in urgent situations has had a significant benefit as it prevents the build up of requests over the weekend - there’s no more manic Mondays.
The two-way asynchronous messaging and image uploads in PATCHS have been invaluable, as has the ability to work across multiple GP practices (we have three sites in our practice group). PATCHS also has SMS capability for ad-hoc outgoing communications too, which means we don’t have to use different systems to do this. However, the thing that excites me most are the new upcoming features. The AI triage and workflow module - due for general release soon - is able to automatically direct requests to clinicians and prioritise their urgency instead of relying on receptionists. This means patients get attention quicker based on clinical need, and reception staff are freed up to do other things. We're also looking at speech recognition and language translation to improve accessibility for patients that may struggle typing.”
How have the team taken to using PATCHS?
“The feedback from GP practice staff has been excellent with comments such as “it just saves a lot of phone calls to the practice…It’s taken a lot of pressure off reception” and “it frees your time up to do other things as well, keep on top of your other work, which is good”. Our patients love it too, and have rated PATCHS 4.4/5.0 from over 15,000 reviews. Typical comments we get daily include “find it easy to use, quick and saves time waiting to see a doctor” and “a really great system. Even possible to navigate well on a smart phone. Has to be the future of seeking medical assistance.”. They particularly like being able to contact the practice without waiting on the phone, checking the progress of their request, and being able to send the practice documents or images in a few clicks. “
Finally, with so many solutions in the market, was there any other factors that led you to adopting PATCHS?
“We're also assured because PATCHS is backed by Advanced, one of the largest healthcare software companies in the UK, who has the size and financial stability to support it long term. There are so many online consultation providers out there it's difficult to know which ones will still be around in a few years’ time. Many practices will be familiar with Advanced because it supplies Docman, which PATCHS integrates with. Dealing with one company for tech support is so much easier, and can simplify things when CCGs purchase IT solutions too.”
PATCHS is free to Docman 10 customers until 31 March 2021 and is available on the GP IT Futures Catalogue. If you want to find out more about PATCHS email firstname.lastname@example.org.