eConsult - web based triage for General Practice
Posted on 23rd August, 2016
eConsult is a decision support tool designed by GPs for GPs to top-slice some patients demand away from the consult room into self-help and alternative healthcare environments whilst also providing the opportunity for a significantly more efficient clinician, patients interaction if required.
Patients access the service through the trusted practice website via an imbedded web banner. This will allow patients the opportunity to:
- Utilise a range of self-help content that has been developed by ourselves and by working with a number of syndication partners, including NHS Choices and NHS Inform. This includes videos on self-help. Further to this, patients are provided the opportunity to have this content emailed to them for reference.
- Utilise bespoke sign-posting options. This is defaulted to a local pharmacy finder (again provided by one of our regional syndication partners, e.g. NHS Choices, NHS Wales Informatics Service) with guidance provided on over the counter medication available for each condition and regional triage service (NHS 111 or NHS Direct Wales). Additionally, we can imbed additional condition-specific local or national services. This works particularly well for services that allow online self-referral (eg. Local CBT services).
- Submit an eConsult to the practice with a promise of a GP review and a response by the end of the next working day. The submitted eConsult creates a highly specialised risk report for the GP to review asynchronously. This asynchronous nature of the doctor patient interaction is a key element in the efficiency gains from using eConsult. Again, the patient has the opportunity to have their eConsult emailed to them for reference. The patient is able to submit three different types of eConsult:o Condition specific: We have developed 100 condition specific questionnaires for patients to complete. These conditions were selected as they are some of the most common that present within general practice. These highly focused templates are designed to extract detailed information related to their specific condition/symptoms so to aid a complete remote treatment episode.o Generic: This is designed to appeal to patients that are unsure of their specific condition or are suffering from a condition that does not fall within the condition specific template. This template allows a patient to remotely consult for any condition.o Administration: These templates have been designed to allow patients and practices to manage routine administration requests (eg. Immunisation certificates, fit note extension etc) in a completely remote process and thus removing the need for a face-to-face clinical intervention.o Each of the questionnaire sets has the opportunity to capture QOF data, they are imbedded with red flag functionality to intercept and re-direct patients that present with clinically urgent symptoms. Patients provide answers in the format of free-text, yes/no responses, confidence scoring, via photo uploads and via imbedded PHQ-9 and GAD-7 questionnaires (for mental health conditions).
The service is currently live in 285 practice around the UK providing over 2.5 million patients with access.
Visit our website (www.webgp.com) for more information and to access the demo site.
- On average an eConsult risk report takes a clinician 2.9 minutes to review
- A third of all patient who use the service interact with self-help and sign-posting content. 18% of these patient do not require a GP appointment after this interaction
- Patient satisfaction and recommendation rates are both well above 85%
- Socially stigmatised conditions present in significantly higher numbers (e.g sexual health, rectal bleeding, mental health conditions)
- 60% of all eConsults can be managed remotely (40% via the issuing of a prescription, 20% via a telephone follow up)
- Clinicians using the service will see no change in level of indemnity or increase in premiums from their insurer
- "Red flags" are imbedded into all condition templates to intercept patients that present with clinically urgent symptoms (a feature unique to eConsult)
- Face-to-face and telephone appointments become more efficient as the clinician has the patient history upfront
- eConsults count as appointments offered under most GP contracts
- An eConsult typically takes the patient 5-10 minutes to complete
- 90% of risk reports are no more than two sides of A4 in length
- During our pilot study 100% of GPs found the risk reports easy to follow and considered them as comprehensive history gathering questionnaires