Patient Care Messaging Pilot Project. Simon Jones Primary Care ICT Manager

Transcription

1 Patient Care Messaging Pilot Project Simon Jones Primary Care ICT Manager

2 PCT demographics 44 GP practices Registered population c. 220K Average DNA 5-10% 98% use EMIS as clinical information system

3 the problem It has been calculated that each appointment with a GP costs 18 Almost 17million GP appointments and nearly 5 ½ million practice nurse appointments are being wasted each year. If you have a mobile phone why not set the alarm beforehand Doctor Patient Partnership Keep it or Cancel it campaign

4 a solution? Automatic text messaging DNA cost the NHS an estimated 250m a year in England alone Many patients carry mobile phones A timely message could cut the rate of non-attendance Reminders are generated automatically through integration with the GP clinical system The system can carry manual messages and receive text responses from patients

5 Expected outcomes improved convenient service to patients (NHS Plan) running a more efficient practice (3-8% reduction expected) better practice quality Fit in with NPfIT (but not under it s scope) Besides appointment reminders other uses of Patient Care Messaging are: diabetes clinics new patient registrations flu jabs post natal clinics disengaged patients...

6 Types of Messages Appointment reminders Special messages Invitation to have a flu vaccination Don't Give results Any other confidential information regarding patients' health

7 Independent evaluation By UCL s CHIME dept. Comparable data Patient satisfaction User satisfaction

8 The project Project plan proposed and agreed between Islington PCT and iplato (6 month project) 1. Assessment, Planning and Statement of Work 2. Solution specification 3. Customisation 4. Integration and Testing 5. Launch and pilot support 6. Pilot evaluation 2 months 4 months

9 Changes to plan Project plan originally identified one GP practice as pilot site Increased to 3 GP practices for comparison reasons in evaluation i.e practice size, ethnical mix, locality Pilot period extended to 6 months from 4 (until March 05) Numbers of patients %-20% with mobile phones Pilot practices Registered population Population with mobile phone recorded

10 Confidentiality Project agreed with PCT Caldicott Guardian Issues of patient consent Implied consent v explicit consent Lesson learnt

11 Informing patients Sent to patients with mobile phone Made available in GP practices With the new Patient Care Messaging service your GP surgery will be able to get in touch with you by sending text messages to your mobile phone. Patient leaflets For more information pick up a leaflet available at your surgery reception. A1 posters

12 Raising awareness locally

13 Training Training materials produced by iplato Training given on-site shortly before go-live date On-going support given to PCT administrator

14 Further considerations Impact for non English speakers? Translation of public leaflets? How will the pilot/ongoing developments impact on: Deaf and deafened populations (205 profoundly deaf but 1:7 with a hearing problem) Visually impaired people People with learning difficulties (713 across borough) People with mental health problems Women particularly those under threat from domestic violence Carers? Confidentiality issues e.g teenagers going for contraceptive advice Consultation with above via local groups

15 PCM Pilot start September 1 st 2004 duration 7 months sites 2 GP Practices (originally 3) patients 3,250 (on 14,909 registered patients) messages8,487 sent objectives reduce DNA level by 3-8% improve communication w. patients costs 8,400 for integration and proj.mngt. 3,000 for 50,000 text messages

16 Results City Road Medical Centre % Date REG PTS APPTS DNA'S DNA ratio SMS sent Sep % Oct % Nov % Dec % Jan % Feb % Mar % Apr % May % Jun % Jul % Aug % 90 Sep % 277 Oct % 419 Nov % 378 Dec % 297 Jan % 3296 Feb % 466 Mar % 435 Total /09/ /10 / /11/ /12/ /01 / /02/ /03/ /04 / /05 / /06/ /07 / /08 / /09/ /10/ /11 /2 31/12/ /01/ /02 / /03/ % 8.00% 7.00% 6.00% 5.00% 4.00% 3.00% 2.00% 1.00% 0.00% APPTS DNA'S DNA ratio DNA trend line

17 Summary Results City Road Medical Centre patients messages 1,556 (29% of registered patients) 5,648 sent (incl. ± 3,000 smoking cess.) 68 received (1% response rate) DNA s pre-pilot avg. 20 per week pilot avg. 16 per week level 7.07% > 5.25% result DNA reduction of 26% level reduction of 1.82% (or 6.29%) est. annual savings of 9,483 sm. cess. resp. rate % 9 patients opted out 55% joined progr. as a result of msg.

18 Results Goodinge Health Centre Date REG PTS APPTS DNA'S DNA ratio SMS sent % Sep % Oct % Nov % % Dec % Jan % % Feb % 6.00% Mar % 2500 Apr % May % Jun % Jul % Aug % Sep % % 4.00% 3.00% APPTS DNA'S DNA ratio DNA trend line Oct % 523 Nov % % Dec % 362 Jan % 411 Feb % 451 Mar % 439 Total 2829 Sep 2003 Oct 2003 Nov 2003 Dec 2003 Jan 2004 Feb 2004 Mar 2004 Apr 2004 May 2004 Jun Jul 2004 Aug 2004 Sep 2004 Oct 2004 Nov 2004 Dec 2004 Jan 2005 Feb 2005 Mar % 0.00%

19 Summary Results Goodinge Health Centre patients 1,694 (18% of registered patients) messages2,829 sent 97 received (3% response rate) DNA s pre-pilot avg. 49 per week pilot avg. 30 per week level 5.88% > 3.61% result DNA reduction of 39% level reduction of 2.27% (or 12.78%) est. annual savings of 20,991

20 In Summary - Islington PCT DNA rate reduced by avg. 32% DNA level reduced by 9.5% (for PCM users) Potential net annual savings 471,158 Improved patient communication avg. patient response rate of 2% service penetration of 24% (35% is realistic goal) only 0.6% opted out of the service (21 patients) Large untapped potential other practices other communications

21 Enhancements.we d like to see! Stronger links with clincal system using NHS standards (EMIS API) Satisfy DPA/Caldicott requirements Multi-language support Improved on-line reporting of PCM usage

22 Conclusion summary And Questions?