Transforming General Practice Online access for patients = efficiency for GPs Harry

Demand by time of day, painful. Rydal GP, charts by PA Navigator

Remote Asynchronous Which mode? Synchronous Local ££££ £ ££

Remote Asynchronous Remote Synchronous Local Asynchronous Local Synchronous Triage to appropriate mode

Mrs Brindle is at home, with a sore knee, describing the problem to seek help from her GP

Dr Hannan receives the history instantly, decides to call.

Mrs Brindle takes the call from Dr Hannan: reassurance and a prescription to pick up. Takes 2 minutes

Exploring symptoms to give a structured report Example, “chest infection”

The patient reviews the history & sends. GP can now make fully informed decision.

80,000 questions…

Traditional model, see all patients 36 x 10 min = 360 min 36 calls Total 360 min

Telephone all patients 15 x min Total 330 min, saving 30 min 36 x 5 min 180 min 36 x 5 min 180 min 36 calls

All patients access online 11 x 10 min 36 x 1 min 7pts 11 x 5 min 36 submissions Total 210 min, saving 150 min

Demand turns out to be stable, predictable and manageable, GP telephone led Rydal Group practice

Average wait time to see a GP falls off a cliff Bourne Galletly MP, charts by PA Navigator

The limit of performance in a telephone led system? Rydal GP, charts by PA Navigator 14 minute median response time is stable. Little benefit in improvement

Demand shifting from phone to online over 30% in two months. 2/3 medical, 1/3 other Phone message changed Website live New phone message by GP

Replacement, not additional demand. Face to faces have dropped 15% Website live New phone message by GP

All ages are using it, 0 to 94 years old. 60/40 female/male split is usual GP demand

Most users are patients, but parents and carers are important too.

An idea of clinical conditions: very varied, long tail distribution. 83% are symptoms.

20% by type are 50% by volume. Top 10: Skin condition Chest/throat infection Cough Ear/nose/throat Back pain Digestion Abdominal pain Rash Anxiety Headache

Patients are happy to spend their own time giving their history, most between 2 and 12 minutes.

Some feedback left online… This seems like a good way not having to explain your private symptoms to the receptionist. I like this; I don't have a lot of time to wait on the phone so would prefer to deal online. I can see myself using this all the time now. Used because of difficulty contacting practice while I am at work. It is not always convenient to discuss personal issues. been excellent so far! I used this system because of the delay in a telephone call to the surgery taking a long time to answer. I felt as if it asked a lot of questions, some didn't appear to me as a lay person to be relevant

While 79% present one problem, 21% with more than one is significant.

Most users want help from any GP, just 22% ask for a named GP

Ease of use All demand Rapid service

"Listen to your patient, he is telling you the diagnosis" William Osler on a screen

Independent Research Cambridge/ RAND Europe GP-patient relationship

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