Marie Loizides, Associate Director of Performance Analytics at Barking, Havering, and Redbridge University Hospitals NHS Trust, explains how the digital transformation of MSK referrals helped GPs & hospitals work smarter to cut patient waiting times
As the elective care backlog surpasses the seven million mark, it is clear a multi-pronged approach to tackle long patient waiting times is needed. National strategies from reducing no-shows to eliminating waits of over 78 weeks to zero by April, have been introduced to help tackle the long wait times for care. Much can be done on a local level too.
For many of our patients, the chronic pain and fatigue caused by arthritis or other musculoskeletal (MSK) conditions can make everyday tasks, like cooking, a struggle.
Due to organisational boundaries and historical funding issues, some patients were facing long waits to access physiotherapy services. It was our goal to shorten the time between referrals to treatment by reducing incorrect referrals.
We set out to speed up MSK referrals by ensuring patients had access to the right service or consultant the first time.
Our road to digitalisation in patient care
Before digitising the MSK referral process, GPs had to fill in a Word-based document to make the referral and ensure key information like blood test results or CT scans were attached. But the process was failing.
As many as 3,000 referrals were being rejected each year because they were missing key clinical information.
This caused a delay in the system because if a referral is missing vital information, like MRI results, it can’t be processed quickly – leading to excessive patient waiting times. This also increases the risk the patient will be referred to the wrong clinic or for the wrong treatment.
Bringing clinical decision-making into the GP surgery was integral to improving the referral process and ensuring patients attended a consultation at the right clinic the first time. We developed a clinical algorithm with the help of NEC Rego to make this vision a reality.
As collaboration underpins any successful digital transformation consultation was a crucial and integral part of the process. We consulted with a wide range of practitioners and experts in patient care, including GPs, hospital clinician consultants and physiotherapists, to set different clinical treatment pathways. We then developed and refined the AI algorithm to ensure the agreed right treatment pathway is in place for each condition we treat.
Shifting from a paper-based system to a digital one would enable electronic patient data to be securely shared between primary and secondary care, making it easier and quicker for GPs to make accurate referrals and reduce patient waiting times.
Making it easier for GPs to refer patients
It’s been four months since we went live with the new digitalised MSK referral process. Although we didn’t mandate switching to the digital process at first, almost 80% of GP practices adopted it from the beginning. Previously, using the paper-based system, they would pass referrals to the practice administrative team to laboriously complete and include all the relevant documentation. What’s happening now is GPs fill out the referral with auto-loaded clinical attachments in less than 90 seconds during the consultation.
This time saving equates to 3.5 minutes for every patient referred for treatment which, when added up over a year, could save up to 3,000 GP hours in our area. This is the equivalent of putting another GP into the health service.
Speeding up the delivery of patient care
Automating triage has freed up GPs and consultants’ time and allowed everyone to work smarter and more effectively to reduce patient waiting times.
When a patient speaks to their GP about arthritis or another MSK condition, the doctor can view all their medical data alongside any prior input from the hospital team, giving them the complete picture. This means they can make a more informed decision about which treatment option is most appropriate for their patient when prompted by the questions posed by the digital tool.
This prevents patients from being given appointments at the wrong clinic, as the hospital triage team has already assessed which service is most appropriate before the appointment is scheduled. Accurate referrals have increased by 70% as a result, and there is greater consistency of care for the patient.
Should further diagnostic tests be needed before a consultation with a specialist, the referral tool will prompt the GP to complete this stage. This helps to cut delays and speed up care for the patient.
The technology works as it is a clear pathway for clinicians to follow, making it easier for GPs and hospitals to manage referrals into secondary care.
Reducing elective care patient waiting times
Incorrect referrals impact patients’ mental and physical health and reduce the opportunity for the NHS Trusts to tackle elective care backlogs. Digitalising our MSK referral process has improved patient care, reduced waiting times and signals a new and effective approach to better referral management.
