Online services, consultations and digital triage have become a regular part of GP practices since their introduction as part of the NHS’s 2016 GP Forward View.
Eight years later and there are a lot of different providers and types of online consultation tools in the market, but knowing which one is right for your practice and patients can be difficult.
Increasingly, services are also being bundled together as part of tenders and commissioning. You’re now not just looking for an online consultation supplier, but one that provides video consultations and messaging functionality among other things.
We also know that some CCGs and Health Boards are giving practices a digital budget to pick and choose the different functionality and services from.
Things are starting to get confusing…
It’s not about the number of features, it’s about which features are right
It’s easy to look at the packages in front of you and pick the one that offers the most things. However, how you use your online consultation package, and therefore which one you pick, should be dictated by the value of the information you get from your patients, and how it safeguards them. You want a solution that saves you time and provides you with rich information, safely.
There’s more clinical risk in an online consultation than in a text message. Providers are moving away from specialising in one area to bundling up functionality. By bundling you run the risk of ‘levelling out’ and getting a basic product in some areas when really you want the best in all areas. Just because a provider’s messaging or clinical integration works well, does not mean their patient history collection will work as well.
With that in mind, we’ve broken down what we think is important to look out for when thinking about your next online consultation supplier, and a few handy tips.
- Tip 1: Check what digital solution is being procured and what for.
- Tip 2: Consider ease of use for patients vs risk of overuse.
- Tip 3: Think about the detail and structure of the information your patients will provide.
- Conclusion: What next?
Tip 1: Check what digital solution is being procured and what for.
Are you procuring an online consultation platform, the tools to manage online consultations or both? Do you want one system that does everything, or are you happy using multiple products if they work well together? Check what is included in your package. Sending SMS costs money, someone will be paying for it.
The collection method impacts the information you’ll get from your patient.
We tend to broadly break down online consultations into three main types:
- Mixed, which uses a mix of free-text and intelligent, logic-based multiple-choice questions
- Free-text input, which asks the patient a simple question and then gives the patient room to answer.
- AI-based, which uses machine learning to suggest, or decide, on a diagnosis or next steps for the patient.
There are benefits to each method, but at eConsult we believe that only a mixed model is able to capture all the information required to ensure both clinical safety and time saved for the clinician each and every time.
That’s because you need the structure of questions to be able to competently risk-stratify your patient, but you also want the free text for patients to be able to explain and add detail about their symptoms or concerns in their own words.
Tip 2: Consider ease of use for patients vs risk of overuse.
Practices often have concerns about online consultations ‘opening the floodgates. You need to make a balanced consideration between several things:
- How easy it is for patients to provide the information you need with minimal follow up (for additional information)?
- How detailed is that information for helping you triage quickly (more on that below!)?
- How likely is it that patients will inappropriately use a service that is both easy to use and that doesn’t provide you with all the information you need?
Speak to your patients
and explain why they are being asked more questions, or using a different method. Online consultation is not the equivalent to booking an appointment, but patients may not know this straight away.
Collecting the right information each time to help you triage
To make an accurate triage decision the practice needs the right information. This needs to include detail about their symptoms and also rule out any more worrying symptoms that a patient might not have considered.
Most online consultation providers have a standard emergency screener at the beginning of each online consultation. This is to catch known symptoms of a heart attack or now COVID symptoms for example and direct the patient to emergency care. However, it is at the patient’s own risk if they declare that they’re not suffering from emergency symptoms, and many providers don’t SafetyNet or risk-stratify beyond this point.
Additional structured questions are critical to identifying any urgent patients beyond the initial screener and for directing them to more urgent care. Patients might not understand the relevance or relationship between different symptoms in the same way that clinicians do. That’s why responsive, follow-on questions are critical to catching urgent symptoms and redirecting patients to more appropriate care.
You want assurance that patient submissions that reach your practice are not about critical symptoms and that they are patients that you can safely manage within your collective scope of practice. That said, you still need to be able to quickly identify and triage the many incoming patient requests that you’ll have online. That’s why additional risk stratification from structured questions is important.
Only an online consultation collects information from the patient independently in their own time, meaning that’s not time someone in your practice is spending on the telephone. It’s also likely to be faster for patients than waiting in a telephone queue, even if it takes them several minutes to provide this thorough information online.
Asking structured questions upfront means there is a higher chance that a triage decision can be made without having to contact the patient for more information. This means time saved for the clinician and a quicker time to treatment for the patient.
Tip 3: Think about the detail and structure of the information your patients will provide.
Does your system collect all the information you need on the first patient interaction? Ensuring your practice is trained to read online consultations is key. Being able to quickly review key points of information is essential.
If you are working at scale with other practices (an eHub), this extra level of detail is vital. We have already set up 10 across the country. Get in touch to find out more about eHubs.
Every practice is different. Choosing an online consultation platform that can be customised to your practice needs is essential.
eConsult allows you to customise the following features:
- Patient access hours, allowing you to manage demand and set your own operational hours for platform availability
- Local services, allowing you to add in your local services for certain conditions
- Response templates, allowing you to edit the quick responses to patients
- Proxy access, changing if carers can consult for patients they care for
What to look for?
Does your online consultation platform allow you to customise the product to fit your needs?
Starting out with an online consultation platform can be challenging. It is a change in process that requires thinking. Once implemented and running well the benefits can be huge, but getting this right needs planning.
How long has your online consultation provider been onboarding practices? Experience in this relatively new market is hard to come by so choosing a company with expertise can make a big difference.
eConsult has been around since the start, we have over 6 years of experience in online consultation and have onboarded over 3500 GP practices across the UK. We have a dedicated transformation team, a wealth of training, and a 7 day/ week support team.
What to look out for?
Does the online consultation provider have experience? Do they have a structured onboarding process, including training? Is there additional transformation support?
The benefits of digital triage and online consultation can be huge, ranging from improved safety to more efficient triage, better patient demand management and overall better patient care. However, choosing the right online consultation platform for your practice, geography, or patient demographic will make a huge difference between beneficial and something which adds work to the practice.
Understand the needs of your practice, and what you need the digital triage platform to do. We know there is a lot to think about, which is why our team is here to help you understand if eConsult is the right platform for you.